If you haven’t had a wage increase in 15 years, you’re in trouble. So, when you are a key lynchpin of the Government’s health strategy, you are in a serious head scratching state: does not compute. But, we are used to mixed messages. As is often the case, it took a crisis to show the value of community pharmacy to the people that they serve.

The last three years have been extremely difficult in community pharmacy. The arrival of COVID at the start of 2020 signalled an enormous change in both work practices and our patients’ perception of our value. It is easy to forget that in April 2020 most of us were in a state of constant anxiety. There were acute shortages of essential common medicines, including children’s painkillers. We were scrambling for stock. We had physically introduced barriers into the pharmacies to stop public access. Serving through a hatch, or over a social distanced barricade, in most cases we lived in constant uneasiness, worried about this virus that we still hadn’t characterised. Yet, we went to work. We did not start working from home. We served our communities, in person, to the best of our abilities. It is little wonder that community pharmacy has found itself as the most trusted profession in Ireland in the last few years.

As GP surgeries across the country closed their doors, ours remained open. We still have the legacy, where many medical practices have never quite recovered from the heightened level of pressure. In many parts of the country, it is extremely difficult to get a timely appointment with any doctor. Regardless of whether you are visiting as a public or private patient. In an era where there is already a shortage of General Practitioners, we are constantly meeting patients who tell us that they cannot find a doctor. One upshot is that we have seen a surge in online doctors, low-cost walk-in clinics, and other online services that often raise profound pressures and questions in every pharmacy with many transactions. It is completely understandable that the public will flock to what are seen to be easily accessible prescription generators, without fully realising the implications of a less than full-service GP practice. Another feature that has characterised our practice over the last three years is simply the increased complexity of the patient profile. The build-up of inaccessibility of services over that key period, has meant that patients are presenting later to hospitals, and are meeting multiple consultants with very little communication between them. We are frequently left as the honest broker between these professionals, where the GP cannot be contacted in a timely manner.

Within all this, the State pushes us as a solution. Go to your pharmacy instead of A&E. Go to your pharmacy to get a vaccine. Get our free contraception, your triage, your advice. We have heard these State sponsored messages constantly over the last few years. Yet, nobody seems to be connecting the dots. To provide these services, we need resources. We need money, staff, facilitation. We need a PCRS and PSI that enables us to function efficiently. We find ourselves in an extraordinary situation of looking for a reversal of cuts from almost 15 years go. The Ministers, the civil servants, the nurses, doctors all got their income restoration. This is not an academic exercise. Pharmacies, as well as the specific issues unique to the sector, are suffering the same pressures as every other business. We are seeing hours getting cut.

In my own town, half the pharmacies have reduced their Saturday hours substantially. Other places have completely lost weekend pharmacy services. This is a canary in the coalmine moment. The pressures have built to the extent that our service is beginning to creak. It is extraordinary that in my fourth decade of working in pharmacy, we still have a pharmacist manpower crisis. We trebled the number of pharmacists trained in the state. Yet, the new graduates are leaving the community sector in droves. Much of this is down to underinvestment, creating deeply frustrating, unacceptable working conditions. We had a golden period of a few years, where the State recognised our value, way back in the 1990s. They even agreed to finance the profession centrally, supporting major projects. From this was borne the claim printer. A mixed blessing, if ever there was one. Yet, we exist where the administrative burden of the antiquated procedures, that we are expected to follow, are so bizarre that people struggle to believe them. It is not simply increased income from the State that we need, it is infrastructural reform. We have a legacy of ad-hoc schemes, regulations, ministerial brainwaves and maladministration that is utterly unacceptable.

The PCRS pharmacy suite is anachronistic, counterintuitive in parts and utterly unsuited to modern pharmacy practice. We provide a valuable, essential service to the people of Ireland. Proper restoration of our remuneration is the very least we should expect.