HSE and Harney won the pharmacy battle
Here are the bones of the content of my health slot on yesterdays RTE Radio 1’s Drivetime programme:
When I walked into a pharmacy in a small town in West Cork on the 7th of August and they told me that they were fully dispensing despite their participation in the IPU action, I knew that Mary Harney and the HSE had won the battle and probably the war.
The ‘war’ was between the HSE/Dept of Health and pharmacies in the IPU over the reduction in fees paid under the community drugs scheme (I go into more detail on this in an earlier blog) to pharmacies.
It was a situation that has been going on for years whereby the government allowed fees paid to pharmacies under community drugs schemes to reach very high levels.
Last year, €1.7 billion, 16% of the overall €16 billion health budget was spent on community drugs schemes (free drugs to medical card holders and reimbursement once over €100 paid on drugs out of pocket for everyone else). Of this, just €1.1 billion was spent on drugs, the rest was on fees and distribution.
Government had tried unsuccessfully before to reduce these fees but were stopped by the high court (last years Hickey judgement). In February, emergency legislation (The Financial Emergency Measures in the Public Interest), allowed HSE to announce cuts to pharmacy fees by 24/34% (depending on who you believe) with effect of 1 July.
This introduced new, more streamlined and reduced fee payment system to pharmacies.
The pharmacies threatened and went on industrial action with effect from 1 August. About one third of pharmacies participated in the strike. Some closed, others were just not dispensing. It started on the August bank holiday weekend but really had faded out before the week was out.
In the case of the pharmacy that I visited (purely for personal reasons), the pharmacist told me that it was 25 miles to the nearest pharmacy and she just could not justify not dispensing to regular clients in need of drugs. Many of these were older people or people with long term disability or illness, many without any form of transport. By the Thursday they decided to dispense to everyone.
The HSE had put contingency plans in place (dispensing through community hospitals) which resulted in long waits and some confusion in dispensing, however the world did not fall in. Within 11 days the action was formally called off by the IPU.
According to the IPU, they recommended all pharmacies went back to work on basis of: patient safety concerns; the minister agreed to meet with them about future role of pharmacy; a review of fees would take place by the end of June 2010 (this in fact was already stipulated in the emergency legislation).
The new fee structure has been in place since 1 July remains. This will result in significant savings to the exchequer – €55 million this year and €133 million next year, according to the Dept of Health. The pharmacies have yet to meet the minister to have discussions about ‘future co-operation’, but certainly the DOH and HSE have won this battle and probably the war.
Given that McCarthy is recommending saving €370 million by revising contracts with GPs, opticians, pharmacists and dentists, the precedence has been set for significant downward reduction in fees paid to health professionals.