Duncan Smith (Dublin Fingal, Labour)
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11. To ask the Minister for Health to provide an update on negotiations to increase fees for dispensing for pharmacists; and if he will make a statement on the matter. [39357/24]

Duncan Smith (Dublin Fingal, Labour)
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There are ongoing negotiations on fees for pharmacy dispensing. In the context of the budget and the recent announcement, I am seeking an update on those negotiations and where they are going.

Stephen Donnelly (Wicklow, Fianna Fail)
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I thank the Deputy for his ongoing advocacy and work in this area. The budget contained very good news for progress in this area. I have allocated full-year funding of €50 million for these negotiations. There would be €25 million available next year on an assumed commencement date of, let us say, July 2025. There is, however, full-year allocation of €50 million. The ask from the Irish Pharmacy Union, IPU, is a lot bigger than that, obviously. It will seek more money, as happens in negotiations but €50 million is a sizeable allocation in the context, for example, of the different ways and patient services that could be funded.

A clear process was in place in this regard. First, we needed to get recommendations on any laws that needed to be changed to enhance pharmacy practice. We received those recommendations and those laws are now in place. I thank the Deputy and others for their support in bringing that forward. We now have a legislative framework to allow pharmacists to extend prescriptions, for medicine substitution protocols and for common conditions. This will bring in a new era in the services pharmacists can provide locally. I have repeatedly said that our pharmacists are highly trained and skilled healthcare professionals who have been underutilised in Ireland for a long time. One pharmacist said to me recently that pharmacists have been waiting 20 years for this new phase. Step one was to get the recommendations, which we have received. Step two was to pass the relevant legislation, which we have done. Step three was to allocate money in the budget, which I did this week. If I asked my officials to negotiate with no money on the table, it would just be paying lip service. It would not be real. I wanted to ensure a real amount was on the table. That has happened this week.

Duncan Smith (Dublin Fingal, Labour)
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I agree with the Minister that pharmacists are all of those things. I am sure he will agree that they are also highly trusted in the community. The great potential of unlocking more community care that is in situ and close to where people live is an aim of both the Minister and me. The funding allocation is welcome but now the negotiation fee must be addressed. Before the financial emergency measures in the public interest, FEMPI, legislation was introduced, the dispensing fee was €6. It is €4.51 now. The IPU’s ask is in and around €6.50. A total of 10% of community pharmacies are operating at a loss, as I am sure the Minister knows. Up to one third of them are struggling. He has set the Government’s stall out and he has allocated money, but now it is about the delivery of these negotiations. There is great opportunity in this regard, as he will be aware. There is an appetite among pharmacists to deliver, which will, of course, relieve pressure on our GP services and all the rest. It is something the public want. Will the Minister be able to match, or get close to, the figure the IPU will seek for dispensing fees and other fees?

Stephen Donnelly (Wicklow, Fianna Fail)
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It would not be helpful to set out the State’s negotiating position. What I have said to the IPU and my officials is that everything is on the table. The Government has put €50 million on the table this week, which is a sizeable amount. Of course, the IPU will say it is not enough and will want more. It is a sizeable amount, however. Everything can be discussed in the round negotiations. The IPU can discuss the fees that are currently paid and anything else.

Irrespective of the negotiation on fees, which will happen as there is a process for that now, we have provided new opportunities for new revenue streams for pharmacists. It will be a market-based discussion as to how much pharmacists want to charge for a prescription extension for a private patient, for common conditions or to prescribe oral contraception. They exist in the private market. GPs charge different amounts and I am sure pharmacists will do likewise. There will be a discussion on the €50 million allocation. We have opened up new services which will create new revenue streams for pharmacists, at least for the private patients attached to them.

I have also committed to undertake a root-and-branch review of the bureaucracy and the red tape in order to cut the red tape to make it easier for pharmacists. This will reduce the operating costs and the hassle for the pharmacists as well

Duncan Smith (Dublin Fingal, Labour)
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A lot of the discussion among pharmacists concerns the volume of administration and paper-based work they must do. We had a debate last week – I brought this issue up in my budget discussions - about the move towards electronic health records and, more generally, towards an e-health model.

We need to see that in the pharmacy sector as well. Pharmacists operate in a private retail environment but I am talking about the public side of their model. We cannot just say they will always get a few bob from selling deodorants, packages, non-prescription medications and all the rest, because that is not necessarily a given. They are competing with others. I see very many over-the-counter medications in the aisle of the supermarket and I can look past look past a pharmacist's till at those same medications. Is it right that they are being sold in a supermarket and a pharmacist's at the same time? There are threats on the private retail side as well. We have a great opportunity to move forward positively because pharmacists can unlock care in the community that could ease pressure on GPs. That is where I am coming from in this area.

Stephen Donnelly (Wicklow, Fianna Fail)
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As the Deputy said, pharmacists are highly trusted and skilled. They did an incredible job during the Covid pandemic. There was resistance to expanding their scope and that is why it has not happened in a very long time. I do not subscribe to this thinking. Expansion will make a big difference to ordinary punters in the community in that they will not have to go to a GP with minor ailments, such as eye conditions and rashes. Rather, they will be able to get certain prescriptions from pharmacists and have them extended. This is obviously an opportunity for the public and also one for pharmacists in terms of new services. In this regard, I have said there is significant money on the table. There is also a good opportunity for general practice because what is being done will take some of the pressure and lower acuity work off GPs.

One of the things we have committed to doing as part of cutting the red tape is getting rid of the dot-matrix printers, which may have been invented sometime in the 1700s, fired with coal and powered with steam. Pharmacists will be very happy to see them leave their premises.