Pharmacy cuts - A message from the IPU

Following strenuous communication with the Minister for Health and his office, the IPU has secured a meeting with the Minister for Health on Thursday 5 December regarding the proposed cuts to pharmacy funding. At the meeting, we will be demanding that the Minister row back on the unreasonable, unfair and unjustifiable cuts and instead immediately keep his previous clear commitments to start negotiations on a new pharmacy contract and investment in pharmacy services.

To date, the IPU has been extremely active in canvassing support from political representatives and has met with opposition spokespeople for Health. We have also been actively targeting Government politicians including Cabinet Ministers, TDs and Senators and have provided support to individual members who have made contact with them.

The IPU is strongly encouraging all pharmacists to make contact with their local public representatives, especially from Government parties, to highlight their concern at the betrayal of previous clear commitments and ask them to raise the issue with their parliamentary parties. Many pharmacists have already been in touch with TDs and the feedback from Leinster House is that this is starting to make an impact. To amplify the campaign, we ask that each pharmacist get at least five other pharmacists in your locality to do likewise, which they can do by either picking up the phone to their local representatives or by sending them an email.

Background:

Unreasonable, unfair and unjustifiable cuts to the community pharmacy sector are being proposed by Minister for Health – Stop Cuts Now!

In October, the Department of Health initiated a consultation process under the Public Pay Act with the IPU. Following an initial meeting, the Department wrote to the IPU on 25 October outlining the following proposed structural changes to pharmacy fees, which would apply from 01 January 2020.

These proposed changes are:

Replace current phased dispensing fee per item for each phase other than the first dispensing with a monthly patient care fee of €45.00
Reduce the number of items paid at €5.00 from 1,667 to 1,000 per month.
Abolish the High Tech patient care fee of €31.02 payable in the months in which no dispensing takes place.

Cuts Not Fair or Reasonable

Cuts will hit pharmacies serving rural, isolated and disadvantaged communities hardest

These cuts will impact disproportionately on pharmacies which dispense lower than average numbers of prescriptions, which will irrevocably damage the pharmacies serving rural, isolated or disadvantaged communities.

The proposed change to the fee bands is markedly regressive, having the greatest impact on pharmacies dispensing 2,500-3,000 items per month – it would result in a crippling reduction in dispensing fee income of up to 9%.

These pharmacies cannot survive any further cut in their incomes, never mind one of this magnitude: with average margins as low as 4% this cut will put their survival in jeopardy.

Broken Government promises

As of 1 January 2020, the rates imposed under FEMPI no longer apply: Minister for Health repeatedly led the IPU to believe that FEMPI would then be unwound.

The Minister is reneging on previous commitments without any explanation, reason or justification.

At IPU National Pharmacy Conference in May 2019, Minister Harris committed to starting discussions on a new pharmacy contract, on moving beyond FEMPI to a ‘higher terrain’ and on a program of investment in pharmacy services. This commitment is being betrayed.

Cuts make a mockery of Sláintecare

The Sláintecare Action Plan for 2019 sets out the first steps in a ten-year plan to deliver health and social care services with the intent that the focus is on providing the right care, in the right place, at the right time in a way that is efficient, effective and sustainable, namely in the community

The Government has committed to a decisive shift towards primary care, but there are simply not enough GPs to deliver this: The government must, therefore, utilise the network of 1,870 Irish community pharmacies.

A modest investment in pharmacy-based services would free up crucial capacity in GP surgeries and achieve cost-efficient treatment across the continuum of care.

Further cuts to the pharmacy are not reasonable or rational; don’t tie in with Sláintecare; will affect rural, isolated and disadvantaged communities more; and are totally at odds with Government commitments

Why are these brutal and unjustifiable cuts being proposed? Stop the cuts and start talks now!

Many pharmacists have already been in touch with TDs and the feedback from Leinster House is that this is starting to make an impact.

To amplify the campaign, we ask that each pharmacist get at least five other pharmacists in your locality to do likewise, which they can do by either picking up the phone to their local representatives or by sending them an email.

You can and download and view an up to date list of TD's contact information here

The suggested text of such an email can be found below.

It is in all our interests that these cuts are stopped in their tracks.

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Re: New Pharmacy Contract / Unwinding FEMPI

Dear ,

I am writing to you on a matter of grave concern to me and to all community pharmacists. Compared with public servants and other contracted professions, we have been treated unfairly, inequitably and in bad faith regarding the failure to unwind FEMPI cuts to pharmacy fees. The situation is now being made considerably worse with unexpected and unjustifiable proposals to further cut pharmacy funding.

At the IPU National Pharmacy Conference in May this year, the Minister for Health publicly acknowledged the cuts to pharmacists’ incomes that had been imposed during the financial crisis and the resulting financial pain felt by pharmacists and stated the Government’s intention to unwind those cuts. He also committed to starting talks on a new pharmacy contract and new pharmacy services. “Let’s get that done this year,” he said.

Like all pharmacists, I took the Health Minister and the Government at their word and, as a result of the Minister’s commitment, looked forward to FEMPI being unwound with increased investment and expansion of healthcare services in pharmacy, which I know will deliver real benefits for patients and the public and will take pressure off the rest of the health system and in particular GP clinics. Following the announcement of increases in payments to GPs, community pharmacists are now the only profession to have had no fee restoration and, despite repeated commitments, continue to suffer from crippling austerity cuts that have been lifted from other sectors.

It was extremely alarming therefore to be informed that instead of an expected positive review of pharmacy fees and increased investment in pharmacy services, the opposite is planned, with significant cuts to pharmacy funding proposed to be introduced from 1 January.

The proposed cuts will have a negative long-term impact on the sustainability of community pharmacies throughout the country, including my own, and are nothing less than a betrayal of clear commitments that the Government has made publicly to the pharmacy profession

I am now requesting that you convince the Minister for Health to row back on these unfair and unjustifiable cuts and instead immediately start the repeatedly promised negotiations on a new pharmacy contract and investment in improved pharmacy services for the benefit of the public.

Yours sincerely,

_________________

Community Pharmacist

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