It's time to make good on government commitments to pharmacists

Three years on from a bold pledge, Budget 2020 provides an opportunity

By Darragh O’Loughlin Irish Pharmacy Union

There were several commitments regarding pharmacy services in the 2016 Programme for Government which, if implemented, would have provided greater access to safe, timely care, closer to patients’ homes.

Among them was the promise that “within two years, we will expand the role of community pharmacists in managing the health of patients and medicine prescription” – a bold pledge that would have made a real difference to the primary care system.

However, three years later, we have had no progress, and we continue to drift further away from international best practice in terms of how we allow pharmacists to contribute to the health service.

At a time of major crisis in our own health service, the range of services Irish pharmacists can currently offer is in stark contrast to what is on offer in countries such as the UK, Canada and New Zealand.

While we look on in awe at what is happening in other countries, there is a commonality in the theme emerging right across the Irish health system: delays. Delays with appointments, which delays diagnoses and treatment and, more critically, the delivery of health solutions for the patient.

To exacerbate the situation further, any physician will tell you that early intervention is crucial so not only does this frustrate the operation of the health system, but also the patient’s experience of it and can worsen their health outcome.

This needs to be urgently dealt with, and community pharmacists are keen to play their part. 

Significant outreach

The IPU represents 95% of all pharmacists in Ireland and our members receive 78 million visits to their premises every year – or 17 visits per annum per man, woman and child in the State – and over half the population lives within one kilometre of their nearest pharmacy. 

This is a significant outreach that provides an unprecedented level of access to the general public.

Therefore, providing the pharmacy sector with an opportunity to significantly expand our scope to the benefit of patients, the public and the health system itself makes sense.  

Numerous detailed proposals have already been presented to Government.

These include a minor ailment scheme that would enable medical card patients to receive treatment for common illnesses such as hay fever, migraine or skin conditions free of charge and direct from their local pharmacy.

They also include a structured pharmacy led monitoring service for patients on newly prescribed medications for long term illnesses including chronic obstructive pulmonary disease (COPD) and type 2 diabetes. A pilot in Ireland has already shown this improves ‘optimal adherence’ to medications and could bring about longer term savings to the health system.

Our ambition for the delivery of primary care doesn’t stop there: we want to develop a Chronic Disease Management programme in partnership with GPs, roll out smoking cessation supports to medical card holders and provide contraception to women, without prescription and free of charge.

Since the 2016 Programme for Government we have seen further Government commitments for community pharmacists. The Sláintecare Action Plan 2019, published in March, reiterated initial commitments in the Programme for Government to involve pharmacists in developing more local services.

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However, specifying what these are and putting flesh on the bones of these commitments is now required for the pharmacy to evolve and deliver 21st century patient and, indeed, health system solutions.  

With public satisfaction ratings of over 90% for community pharmacists, there is nothing to fear and in fact our profession is ideally positioned to deliver on the Government’s Sláintecare healthcare strategy.

We have consistently put forward proposals that would help alleviate current primary healthcare deficits, offer significant savings and efficiencies to the health service.

While many of our proposals have been met with apathy, we continue to be enthusiastic about the additional contribution we could make.

Let’s do a little for a lot. It makes sense and Budget 2020 provides an opportunity for progress. 

The Government recognises this, we know this, and our patients want this. So, why the delay?

Darragh O’Loughlin is the secretary general of the Irish Pharmacy Union.

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