Graduate

A NOTE FROM THE EDITOR Jack Shanahan, MPSI
Something has got to give
March 2017 has already gone down in pharmacy history as
another painful inflexion point. A further series of blows
have hit community pharmacy and, by extension, the public.
None are
particularly
earth shattering
but all illustrate
the frequently
dysfunctional nature of
pharmacists’ relationship with
those that make decisions.
We started with the over-70s
medical card tax cut. While
it had been well-flagged that
this group would only pay
a maximum of €20, the first
we heard of the individual
tax being reduced was when
it was leaked to the press
as it went to cabinet. While
we all welcome the reduced
burden on the patients, we,
once again, face the familiar
frustration of a process that
does not allow for an orderly
implementation. Again, we
have been left scrambling to
patch our already numerously
patched dispensary systems.
And it went on. It is not
clear if it is desperation
or dysfunction that the
PCRS has chosen to do cuts
by stealth. The first that
most pharmacists heard of
the delisting, rather than
reference pricing, of most of
the PDE5 inhibitor drugs from
community drug schemes
was from the IPU or the press.
Since the introduction of
this drug class, the imposed
limits marked them out as a
reluctant cover. The headline
saving of a few million euro,
compared to the social cost,
is truly petty and unfair. And
then, to crown an already
difficult month, we learned
that we may not get paid
for legitimate dispensing of
the expensive, but popular,
Prolia injection. One issue is
becoming abundantly clear:
the growing list of restrictions,
via PCRS-mediated rules, is
growing extremely difficult
to manage. Our otherwise
excellent IT systems are
struggling to cope with
the frequently arbitrary
requirement for getting paid.
Something has got to give.
Lest anybody thinks that the
month receded uneventfully,
the closing date for pharmacist
nominations to the PSI council
have closed. When you read
this, we will know the names
of those that are willing to go
forward. As I write, bar one, I
have no idea of the names of
those that are standing. It is
a difficult job to do properly.
Like all committees, there are
two ways a council member
can approach membership.
One way is to read the
voluminous, frequently
tedious, work presented to
each member on an iPad
before the meetings. The
other way is to wing it, iPad
unopened save for a cursory
review of the headlines, and
take your direction from the
chair. While I am sure that
all council members fall into
the former category, I can say
with certainty that I have a
great opinion of those that
are vacating their seats this
year. It would be fair to say
that they have had an eventful
term on council. It would be
equally fair to say, regretfully,
that their experience has been
one that would not encourage
colleagues to “do the State
some service”. The last few
years have been extraordinary,
judging from the notes from
the public sessions of the PSI
council printed regularly in
this publication. While these
are by definition, filtered, they
still have given us a reasonably
clear insight into some of the
PSI’s activities. It is not a pretty
picture. There are exercises
that are breath taking for their
sheer extent of cynicism. It is
as if the staff of Yes Minister
wrote a series of scripts,
omitting the black humour.
n recent times, we have seen
the chilling effect of a state
losing all sense of democratic
normalcy. In Erdogan’s
Turkey, we have seen reports
of tens, if not hundreds of
thousands of ordinary people
persecuted by a paranoid
system. The concept of being
innocent before being proven
guilty seems to be gone, the
fearsome populism that sees
simplistic arguments used to
enforce a sense of paranoia.
This will culminate in a
referendum that, if passed, will
turn Turkey into an autocratic
dictatorship. All power will
flow from the top, unhindered
by the filtering of debate by
reasonable people. One thing is
certain, it will be the autocrat’s
way or no way. While such
a comparison may seem
excessive, it is not without
parallel.
The PSI has seen two reports
that have suggested that
democracy would be so much
better if there were no elected
pharmacists on council.
The last tome, mentioned
here before, went as far as
to suggest that elections
to council should be done
away with. The pharmacists
would be simply nominated
by the Minister for Health.
This is GUBU of the highest
order. It is also a perverse
tribute to the abilities of the
elected pharmacists. We
need independently minded
pharmacists on council. We
need people that can bring
some common pharmacy
sense, with an ability to
actually talk.
These elections are
important. Use your
vote wisely.
If you have any comments, queries or issues to raise, send
your “Letters to the Editor” by email to ipureview@ipu.ie.
IPUREVIEW APRIL 2017 7