Pharmacy Bill, 1951—Second Stage.

Minister for Health (Dr. Ryan)

I move that this Bill be now read a Second Time. Under the present law relating to pharmacy, which dates back to 1875, provision is made for two classes of pharmaceutical practitioners, pharmaceutical chemists who are entitled to keep open for the sale of poisons and to dispense the prescriptions of medical practitioners, and registered druggists who may mix and sell poisons, but may not dispense such prescriptions. The grade of registered druggist was not provided for in the original Act but in an amending Act passed in 1890. The new grade was, apparently, created to ease the hardships caused in some parts of the country by the shortage at the time of pharmaceutical chemists. There is no such shortage at present and the continuation of the two grades is no longer necessary.

The Pharmaceutical Society of Ireland, the statutory body controlling the registration of both pharmaceutical chemists and registered druggists, wrote to me recently stating that they and the Registered Druggists' Association, an organisation representative of druggists, concurred that the perpetuation of the druggist grade was undesirable, and requested me to introduce legislation on the matter. This Bill, which provides for the eventual discontinuance of the druggist grade, was prepared after consultation with these bodies, and is based on an agreement reached between the two organisations.

Under the Bill, persons who are now registered druggists will, in accordance with regulations made by the Pharmaceutical Society with the consent of the Minister, be permitted to sit for an examination to qualify them as "dispensing chemists and druggists". This examination will be held at intervals during the next three years.

Those who qualify as dispensing chemists and druggists will be permitted to compound medical precriptions and, generally speaking, to carry on a pharmacy business in the same manner as a pharmaceutical chemist. Those registered druggists who either fail this examination, or do not sit for it, will be allowed to carry on as at present. Provision is included in the Bill for the protection of the title of "dispensing chemist and druggist", and generally for the application to the new class of practitioner of the provisions of the Pharmacy Acts.

It is provided that no apprentices may be taken by registered druggists after the date on which the Bill was introduced in the Dáil. Persons who before that date were serving their apprenticeship will be permitted to proceed to the examination to become registered druggists in the normal way. It is also part of the agreement reached between the Pharmaceutical Society and the Registered Druggists' Association that these apprentices will be permitted to transfer to become apprentices to pharmaceutical chemists without doing the usual preliminary examination for such apprenticeship. There is no need, however, to provide for this in the Bill as it can be arranged by an amendment of the regulations of the Pharmaceutical Society.

While those who are now registered druggists or who are training to become registered druggists will have all their rights preserved, there will, therefore, be no further additions to their number and, with the passage of time, there will be but one class of pharmaceutical practitioner, namely, the pharmaceutical chemist. This will, I think, be more satisfactory from the points of view of the society, its members, and the public. The Pharmaceutical Society are at present considering a scheme for the improvement of the training of pharmaceutical chemists whereby there will be better provision for theoretical instruction, and a series of graded examinations, on the lines of those held in connection with the acquisition of university qualifications, will replace the present single qualifying test. This scheme, in conjunction with the change to be effected by the present Bill, should raise considerably the future standard of those qualifying in pharmacy.

As this Bill is the outcome of an agreement between the parties mainly interested in its terms, and as all existing rights are being preserved, I recommend it with confidence to the Dáil for a Second Reading.

Mr. Dillon

I want to direct the Minister's attention to this fact, that he has secured agreement from all the interested elements in a very formidable vested interest. His colleague, the Minister for Industry and Commerce, is in the process of drafting legislation to deal with trade rings. There is no more ferocious trade ring in this country than the pharmaceutical chemists.

Now, nobody in this House will dissent from the proposition that a man who is to be authorised to dispense doctors' prescriptions, or to handle poisons, should require to be a person with adequate qualifications so as to ensure that he will not frustrate the physician's purpose by failing to compound his prescription correctly, or that he will not sell, without due precaution, dangerous substances to the public generally. But I think if the Minister reflects he will agree with me that fully 70 per cent. of the trade transacted by pharmaceutical chemists at the present time has nothing to do with dispensing prescriptions, nor with purveying poisons or dangerous substances to the public. What has actually happened is this: the pharmaceutical chemists, having established themselves within the charmed circle of the pharmaceutical association, entrance to which is controlled by an examination conducted by the association, the Pharmaceutical Society then, acting as a trade organisation, proceed to open negotiations with a number of wholesale purveyors of commodities like soap, cosmetics, patent medicines, toothpaste and a variety of other universally used articles, for the purpose of ensuring that these commodities will not be sold through any retail distributor who is not a member of the Pharmaceutical Association. Their method of enforcing that is to say: "If you distribute your commodities to anybody but a member of the Pharmaceutical Society, then no member of the Pharmaceutical Society will handle your commodities."

Now, I agree that common sense demands that the person who dispenses a doctor's prescription should be trained and trained under suitable supervision so as to ensure that he is competent faithfully to carry out the doctor's directions. If I want to buy a box of Singleton's eye ointment—as a matter of fact it is not one of the confined commodities but it is one of a very large number of commonly used domestic remedies—why should I have to go to a pharmaceutical chemist for it? I think the Minister will find out on inquiry that the distinguishing mark of all these commodities is that the retail profit margin is very very large, and the only reason why the retail profit margin can be kept at that level is because the retail distribution is confined to the Pharmaceutical Society. Now, there was this half-pharmacy and half-shopkeeper loophole in their enclave, that if you were not in a position to pass the entrance examination prescribed by the Pharmaceutical Society you could not become a pharmaceutical chemist's apprentice at all. There used to be access to a sort of a pharmaceutical chemist business through the Registered Druggists' Association which bore, I gathered, to the Pharmaceutical Society much the same relation as the apothecaries bore to the Medical Association.

We are now asked by the Pharmaceutical Society to close that loophole and we are assured by the Minister that the members of the Druggists' Association are agreed. Why would they not? Observe, the Pharmaceutical Society has provided in the agreement that if you are a druggist they will prescribe a nice simple examination that will make a pharmaceutical chemist out of you and anyone who is apprenticed to a druggist will be helped to get into the charmed circle. In fact no one's feelings are to be ruffled until this comfortable arrangement is given statutory effect. Then when everyone is safely inside the stockade, out with the bows and arrows and challenge the consuming public.

I have now to suggest to the Minister that this would be a suitable occasion to provide that, if the Pharmaceutical Society is to be convenienced by statutory approval of their monopoly, they would give the Oireachtas a corresponding undertaking that on the drugs they distribute there should be a fixed maximum percentage profit. I will exclude prescriptions from that if you like. I leave the pharmacist to sell his skill as a compounder at whatever value he himself sets upon it and the consuming public are prepared to pay for it. But apart from things which he himself compounds they should be ready to satisfy the Minister for Health that in respect of any particular commodity handled by them a maximum percentage profit is not exceeded. Remember, and I think it is worth remembering, that if you bring a doctor's prescription into any chemist's shop in Ireland and it has been compounded once already, the second chemist to whom you bring it will look at the back of the prescription at the first compounder's trade mark and will there see in secret figures the price charged by the first chemist for this mixture, so that there will be no wide discrepancy between the price charged by a relatively simple or honest pharmaceutical chemist and a more enterprising pharmaceutical chemist who sets a higher value on his compounding powers. The constituents of a bottle of medicine may cost a compounder 2d. The first compounder might value his skill at 2/4 and sell the bottle for 2/6, whereas the second compounder might value his skill higher and charge 5/-, but if you look at the back of the prescription you will see a series of hieroglyphics which will indicate that such a pharmaceutical chemist charged this fellow, say, 5/- for the prescription.

Now I do not pass judgment on that practice but I do say that a long suffering public which accepts such arrangements is entitled to say, when its Oireachtas is approached for statutory sanction of what it represents to be a professional monopoly exclusively for the protection of the health and wealth of the public lest they be poisoned by unskilled persons, that while we express our profound gratuity for this solicitude for our continued health, wealth and prosperity, we should reasonably suggest to the Pharmaceutical Society, without desiring to intrude into the secrets of their trade, that they should give us a general undertaking that, excluding mixtures compounded in their own establishments by themselves, they will bind themselves not to take more than an agreed maximum percentage of profit. I do ask the Minister, before this Bill is finally disposed of, to consider asking the high contracting parties to this alliance exclusively inspired by the public interest that they should show their disinterest by a further gesture to confirm their solicitude not only for the public health but for the public purse.

Dr. Maguire

I would like the Minister to clarify a couple of points that occurred to me from Deputy Dillon's remarks. I would like to know whether the old system, whereby a boy or a girl who served their apprenticeship down the country and then came to Dublin to complete their course and obtain work in Dublin at the same time, is going to be ended, or if this course, under the auspices or the aegis of the Pharmaceutical Society, will entail lectures during the day with resultant increase in expenditure on the part of the student or his parents. I would not like to think that the path to becoming a pharmaceutical chemist will be made any more difficult because it is generally recognised at the moment that in the last couple of years it is almost impossible to qualify as a pharmaceutical chemist.

I do not know whether it is a desire on the part of the society to keep just the select few. I certainly had a number of cases where untold hardship has accrued both to the students and the parents in this matter through difficulty in qualifying. Perhaps it is more desirable that standard lectures should be given rather than that these boys and girls should have to work during the day in chemists' shops and then have to attend lectures at night. Probably it would be better for their health in the long run and, perhaps, it would eventually result in their qualifying much easier than hitherto has been the experience.

I also wonder if an end will eventually be reached to the practice indulged in by a number of chemists of prescribing for patients themselves without having prescriptions from the patient's doctor. That has been the rather undesirable practice. I do know that the society do not look upon it with favour but, nevertheless, it goes on. Indeed, I have several mothers of children coming in to me who tell me: "The child is very ill. I went to the chemist a couple of days ago and got a number of M. and B's." Of course, the unfortunate mother had not the vaguest idea how to administer them. The same state of affairs exists, not only with pocket drugs, like slumber drugs, but also with proprietary preparations. I would like to know if the Minister could give me some idea as to whether there is any provision to be made in the Bill in connection with this matter, which is a bugbear, not so much for myself but for members of the profession generally.

Mr. P.A. Brady

I welcome this Bill and I want to compliment the Minister on introducing it so expeditiously. The Pharmaceutical Society was formed in 1875 to qualify people to compound prescriptions and to sell poisons. The Amendment Act of 1890 introduced two clauses providing for a special examination for people entitled to sell poisons only. With all due respect to what Deputy Dillon has just said, there are roughly 1,000 chemists carrying on a practice in this State. Looking back over the years, I maintain that these chemists have fulfilled their obligation to the public in the manner in which they have conducted the sale of poisons. They have acted, as it were, in the capacity of liaison between the doctor and the patient. Speaking from a statutory point of view, it is the duty of the Pharmaceutical Society to see that their students are properly educated and properly qualified to fulfil these duties.

As the Minister has said, the Bill which is before the House is an agreed measure. There are about 50 people practising as registered druggists in this country. The druggists and the members of the Pharmaceutical Society have been in consultation for some time. Realising their responsibilities and in order to keep abreast of modern trends, they agreed to give any of these druggists who so wished it the opportunity of passing a special examination, so that they could qualify as chemists and be enabled to dispense prescriptions and to sell poisons. Of course, the druggists who do not wish to pass this examination will remain as they are.

We all realise the changes that have taken place in recent years, and those that are taking place at present, in the methods of prescribing—the introduction of antibiotics, and so on. Therefore, we must step up our curriculum. With that in view, the Pharmaceutical Society are at present working on an educational programme which will entail the spending by students of a full academic year in the College of Pharmacy for the purpose of studying both scientific and professional subjects. Students will also have to spend a certain amount of time in a recognised pharmacy so as to get practical experience. This educational programme will be introduced for the purpose of facilitating the student so that he will be enabled to make a better preparation for his examination and thus be better prepared to undertake what suggest themselves to me as very onerous responsibilities.

I heard the former Taoiseach saying at a function recently that of all the bodies of people he had met, taking a broad view, the chemists of this country conducted their businesses more thoroughly than any other, and I agree with him fully, taking into consideration the very great importance and seriousness of their vocation. Every day of the week they are handling poisons and making up prescriptions and yet there are very few, if any, fatal mistakes made. As I said, they are the custodians of the poison laws of this country and are responsible to the State.

I will now touch on the subject of our examinations. A Government visitor is present at all the Pharmaceutical Society's examinations, and these examinations were not at any time competitive. I can give Dr. Maguire instances of girls aged 21 and 22 years who sat for the society's examinations, and who got the final qualifications without any difficulty whatsoever.

I welcome this Bill for this further reason: it was a great disadvantage to have a student, a quasi-student, working in a pharmacy during the day who had to attend lectures in the College of Pharmacy during the night. Naturally, he did not have the same facilities for studying as, possibly, a medical student or a law student who could devote his full time to it. That is why we rectified the position in our educational programme.

Mr. Dillon

The students had to spend only 12 months in Dublin attending the Pharmaceutical College.

Mr. P.A. Brady

Up to the present, the students have had to serve four years behind a counter in a chemist's shop. Under the new scheme they have got to serve three years in a chemist's shop and one year in the College of Pharmacy for the purpose of doing scientific and professional studies. This is a whole-time course——

Mr. Dillon

And they are not able to earn a penny.

Mr. P.A. Brady

——and it will give them an opportunity of studying. I will end on this note. I welcome the Bill, and I compliment the Minister on introducing it so expeditiously. I am satisfied that it will operate to the benefit of the student and to the benefit of the public.

Mr. Dillon

Would the Deputy favour us with his view on the possibility of the society giving us an undertaking not to exceed a certain margin of profit?

Dr. Ryan

The point raised by Deputy Dillon is, I think, not exactly relevant on this particular Bill. We are dealing here with the qualifications that are necessary for pharmaceutical chemists and for the Pharmaceutical Society in future. There is another society, I think, called the Irish Drug Association, which is a sort of trade body which may have engaged in the restrictive practices to which Deputy Dillon referred. However, I am not quite certain of that. I think this would be a matter for a Bill dealing with restrictive practices, should the Dáil wish to introduce it. The Minister for Industry and Commerce has promised to introduce a Bill after Christmas dealing with that particular point. I have no doubt that there would be powers in that Bill to deal with the abuses outlined by Deputy Dillon, if he is correct in his outlining of them.

As regards the point raised by Deputy Maguire, this Bill makes no change whatever in the course that will be prescribed for an assistant. Deputy Brady has told us what the Pharmaceutical Society intends to do, but what they have done does not come within this Bill. I presume that they would have done that whether this Bill was passed or not.

Mr. Dillon

Does not the Minister see that so long as the druggist loophole was open the pharmaceutical chemists could not tighten the noose?

Dr. Ryan

I admit there is the point that there was always, if you like, a loophole. The man who felt he could not pass the more difficult examinations set by the Pharmaceutical Society could become a druggist. I think, however, Deputy Brady is probably right in saying that for modern medicines, antibiotics and so on, it is necessary to have a higher standard of education for those dealing with medicines.

Mr. Dillon

Although antibiotics are exclusively prepared by the manufacturers?

Dr. Ryan

But the chemist may make a mistake which would be a desperate thing. If you give twice the correct dose of Glauber salts, you do not cause a lot of harm but if you give twice the dose of these vaccines you might do a lot of harm. That is why I say it is more important to have a higher standard for the newer drugs now dispensed by chemists. Deputy Maguire mentioned that some pharmaceutical chemists prescribe themselves. I agree that that is a reprehensible practice but I am not dealing with it in this Bill. It is a matter for the Pharmaceutical Society. The Pharmaceutical Society deals only with the standard of examinations, knowledge prescribed, professional conduct and so on. They do not deal with such things as prices, restrictive trade practices or matters of that kind. That would be a matter for the trading body, the Irish Drug Association.

Mr. Dillon

Which is composed of the same people.

Dr. Ryan

Perhaps.

Mr. Dillon

May I ask the Minister a question? He points out that this Bill does not give the Pharmaceutical Society any additional powers to prescribe the course students must follow but, as Deputy Brady has pointed out, the intention of the Pharmaceutical Society, once they have got the Bill, is to prescribe that a student must do three years' apprenticeship and one year's study whereas, heretofore, he could do one of his four years working as a fourth-year pharmaceutical student in a chemist's shop.

Mr. P.A. Brady

That did not happen in actual practice.

Mr. Dillon

I can assure the Deputy that some of my neighbours who came up here as fourth-year students did go into chemists' shops. It may be that one chemist would be more kindly than another and would allow the chap a little pocket money if he were satisfactory. It greatly helped the parents, sometimes relatively poor people, if their boy got so much pocket money because it is a heavy burden on country people to send their children up here to qualify.

An Ceann Comhairle

What has become of Deputy Dillon's question?

Mr. Dillon

Does the Minister realise—as Deputy Brady pointed out, they have not prescribed these new and more exacting conditions because there was always the loophole of the Druggists' Association—that so long as that loophole was there, the screw was not turned too tightly but close the loophole and, as the Minister says, there will be no control whatever. They can raise the standard so as to reduce the total number of pharmaceutical students. I put it to the Minister that we should ask some kind of guarantee or undertaking that the standard will have to be approved by him——

Dr. Ryan

I was going to say that.

Mr. Dillon

——so that we shall not give them a bigger power to reduce the number of students.

Dr. Ryan

The regulations must be approved by me and certainly if I thought they were taking advantage of it to put the standard too high——

Mr. Dillon

That is the difficulty.

Mr. P.A. Brady

Perhaps I might be allowed to clear up one point. The position is that instead of a student doing four years in a country shop, as he did before, he will, if we put through our programme, do only three years.

Mr. Dillon

He used to do the fourth year in Dublin.

Question put and agreed to.

An Ceann Comhairle

Committee Stage?

Dr. Ryan

I think it possible that I may have an amendment or two to propose. I would, therefore, ask that the Committee Stage be fixed for next Tuesday.

General Mulcahy

Would the Minister take into consideration, after everything that has been said in regard to the examination side, that in dealing with Section 3 of the Bill in Committee we might have a fairly detailed exposition of what the change in the educational system is going to involve for parents?

Dáil Éireann debate -
Wednesday, 5 Dec 1951