asked the Minister for Health if, in view of the hardship which will be caused to medical card holders by the recent agreement between the Irish Drug Association and the Hospital Pharmacists' Association, he will intervene in this dispute with a view to bringing about a speedy solution.
Private Notice Questions: - Pharmacists' Dispute.
asked the Minister for Health if he is aware that extreme hardship is being caused to medical card holders by the totally inadequate alternative arrangements for the supply of necessary medicines; and that there exists a real danger to life; and if he will intervene today before any tragedy occurs.
In the context of the questions the obligation placed by statute on health authorities is to make available to eligible Health Act patients drugs and medicines prescribed for them by their district medical officers. According to my information it is only in the Dublin area that the normal arrangements for doing this have ceased to operate; and in that area, the health authority have introduced an alternative scheme which should ensure that no eligible person will be left without the drugs and medicines prescribed for him. Admittedly the revised arrangements will involve a measure of inconvenience for the sick person or his relatives; but the essential point is that he can get them, and without undue delay.
Yesterday the Dublin Health Authority arranged that assistance officers would supply the holders of prescriptions with formal orders on retail chemists — the chemists to be recouped subsequently on presentation of their bills. The retail chemists have decided, however, that they will not hand out medicines to patients except on a cash-down basis. To counter this attitude the health authority are now arranging that patients who have the necessary cash may pay the chemist and then be reimbursed promptly on presentation of the receipted prescription; and that patients who lack ready money can have their prescriptions costed by the chemist whereupon they will be supplied with the necessary cash to pay for the medicines.
As the health authority, despite the disabilities imposed on them by, and arising out of, the dispute to which the Deputy refers, are providing a satisfactory, if slightly inconvenient, service, I do not feel that there is any need for me to intervene.
Is the Minister aware of the enormous delay in obtaining medicines during daylight hours? There is no system available in certain large housing estates whereby medicines can be obtained after normal business hours. Calls by doctors after normal business hours are usually of an emergency nature and emergency medicines are needed. The only alternative for dispensary doctors in these large housing estates will be to shift the patients to hospital.
In reply to the Deputy I have found my communications with the Dublin Health Authority to be reasonably adequate. The reply I gave the House is the very latest information I can secure, having talked with officers in my Department only ten minutes ago. Deputies should communicate with the Dublin Health Authority if the ambit of their information is insufficient or if there are areas where there is more than great inconvenience to patients but not any question of danger to life.
Does the Minister not consider it would be in the public interest for him to intervene in this dispute which dates back to December, 1969? The City and County Managers' Association have been adamant in not meeting the Pharmacists' Association. The present arrangement will cost the central authority more and it would be better if the Minister intervened, as he did in the case of the junior hospital doctors where again the City and County Managers' Association were recalcitrant. The Minister's intervention at that time solved the problem and I feel sure if the Minister intervened in this dispute now we would not have the danger of fatalities because people did not receive treatment in time. I respectfully ask the Minister to intervene in this particular case.
I disagree completely with what the Deputy has said. There is a total and absolute difference between the circumstances arising in this dispute and the circumstances that arose in connection with the junior hospital doctors where because they were classified as temporary officers it was not thought possible or desirable to establish some form of conciliation machinery, and the Deputy knows that very well. In this case there have been two arbitration awards and a further offer was made by the City and County Managers' Association to the pharmacists. There is no comparison whatever between the two disputes.
I am sure I have the whole House with me in what I am now going to say. As to the action of the retail pharmacists I must say their decision came as a great shock to me. I know many pharmacists personally and have met many others on various occasions. The clear impression I had was that they were a responsible and public-spirited body of people. I find it difficult to reconcile this view with what has been done by the retail pharmacists in the present instance which is to say to a group of sick, lower income patients, including the oldest and most infirm, "We will supply you with medicines if you come in and plank the money for them down on the counter. If you can produce only a guarantee from a reliable public body that they will pick up the bill we will not serve you." In my view the retail pharmacists are morally obliged, regardless of the dispute, to provide drugs to those who urgently need them or who might be in danger of death immediately or within a short period through their not getting these drugs.
Deputies
Hear, hear.
Regardless of the detrimental remarks which the Minister has made about the Pharmacists' Association, is he aware that arrangements made to date apply only to daylight hours? If an emergency occurs during the night is a patient expected to travel to the chemist's shop to find out the price of the medicine he requires, then go to the relieving officer or the assistance officer to get the money to buy the drugs and then go back to the chemist's shop to collect the medicine? Surely the Minister is aware of the hardship which exists in the Ballymun satellite town where there are two lockup private chemist's shops which close at 7 o'clock and there is nowhere else for people to get medicines after that time. There is no alternative but to put these patients into hospital.
We cannot discuss these questions all evening.
I have a few further observations to make to the House: first of all, a meeting of the City and County Managers' Association has been arranged for tomorrow to consider the dispute. The Minister for Health has in the past taken action at one point or another to resolve the dispute. If it will be of any help I am perfectly willing to bring the two parties together as in the case of some other dispute on the understanding that the pharmacists would go back to work pending further examination of their claim. I am perfectly willing to do that and I am waiting for this meeting to take place of the County and City Managers' Association to consider the dispute because I am not the employing authority. If the Minister for Health begins to interfere with the most elaborate machinery that has been created for this purpose it will serve no purpose. Secondly, in reply to Deputy Byrne, I shall immediately get in touch with my officials and ask them to inquire from Dublin Health Authority whether they consider the matter of which he speaks deserves immediate consideration with a view to a mitigation of the problem he mentioned.
Is the Minister aware of the fact that Mr. Lambe of the Dublin Health Authority sent a memorandum to the Pharmacists' Association and said that he had set up a working party to explore the situation and evaluate it anew; that they agreed to defer strike action pending this, that this was done but that the City and County Managers' Association did not even meet to consider this working party agreement?
As the Deputy knows, a very substantial increase was offered over and above what was offered by the arbitrator. There was an arbitration in favour of the pharmacists working in voluntary hospitals. They accepted that. Then there was an arbitration in connection with pharmacists who were employed by the Dublin Health Authority. They refused that. Then the City and County Managers' Association made an increased offer which, with the application of the 10 per cent 12th round, constitutes a very considerable increase on what was offered before. The County and City Managers' Association are meeting tomorrow and I dare say they will take into account what Deputy Dr. O'Connell has stated to me.