The Health (Community Pharmacy Contractor Agreement) Regulations, 1996, provide a system for regulating the granting of pharmacy contracts in accordance with public health criteria. The regulations specify the criteria and procedures under which the chief executive officer of a health board shall determine the issue of new community pharmacy contractor agreements for the provision of community pharmacy services under the Health Act, 1970. They regulate the granting of contracts with a view to (1) bringing Ireland into line with other EU/EEA states where such controls exist in one form or another, (2) improving standards in existing pharmacies and (3) promoting patient access to pharmacy services in rural areas. Because of the absence of any controls in regard to the granting of contracts, Ireland has been compelled to continue a derogation from the free movement of pharmacists directive.
The regulations came into force in tandem with the introduction of a new contract for the provision of community pharmacy services under the Health Act, 1970, which is pro-active in promoting a quality-driven service to the patient. I have no doubt that the service to patients has been enhanced as a result of the new contractor agreement, which imposes obligations that were not in place before. A central and innovative element of the contractor agreement is a clause providing for a review by the pharmacist of the medicine therapy of the patient including screening for any potential drug therapy problems, therapeutic duplication, drug-drug interactions, incorrect drug dosage or duration of drug treatment, drug allergy interactions and clinical abuse or misuse. The review also includes an examination of the rational and cost-effective use of the medicine prescribed, including the choice of medicines and the potential for wastage. The contractor agreement is designed to improve the quality of services by encouraging greater investment in the pharmacy and facilitating the involvement of a greater number of pharmacists in a given pharmacy.
Because of public health considerations, pharmacy services and the licensing and supply of pharmaceutical products is one of the most heavily regulated services in the world. I am satisfied that an unregulated system, in addition to being out of step with arrangements elsewhere in Europe, would lead to a diminution of the quality of professional community pharmacy services. I had a meeting recently with officials of the Irish Pharmaceutical Union, during which,inter alia, the current regulations were discussed. There was general agreement that the time was opportune to review the operation of the regulations to see if they had fully achieved the desired effects, and this will be undertaken as a matter of priority.
The appropriate balance to be struck between public safety considerations and the general desire to remove any unnecessary obstacles to competition will be considered in the context of the review.