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Seanad Éireann debate -
Wednesday, 6 May 2009

Vol. 195 No. 5

Pharmacy Education.

I am grateful to the Cathaoirleach for selecting this matter. I welcome the Minister to the House, particularly since he seems to be in such a benevolent mood. I hope I will get an equally positive and satisfactory answer from him. Once again I am raising the matter of final year pharmacy students. I had to do this previously with a number of matters, including the enormous increase in the registration fee.

Now I am looking at the question of the pre-registration requirement on final-year pharmacy students that they take an additional year, of which six months must be undertaken in a hospital or community pharmacy. This is to provide practical, on-the-ground training and it is very necessary. However, since the passage in both Houses of the Oireachtas in the past couple of months of the Financial Emergency Measures in the Public Interest Act 2009, there has been an unintended consequence and this vulnerable group of students has been caught in a snare. Although they are required to become apprentices in a hospital or community pharmacy, the embargo on recruitment in the public service contained in that Bill means this has, apparently, ceased. That is plainly a nonsense and an unintended consequence.

The hospitals rely on these people. They are the foot soldiers. How are the hospital pharmacies to continue if this system is to be axed arbitrarily in a manner I do not believe had been foreseen? The moratorium was not intended to affect front-line positions such as those in hospitals but it has been left like that. I assume this insanity will be rectified but at the moment the students are, once again, left in total uncertainty. They are coming up to exam time and this is grossly unfair on people who are already in a situation of some anxiety.

For quite a long time all the major hospitals have been taking at least one pre-registration student for a year's training. New students were offered an opportunity for training when the old students leave after completing their training. There was a turnover system so it does not mean additional posts or expense. It is the continuation at no additional expense of the existing system, but this is being axed. The system ensured properly qualified, suitable Irish pharmacists were available for work in hospitals and pharmacies throughout the country. The one-year training is part of the course and it is mandatory to qualify as a pharmacist. It is, therefore, very important that we examine the impact of this moratorium.

Many students have been called for interviews and have even been told they were successful, but this is dependent on the Department and the HSE agreeing on this. Hospitals such as the Adelaide and Meath Hospital, Dublin, Incorporating the National Children's Hospital in Tallaght, St. James's Hospital, Sligo General Hospital and Galway University Hospital have had or arranged interviews and selected people only to be told the position is pending the agreement of the continuation of funding. This is unacceptable. These hospitals have pre-registration positions, but after November they will not have them. The hospitals will also suffer. As I have said, these pre-registration students make up the junior grades of the hospital pharmacy staff. How will the hospitals run without them? They are already under pressure.

It is not an additional expense. This November, the current crop will come to an end and the salary normally transfers to the new student. In many cases, the salaries were already taken into account in the budgeting forecasts so there is no real reason for this cut. However, the moratorium means that no hiring can be undertaken, not even of replacement staff. I believe, and I hope the Minister of State will agree, that these positions are required of students in order that they may become qualified as pharmacists. It is a mandatory situation upon which the hospitals depend for a certain level of staff. These positions should be designated as training places and safeguarded, year after year. They should be ring-fenced, as happens in the case of doctors and nurses.

If major teaching hospitals are not to take on these students the situation will be unthinkable. What would happen, for example, in St. Vincent's Hospital or the Mater Hospital, just around the corner from me? Ultimately, the situation effectively punishes students who got good leaving certificate or A level results and remained in Ireland to study pharmacy. If they had gone to the United Kingdom like many other students they would not have this problem because it does not exist there. The Irish pharmacy student is in danger of losing out not because he or she is lazy or not up to scratch but simply because there has not been forward planning.

The meeting between the Pharmaceutical Society, the Department of Health and Children and the Hospital Pharmacists Association was supposed to take place tomorrow but it has been postponed. This means that many students who are now approaching their exams may have to spend the entire summer not knowing whether they will get a job or should look for accommodation in Dublin, whether they can return home or must work all summer to support themselves. The reason is that the pre-registration training is a five-day week position.

I remind the Minister of State that these are the people who have already paid an enormously increased €1,500 registration fee. Do they not deserve to be treated as they have been in the past instead of being left in this catch-22 situation?

I happen to know the Minister of State, who is a decent midlands man, and I ask him to use that valiant old Fianna Fáil phrase I have heard so many times and have sometimes mocked, namely, "in fairness". In fairness, can the Minister of State not do something for these decent students? I await his reply with great interest.

"In fairness" has also been shelved as the new way forward. The Senator might notice that those words are no longer used.

I apologise that the Minister, Deputy Harney, cannot be present. I am taking the Adjournment matter in her name. Pharmacy graduates are obliged to complete one year of post-qualification training before they are eligible to become registered pharmacists. This is to fulfil the EU obligation that pharmacy education last a minimum of five years. In addition, at least six months of the pre-registration training must be in a clinical sitting, either in a community or hospital pharmacy. This course of study, supervised work experience and examination is organised by the Pharmaceutical Society of Ireland, PSI. To date, the majority of pre-registration pharmacy students have tended to undertake 12 months of pre-registration training in one establishment, for example, a community or hospital pharmacy. However, it is possible for students to undertake two six-month placements, one of which must be in a community or hospital pharmacy and the second in another establishment relevant to the practice of pharmacy, for example, the pharmaceutical industry, academia etc.

The PSI has informed the Minister for Health and Children, Deputy Harney, that it is preparing a contingency plan in case of a shortfall in the number of placements available this year. Notwithstanding the Government's decision to introduce a moratorium across the public service, certain posts in the health sector may be filled through exemptions in the employment control framework for front-line posts. The framework allows for a growth in the number of front-line posts within the overall approved employment ceiling of 111,800 work-time equivalents for the health sector.

Provision has been made within the employment control framework for the continuation of the normal arrangements in respect of the filling of clinical placements, rotations and training positions for health care professionals, including trainee pharmacists. The PSI has been in discussions with the HSE concerning the number of placements available in the hospital sector and to ascertain whether there is an opportunity to increase the throughput of students in this area.

The Minister welcomes the initiative of the PSI in developing a contingency plan that will endeavour to ensure all students are enabled to acquire a "qualification appropriate for practice" and thereby to obtain registration as pharmacists and practise their profession.

The PSI's plan will require the full support of the HSE, community pharmacies and the pharmaceutical industry, as well as tutor pharmacists across all sectors of practice, in the community, hospital, industry, academic and regulatory sectors, if it is to succeed. The Minister urges all concerned to support the PSI in this initiative.

I formally thank the Minister of State for his reply but, as he will no doubt understand, it is completely unsatisfactory even from an intellectual and logical point of view. I understand the Minister of State was merely reading it but his script acknowledged a particular situation with particular consequences and then offered a garbled generalised response which is not a solution. It depends on the Pharmaceutical Society of Ireland to do this, that or the other. That society has received €1,500 from students, an enormously inflated fee, but what is it doing?

These students are already qualified or fairly well so. They are senior sophomores in their final year who have slaved and done the work that is a required part of their course. Is the Minister of State seriously suggesting that it is the responsibility of the PSI rather than that of the Government and the HSE to ensure that these students are permitted to complete the course to which they are entitled? It beggars belief.

I made my point and, judging by his facial expression and occasional nods, the Minister of State appears to understand it. I know he is not the Minister principally involved, who is the Minister for Health and Children, Deputy Harney, a woman for whom I have considerable regard. I ask the Minister of State to transmit to her the necessity to be prepared to meet representatives of these students and to iron out this matter for once and for all. They cannot be left in limbo over the summer. It is just not human.

I can understand Senator Norris's frustration at a response that appears to defer the responsibility of Government to initiate and support the proposal. I reiterate this suggests the PSI plan will require the full support of the HSE and community pharmacies. It is not a matter of leaving the issue out and depending on the process to happen.

From the briefings I have had with the senior Minister, I can say it is her intention to meet those involved and be proactive in this area. I hope that will happen within a matter of days.

I thank the Minister of State. People who have completed all the requirements should be entitled not to be frustrated in this bizarre way. I know that neither the Minister of State nor the Minister, Deputy Harney, would wish that.

The Seanad adjourned at 8.50 p.m. until 10.30 a.m. on Thursday, 7 May 2009.
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