Vol. 527 No. 5
10 Mr. D'Arcy asked the Minister for Health and Children if he will consider a new and reinvigorated role for hospital pharmacists as recommended by the Hospital Pharmacists Association of Ireland, as a contribution to an improved secondary health service. [28947/00]
The document referred to by the Deputy was produced by the Hospital Pharmacists Association of Ireland in the context of pay talks under the Programme for Competitiveness and Work. These talks concluded in early 1998 with the issuing of an adjudication board report. The pay terms of this report were implemented by means of a circular from my Department in September 1998. The Hospital Pharmacists Association of Ireland has not approached my Department with a view to discussing a new role for hospital pharmacists since these talks concluded in 1998.
Other policy initiatives in relation to hospital pharmacists have since been put in place by my Department, including the establishment of a materials management forum, which aims to develop and agree proposals relating to the procurement process to ensure optimum value for money in this area.
In an attempt to rectify the difficulty in recruiting and retaining hospital pharmacists, revised pay structures were put in place, which resulted in an improvement in the salary level. It also allowed for entry to the salary scale from the sixth point upward for the basic grade hospital pharmacists. I intend to meet the Hospital Pharmacists Association in January and I would be more than happy to consider any proposals the association wishes to put before me.
Will the Minster agree that pharmacists in hospitals and in the community are a greatly under utilised resource? Will he agree that in excess of 50% of medicines are incorrectly taken by patients and that community pharmacists, in particular, could play a role in assisting people to redress this problem and that process of assisting people should start before patients leave hospital? Does he consider there is a role for hospital pharmacists to become more proactive in informing patients before they leave hospital about the correct use of medicines, what they should not be used with and if there is a reaction what to do, instead of simply finding that a significant number misuse medicines or stop taking them because of an early reaction to them?
I agree 100% with the Deputy on that proposition. I met the Irish Pharmaceutical Union on that issue. Community pharmacists, in particular, are anxious to become involved in the major health promotion campaigns in which we are currently engaged. The idea behind the regulations introduced in 1996 to regulate and control pharmacies was to orient and develop pharmacies towards providing that additional primary care advice and service to the public. That was the fundamental philosophy underlining those regulations to improve the quality of pharmacies. That is why I have been so advised by the Department. I have been in discussion with community pharmacists and they consider they have a strong role to play in health promotion, once the patient has left his GP, in terms of advising them on the consumption of medication, adverse reactions and how best they should take their medication.
An elderly gentleman from a rural isolated area was discharged from hospital at 9.30 p.m. on a weekend night. As he did not have family at home, he had to ask a neighbour to bring him home. Hospital personnel gave him medication only for that day. As he does not have transport, he was not able to travel to his local pharmacist. He lives 60 miles from the hospital and he was not able to get medication until the following Monday.
Will the Minister send a directive from his Department that when people, particularly those living in rural isolated areas, are discharged from hospital they should be given enough medicine for a number of days rather than the bare minimum? That would be a simple procedure. It is wrong that such patients are not given sufficient medication. That man pleaded with the hospital not to discharge him that night, yet he was rushed out. That is an example of our wonderful health service.
I tabled a question on that matter to the Minister, to which I received a reply stating that the local health board acknowledged that the man pleaded not to be sent home. That man had to be rushed back to hospital the next morning at 7 a.m.
What the Deputy said makes sense, that adequate supplies of medication should be given to a patient on leaving hospital. Unfortunately or fortunately depending on one's perspective, the Minister for Health and Children cannot issue directives to every hospital agency to do A, B, C. and D. That is not the way the system operates.
That is why it is the way it is.
We have devolved authority to regions and subsequently to hospital management boards to draw up proposals and strategies within their operational plans to deal with those issues. We are not in the habit of issuing directives every day of the week to people all over the place.
The Minister is good at having photographs taken with chief executives and he is good at PR. The Department has PR people and it is great at photo opportunities.
The time allocated for this question is exhausted. I ask Deputies to make use of the little time available. Has the Minister completed his reply?
Yes.
My question relates to starting a medicine plan in the hospital prior to patients being discharged and when they are discharged such a plan should be continued with community pharmacists. Protocol 9 of statutory instrument No. 150 requires pharmacists to meet that role. Will the Minister agree that it is difficult to meet that role if one is in a shop standing on one side of a cash register and the pharmacist is on the other? Can an incentive be given to introduce a medicine plan?
The idea behind the contractual agreement in 1996 was to improve the quality, space, and facilities to do that. The Higher Education Authority commissioned Bacon & Associates to do a report on the supply of pharmacists, which is a key factor in the development of hospital pharmacy. He identified a significant shortage of hospital pharmacists. That highlights the need for a second school of pharmacy, which the Higher Education Authority is currently considering.
It is looking for a site in Cork.
That matter has gone out to tender.
