JOINT COMMITTEE ON HEALTH AND CHILDREN díospóireacht

Community Pharmacies: Discussion (Resumed).

Chairman

It is fair to say that questions brought up by members yesterday with the Health Service Executive were not answered in full. It was quite clear that issues regarding correspondence were not dealt with. I ask that we consider this situation. I am not trying to dodge the issues before us. There was no opportunity to make further progress because clearly it was not possible to talk to the HSE between last night and this morning.

Rather than divide the committee on motions might we defer the decision for one week to give the HSE a chance to return and discuss what might be done to deal with the €100 million in question? I hear a "No" already. I am not giving a directive but making a suggestion. In the last five years this committee has divided only once. Perhaps we could move this issue forward. I spoke to Deputy O'Hanlon this morning on another matter and now call on him to indicate what he has in mind on this issue, remembering that there are parties here who were not present at yesterday's meeting.

Deputy Rory O’Hanlon

I agree with the Chairman's suggestion that we should postpone the motion rather than divide on it. There are very good reasons we stood down on this issue, one being that we had a four-hour meeting yesterday. An extremely good case was made by members concerning how they felt about the dispute and what they wanted to see happen. The Health Service Executive and the Irish Pharmaceutical Union made their cases. Rather than divide on the issue we should give them a further opportunity. We stressed in particular that we wanted to see action in the next three weeks. For us, as a committee, to get involved in a dispute between two agencies, would be to get in at the deep end. I doubt that there are precedents of committees finding themselves at such a level in this kind of dispute.

I sat here yesterday for almost four hours and for the full meeting on the previous occasion. I am no wiser this morning than I was three months ago about the discrepancy in the figures presented. I propose that the Chairman and one member from each party meet with representatives from the pharmaceutical manufacturers, the wholesalers, the HSE and the IPU. This meeting should be undertaken in private session as a matter of urgency to see if we can get over what appear to be major stumbling blocks, namely, the rebate from the wholesalers, the nature of the agreement entered into and which parties entered into it.

Letters were produced yesterday from the manufacturers stating that wholesalers were not going to penalise pharmacists. The IPU claimed that there is no such agreement. While I am not convinced that a public meeting would serve any useful purpose, if a representative group from this committee were to meet privately with the parties in question there is some hope that we might be able to tease out that particular issue.

Deputy Kathleen Lynch

Yesterday's meeting was useful in that both sides were present. After the previous meeting it seemed that each side felt very uneasy about the fact that certain things were said that clearly were not true. Much of that sentiment was cleared away yesterday.

Obviously the HSE has told the committee something about the wholesalers that is not the case. The IPU knows this. That matter is not in the agreement that we have in writing before us so it needs to be cleared up. One function a committee performs is to facilitate the coming together of groups and I believe that is what happened yesterday. I am not certain that anything useful came out of it, as Deputy O'Hanlon noted, but nevertheless the committee did provide the forum.

I am concerned about this situation because we do not have three weeks. We have two weeks before 1 March. Tomorrow is 16 February and there are only 29 days in this month. I stand corrected in that it is actually 14 February tomorrow — imagine I forgot St. Valentine's Day — but we are deluding ourselves if we think we have three weeks. We should go back to the HSE because it is the barrier in this instance. The IPU is prepared to go into negotiations but the HSE is refusing to do this. That is where the difficulty arises.

We should go back to the HSE and tell it we have agreed a motion, however it may be that we come to that agreement. We should say that it is the express wish of the committee that a solution be found to this problem and that the deadline of 1 March be set aside until negotiations are under way without preconditions. We should be determined to say this.

The committee has no function in approaching the wholesalers. It is important to have their information but no purpose will be served by approaching them. We should certainly go back to the HSE. This is a committee of the Houses of the Oireachtas and it must hold some sway. If it does not, and if the HSE does not listen to us, we will have to agree a motion and perhaps put it to a vote. That is the sanction we have in this case.

The Minister for Health and Children, Deputy Harney, has returned. Perhaps we should meet her. At yesterday's meeting, Professor Kamal Sabra repeatedly told the committee that the HSE was implementing national policy. I think he was mistaken. It is Government policy. If the situation is as he says then clearly there must be some involvement by the Minister. I agree with Deputy O'Hanlon's suggestion that a group comprising the Chairman and one member from each party should speak to the HSE today and tell it that the committee has formulated a motion, that we want it to set aside the 1 March deadline and to enter negotiations without preconditions to resolve this issue.

Deputy Bernard Allen

What is the status of my proposal of yesterday? It was obvious from the HSE that the Minister was pulling the strings. I proposed that we invite the Minister to attend at the earliest date possible, for instance, next week.

Chairman

It was agreed we would discuss it here. I take Deputy Lynch's point.

Deputy Niall Blaney

I agree with Deputy O'Hanlon. He has been in the House for many years and as a doctor would know a fair bit more than the rest of us about health. We uncovered a lot of sores yesterday but I disagree with Deputy Lynch. At our inaugural committee meeting we unanimously agreed that we would work to try to better the health service in whatever way we could and this is the perfect opportunity. We uncovered some discrepancies relating to wholesalers. This is the perfect opportunity to meet all involved. We were given some answers yesterday but not the answers we required and we have a lot more to get. The committee still has an important role to play in resolving this issue and we should not stop here. I second Deputy O'Hanlon's motion.

Deputy James Reilly

As did many people yesterday, I wish to compliment the Chairman on the manner in which he chaired the meeting. However, I must put it to him that there was a tacit understanding the committee would meet in private session this morning, which it did, to discuss a composite motion agreed by all to help move this situation on. It is clear there has been a change of heart on the other side of the House.

I do not find Deputy O'Hanlon's suggestion useful; I do not believe it is workable. Deputy Flynn said yesterday she did some work on industrial relations 20 years ago but I spent 20 years in industrial relations and I do not regard it as the role of this Oireachtas committee to be settling industrial relations disputes. We are not going to spend our entire time going around fire-fighting. We should not even pretend that this is a function of the committee because it is not our function.

Chairman

I would prefer if the committee went into private session. I am not trying to change anything. I was presuming that Deputy Reilly would presume the Government side wanted to have this issue kept quiet. To show that we are trying to work together I suggested a public session. I have no problem with a private session. Is it agreed that we go into private session?

Deputy James Reilly

I suggest we hold on.

Deputy Jan O’Sullivan

I want the opportunity, as others had, of saying a few words.

Chairman

I do not want——

Deputy James Reilly

I ask the Chairman not to pre-empt anybody either, because I have not finished speaking.

Chairman

I was not doing so.

Deputy James Reilly

The committee is in public session, I am quite prepared to stay in public session. I am quite prepared to force the motion and to divide this committee if that is what is needed to show that the problems we uncovered yesterday require a strong hand of Government to intervene, to instruct the HSE — which is an arm of the State — to deal in an honest and transparent fashion with a group of professionals who provide an invaluable service to this country on a nationwide basis.

(Interruptions).

Deputy James Reilly

I did not interrupt anyone. I am quite happy to go back into private session if the purpose of that private session is to discuss a motion which we can all agree on and which will push this issue forward. However, I disagree with the idea of going to meet people for a week here and a week there, when there are only 16 days left in this month, when the Taoiseach is telling the Dáil that people should sign the contracts and prices will be discussed later. It is clear the Leader of the Government has made his mind up under instruction from the Minister and there will not be any change. This is merely a ruse to buy more time so that pharmacists can be strung along further.

It became very clear yesterday that the HSE misinformed this committee on a number of occasions and I commend Deputy Dara Calleary for obtaining this letter from United Drug. I had seen the original letter and I knew damn well that this was not the full context of that letter; that it was no guarantee that wholesalers could hold their prices down or would change their pricing for pharmacists. The reality remains that in 16 days, if the HSE persists with this——

Deputy Rory O’Hanlon

I resent the implication that it is a ruse to buy time. I have spent at least six hours here listening to two sides. I am entitled to be in a position to make up my mind as to who is right and who is wrong. It is not a ruse to buy time. If they wish to meet this evening I would be glad to meet them. I do not want it implied that anything I do in here is a political ruse because it is not.

Deputy James Reilly

Political and ruses do not necessarily have to be the same thing. As the Deputy put them together, I do not necessarily accept what the Deputy has said. This is my view and I am entitled to it too.

Chairman

I have a view on this also, Deputy Reilly.

(Interruptions).

Senator Geraldine Feeney

The Deputy has a problem with us trying to talk to the wholesalers and the IPU. I am aware there is a timescale of three weeks. I am also aware from yesterday's meeting that the HSE left this meeting realising that this has been brought into the public forum. I believe they have a duty to come back to this committee within the next few days. That is what I was talking about. There will be no deferrals. If the Opposition wishes to push a motion I have no difficulty with that.

I was asked yesterday at the end of the meeting by a number of people whether the meeting would be in public or private session. I never thought for a second it would be in private session. It is in public session on the basis of ensuring that all our decisions——

Deputy Kathleen Lynch

That is not a problem.

Chairman

I thought it was for Deputy Reilly.

Deputy Kathleen Lynch

We are here as a committee and this is ludicrous. We are supposed to be trying to resolve a dispute and it seems we have a bigger dispute ourselves. If we carry on like this we are in no position to try to resolve anyone's dispute. It is a case of finding a solution to this problem and not about egos or personalities. This is about finding a solution.

Chairman

We do not want that either. I call Deputy Reilly again.

Deputy James Reilly

This has nothing to do with egos or personalities. It has to do with an understanding that I had from the Chairman that he wished to go into private session to see if we could, without the pressure of public session, agree to a composite motion that would help move the issue forward. This is where I am coming from.

The situation seems to have changed and this is what I am pointing out. I will stand over what I said. I do not see the value in what Deputy O'Hanlon has suggested. I see a value in what happened yesterday in terms of outlining and clearly showing where the inaccuracies and discrepancies are. If the HSE is so strong in its position and believes it has irrefutable figures, why is it afraid of an arbitrator? I thought the members opposite were in favour of an independent arbitration process taking place which can come to a conclusion and that neither side take any action until the arbitrator reports. That seems to me to be perfectly reasonable. I do not understand why such a motion cannot be agreed. I am prepared to support the Labour Party motion. I have no problem with it. If it needs to be put publicly in this committee, we should do so. We do not have a role, as part of the industrial relations machinery, in solving industrial disputes. In any event, we do not have the time to do it.

Senator Frances Fitzgerald

I did not get a chance before now to congratulate the Chairman on the manner in which he chaired yesterday's excellent meeting of the joint committee, at which many facts emerged which are important for both sides of the dispute. I have never before seen such a good example of a democratic exercise at a joint committee meeting. It was good to bring both sides together to gather new information.

Are the Government parties in a position to support the Labour Party's motion or Fine Gael's amendment? That is the key issue. If the committee's proposal is to be about action, as well as words, it needs to send out a strong message. Deputies and Senators from all sides spoke yesterday about the value of pharmacists to the community. We emphasised the need to find a mechanism that can be used to resolve the dispute. Most members of the committee expressed their support for independent arbitration. If we are to show that we are concerned with more than just words, we should pass a motion proposing that no change be made to the contract in place between the HSE and community pharmacists in advance of the establishment of an independent body and the publication of a report by such a body. Such a motion, agreed by all members of the Joint Committee on Health and Children, would send a powerful message to everybody.

If we put a form on the words we spoke yesterday, we will send a clear message to everybody involved in the dispute. Such a motion would not mean we could not take up Deputy O'Hanlon's suggestion too, if the committee deemed it appropriate. It is not particularly appropriate for the committee to get into the middle of an industrial relations dispute. However, we should consider some aspects of the suggestions made by various members yesterday. We could invite the Minister, Deputy Harney, to attend a meeting of the committee, for example. That could be done in addition to reaching agreement on a motion. As politicians, we should state clearly that we have concerns about the imposition of the 1 March deadline. We want to see independent arbitration. Is the Government prepared to support the motions tabled by the Opposition? If the Chairman can answer that question, perhaps we will be able to make progress. Perhaps he will indicate whether he is prepared to accept the motions.

Deputy Niall Blaney

We got into the middle of this debate yesterday. We are now in the middle of the dispute, whether we like it or not. By allowing both sides to make their case, we got into the middle of the dispute. We cannot make an issue of whether we are in the middle of the dispute, or whether we should be involved in it. Whether we like it we are in the middle of the dispute. I do not see why we should not continue with our attempts to resolve the dispute. We are continuing the work we were doing yesterday.

Deputy Jan O’Sullivan

I hope the committee can make a positive input. I am concerned about the tone of today's meeting so far. It was agreed yesterday that the meeting we were to have this morning would deal with the Labour Party's motion, Fianna Fáil's motion and Fine Gael's amendment. A totally different discussion has been initiated this morning. We have not dealt with the substance of any of the motions. I suggest that if we are to make progress, we need to concentrate on the substance of the motions.

We all agree that we want to find a resolution. We do not want the change to go ahead on 1 March next. That was my opinion before yesterday's meeting, but I was convinced of it when I heard what was said at the meeting. My opinion was strengthened further when I read the e-mail circulated by Deputy Calleary this morning. In the e-mail in question, the managing director of United Drug, which is a pharmaceutical wholesaler, states:

From our extensive knowledge of community pharmacy, I can assure you that this will lead to a significant level of closures and reduced service generally due to the financial constraints it will impose on both the wholesalers, and the pharmacies who remain in business.

That indicates clearly that the entire argument made by the HSE yesterday was a sham.

I am enraged that the HSE issued a long press release during yesterday's meeting. The press release, which was on my computer when I returned to my office at the end of the meeting, presents a one-sided view of this matter by quoting selectively in support of the HSE's case, which is totally at variance with reality. That is the background to today's meeting. I have no problem seconding Deputy Lynch's amendment, which proposes that the HSE be asked to withdraw the 1 March deadline. That amendment has to be considered in the context of a motion that has already been agreed by the committee. For that reason, we need to go into private session.

Deputy Beverley Flynn

A previous speaker argued that the joint committee does not have an industrial relations role. I reject that. The committee invited the IPU and the HSE to attend yesterday's meeting as part of its attempts to resolve this issue. The feelings of disappointment of all members of the committee were crystal clear yesterday. I have no difficulty with the committee agreeing a motion later to summarise those sentiments. In light of what we heard yesterday, when some of the untruths and grey areas within the HSE's position were uncovered and crystalised, I will be disappointed if it transpires that representatives of the HSE are unable to come back to this committee to try to resolve this dispute. It might be no harm for the committee to ask the HSE to send some of its officials to a further meeting of this committee within a week to outline how the HSE intends to resolve this problem before 1 March. Our intention should not simply be to pass a motion and then walk away as if our work as a committee is done. That is not what I am about at all. I am here to represent my constituents whose GMS prescriptions might not be filled after 1 March next. I am also trying to keep rural pharmacies in business. If the committee cannot achieve that, if nothing else, it is wasting its time, regardless of any motion it might pass. Perhaps we can discuss the merits of that approach in private session. I will be disappointed if we cannot get answers from the HSE and make progress with a view to resolving this problem.

Deputy Paul Connaughton

An important date needs to be borne in mind throughout this debate. Everything we do today must help to ensure the HSE backs off from its 1 March deadline. If it does not do so, the game will be over because the contracts will come into play and the pharmacists will have far greater difficulties. It is important to stress that there is not much difference between what members on either side of the committee are saying. It is really a question of emphasis. I suggest that any motion agreed by the committee should be strong and, if humanly possible, should have a specific purpose. The motion should leave the HSE in no doubt about where this committee stands. Anyone who sat here for four hours yesterday will know that members from all sides of the political divide were of the one opinion. I do not want rural pharmacies to close. I want fair play. It will take our best efforts in public relations and human resources to solve a dispute such as this one. In addition, we know that it could take the professional arbitrator hours, weeks or months to sort this out. This might drag on until next July or August but so what? All the other disputes did likewise and in the end they were solved to everybody's satisfaction. Whatever way we organise it, that is the route we should be on. I sincerely hope that if we do go into private session that is what will come out of it.

Senator Geraldine Feeney

I agree with Deputy Jan O'Sullivan. Perhaps the meeting got off to a rocky start this morning but I, for one, came in here to try to move the motions on and come to some agreement. I take offence that people would think there was any pulling back on the Government side. People should be under no illusion about that. I think the HSE was under no illusion yesterday when everybody spoke from the one hymn sheet. It was clear where every member of the committee was coming from.

Perhaps there is something wrong with my thinking in saying that, but that is how I saw the meeting yesterday. At 8 p.m. last night I had a conversation with the president and vice president of the IPU who are most anxious to know what we are going to do next. The last thing they said to me was that they did not want the committee to fall apart on a motion, whether for or against it. They felt we were more powerful as a committee staying together than being divided. They also told me they had a meeting with the Minister, Deputy Harney, tomorrow. The IPU is moving on and will meet the Minister tomorrow. I honestly do not see anything wrong with the proposal that was made by Deputy O'Hanlon. I have great respect for him. He is the longest serving Member from any side of the House. He has a wealth of experience that is second to none and which prompted his remarks this morning. He should not be dismissed, mocked or insulted in any fashion.

Deputy Flynn says we can go back to the HSE and that is what I thought we would do, namely, ask the HSE to meet with us. If the HSE's representatives do not want to meet with the entire committee they could meet with the Chairman and one member from each group. In the same vein, it would be objective and positive for the same group to meet the wholesalers within the next week to hear their views at first hand, rather than getting them by letter. As other speakers have pointed out, we still have two weeks to go. There is a lot to do in those two weeks but I feel we can move the process on. There should not be any division between us.

They told us that the operation of the policy is a matter for the HSE.

Chairman

Please we must move on.

Deputy Margaret Conlon

On a point of order——

Chairman

I am trying to go into private session.

Deputy Margaret Conlon

When Deputy O'Rourke asked the question yesterday about the cut of €100 million, perhaps I took it up wrong, but from where I was sitting it was made clear that it was not the Minister's idea to approach the cut in this manner. The suggestion was put by the HSE. Maybe I picked that up wrongly but it was clear yesterday.

JOINT COMMITTEE ON HEALTH AND CHILDREN díospóireacht - Wednesday, 13 Feb 2008

Community Pharmacies: Discussion (Resumed).

JOINT COMMITTEE ON HEALTH AND CHILDREN díospóireacht -
Wednesday, 13 Feb 2008