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JOINT COMMITTEE ON HEALTH AND CHILDREN díospóireacht -
Thursday, 14 Feb 2008

Community Pharmacies: Motions.

The joint committee met in private session until 10.30 a.m.

The meeting will commence in public session.

Will the Chairman please inform the committee about the order in which the motions are being taken? What is the procedure, just so that I am aware of this?

They will be dealt with in chronological order. In that regard——

Is the Chairman taking the Labour Party motion, the first Fianna Fáil motion and then the second Fianna Fáil motion?

No, I am taking the second Fianna Fáil motion as a separate motion.

Is the Chairman withdrawing the first motion?

That is correct.

The only difficulty we have is that this is the first we have heard of it. Normally, one would have some time to speak among——

We shall suspend the committee for five minutes so that people can discuss matters.

Sitting suspended at 10.30 a.m. and resumed at 10.35 a.m.

We will propose the motion. I shall be brief because we have had three days of this and I believe our sentiments are well known. I move:

That no changes be made to contracts between the HSE and community pharmacists in advance of the setting up and reporting of an independent body, whose remit will be to make recommendations on the reimbursement to pharmacists for drugs supplied under the State's community drugs schemes, in consultation with the interests concerned.

In putting the motion, I want to thank the Chairman for the opportunity to debate this issue over such a relatively long period, and for the opportunity to meet with the HSE and pharmacists' representatives. We have had a very useful engagement and a good deal of clarity around the issue. I am particularly concerned, however, that the HSE does not wish to engage in negotiations. It wishes, simply, to force through its proposals, on 1 March without any consultation.

This committee met with both organisations last autumn and we felt there was going to be consultation, but there was not. At this stage we have no option but to put our motion. I had hoped we could have reached all-party agreement on a joint motion to move the process forward. There is common ground among members of the committee across most of what is required in terms of finding a solution.

We are all concerned to ensure patients receive the services they need, and also that pharmacies can stay in business — in particular small community pharmacies which provide an excellent service to the public. That is the intention of this motion. While I accept, fully, the entire content of the motion emanating from the Government, I believe it is not strong enough. It needs to have the wording contained in our motion to the effect that no changes be made prior to the setting up and reporting of an independent body. This committee could send out a very strong message to both of the groups involved in this issue if this motion is passed. In view of this, I commend the Labour Party motion in my name and that of Deputy Kathleen Lynch and Senator Phil Prendergast.

I second the motion.

I appreciate the way the motion was proposed and the Deputy's analysis of what has been happening over the past three days.

The Fianna Fáil motion will propose that the committee calls on both the HSE and the IPU in the interests of patients and as a matter of urgency to work constructively and agree a formula to resolve this issue. In agreement with all our party colleagues, we are of the view that without talks this impasse will not be resolved. As Deputy O'Sullivan noted, our last number of meetings have been devoted to this issue. We have heard from all sides and, in that light, I propose the motion. We call on the HSE and the IPU in the interests of patients and as a matter of urgency to work constructively and agree a formula to resolve this issue.

It will be my intention to second the Fianna Fáil motion.

The Fine Gael Party will support the Labour Party motion and will also move an amendment to the proposed Fianna Fáil motion, as we do not feel it goes far enough. Our proposed amendment will add an addendum stipulating that in the meantime, no changes in the current contract or remuneration will take place.

I echo what others have said with regard to the amount of time we have spent on this. We have managed to get at many facts of which we were not aware. There is agreement in the committee that this dispute needs to be resolved and that the HSE needs to enter into realistic negotiations. It is clear that with one negotiation having broken down, the HSE walked away from the table and then issued a dictat.

I wish to comment on the some of the points made. Yesterday, members suggested they wanted to meet with all the parties and to meet with the HSE next week. I pointed out it was not our remit to arbitrate or get involved in industrial relations but to get at the facts. The Chairman has managed to achieve this very well.

Deputy O'Hanlon stated that the proposed motions come down on one side. I completely reject this. I put it to the Deputy that to have no motion is to support the HSE in its unilateral action and allow it to continue to act as it has. If it does so, in a fortnight's time we will possibly find we have problems with patients trying to access their medicines.

The idea behind our amendment to the proposed Fianna Fáil motion is to secure continuity of supply and give reassurance to patients throughout the country that they will not have a problem getting their drugs from pharmacists, as well as to reassure pharmacists that they have a right to be listened to and to negotiate.

I reiterate that we want value for money and cheaper medicines for our people. However, there is a way of going about this. The way the HSE is going about it is not acceptable. It told us directly earlier this week that it met the Minister and has her backing, and that she has the backing of the Government. It is unfortunate that despite the sentiment expressed by the Fianna Fáil members, they find themselves unable to support the Labour Party motion.

On a point of information, the proposed amendment to which Deputy Reilly refers is in the name of Fine Gael and Labour Party members.

I should have mentioned that.

The motion the Government parties have put to the committee proposes to call on the HSE and the IPU in the interests of patients and as a matter of urgency to work in the interests of patients and as a matter of urgency to work constructively and agree a formula to resolve this issue. Everybody agrees with the sentiments behind the motion — it is clearly what we have been discussing for the past number of meetings. What it lacks is any timeframe, sense of urgency or attempt to address the issue of independent arbitration.

This is why I ask the Government parties to again consider supporting the motion we have put forward in the interest of giving a strong message to both parties to address the issue of the timeframe and for the Government to appoint independent arbitration to remove the pressure and preconditions that have been set. We ask the Government parties to accept this motion because of the urgency of the situation. Nobody has a problem with the sentiments in the Government motion and we want the committee to continue its constructive deliberations on this issue.

I again thank Fine Gael for its very fair analysis of the situation.

Like others, we have debated long and hard on this issue. No member who spoke was not in favour of the position stated in the motion. Senator Fitzgerald said that there is no urgency in our motion. If she reads it again, the word "urgency" is contained in it, so what she says is wrong.

I seek clarity on the following point. Can one support an amendment or addendum and also support a motion? I feel a little bit of politics has entered this issue of late, which is not healthy for the committee. Many members seek to add words to our motion but they seem to have a fear of putting forward a motion themselves. Motions have not been submitted from all quarters, which is worth pointing out. It would be wrong for us to dictate in a motion what should take place in negotiations. As a committee, we cannot go any further than the position in the Fianna Fáil motion.

I do not want to go into the detail of whether the amendment or motion should come first. We can work that out shortly. I remind members that 11 a.m. is the deadline and we must still work through the process of the motions. I call Deputy Aylward.

I do not want to repeat what others have said. We are all here with a unity of purpose to resolve this situation. Our motion is short, simple and direct. It refers to the HSE and IPU, the two parties to the dispute. It also deals with the interests of patients, which is what we are all interested in. No member of this committee wants to have a situation from 1 March where patients are pawns in a bitter dispute. The motion contains the word "urgency". These three issues, namely, the reference to the HSE and IPU, the interests of the patients and the reference to urgency, are in the motion, so it contains all it should contain. As Deputy Blaney said, we do not want to tie the hands of any individual body and we do not want to be seen to come down on any side. We should stay neutral and leave the two groups involved to negotiate and try to come to an agreement. That is what we are calling for.

The urgency of the situation does not seem to be reflected as well in the Government motion as in ours. Fianna Fáil Deputies have been calling for independent arbitration on this situation at public meetings throughout the country. It should happen.

It would have been nice if we could have been unanimous. We could have done that by not having any motion before us. It would be just as easy for the Opposition to accept our motion as for us to accept their one. Nobody has a monopoly on unanimity when it comes to trying to get a unanimous decision. The motion the Opposition wants us to accept comes down firmly on one side. I do not believe it is the interests of this committee to come down firmly on one side.

As regards urgency, the phrase that is most important in our motion is "the interests of patients". All involved — the HSE, the IPU and the rest of us — know exactly what that means, namely, that patients would not be inconvenienced in any way.

I hope, as our motion proposes, that a formula will be found in the next three weeks to resolve this issue. I do not accept that the motion indicates no sense of urgency. As Deputy Blaney observed, the word "urgency" is included. I advise members that Deputy Flynn, who is not here this morning, wishes to be associated with this motion.

When the motions are taken, it will not be the case that we walk away from this meeting and do nothing. We remain committed to resolving this dispute and a plan is in place to that end. It is important to bear that in mind.

I thank members for their contributions in the last three days. In particular, I thank them for the manner in which our work has been conducted this morning. Members on all sides have set out their stall. Before we put the motions to a vote, I will make some concluding remarks. As a Deputy in one of the Government parties, I fully appreciate that it is we who established the HSE. I take no joy in bashing the executive which, thankfully, has not happened.

However, there is a credibility issue in that HSE representatives came to a meeting of this committee last November where we were assured that there was a sense of urgency in terms of the talks that would take place and in seeking to resolve the dispute. This does not seem to have been the case. Last Tuesday's meeting was scheduled in the awareness on the part of the committee that the situation is urgent. Our difficulty was that the HSE did not seem to recognise this urgency. That is why we find ourselves in the situation of having to vote on these motions.

The IPU delegates made their case about their involvement in community pharmacies. This dispute is of such significance to us precisely because of what it might mean for people who depend on their local pharmacies. I refer in particular to medical card holders. From their perspective, it is a matter of great urgency.

There are two positions to consider and it seems a question of how best to address this urgency. I acknowledge the view of Opposition members that a date must be set and adhered to. On the other hand, the Fianna Fáil position is that we put to the HSE the importance of entering immediately into negotiations. I cannot facilitate an analysis of the different proposals to a degree where we all agree. There must be a vote. That is not to say that this committee is now at odds forever. However, we must be realistic; this is about politics and how different people view a situation. I am certain we will all, in our own way, work to ensure that progress is achieved quickly. The onus remains on us to ensure the matter is resolved before 1 March.

Before proceeding with the first motion, I reiterate my wish that there be an opportunity for representatives of wholesalers, producers, the IPU and the HSE to attend a meeting of this committee together. If members consider it not worthwhile to attend such a meeting, that is fine, but we will schedule it and issue the invitations. It will be purely a matter of gleaning information on the background to this issue, no more than that. It will not change the deadline of 1 March.

I propose, given that we are inviting delegates from four different bodies, that the meeting be held in private session.

I have no difficulty with that. In addition, I will bring a proposal to the committee next week on how we should deal in future with requests by other Members to attend meetings. I have not been asked to do so but it would be useful.

I also take this opportunity to apologise to the HSE delegates to whom I gave a commitment that last Tuesday's meeting would last no longer than two hours. I have not been asked to apologise but it is only fair to do so given that the meeting lasted more than four hours. Delegates who come before the committee in future should be able to feel confident in commitments given by me as to likely durations. I broke that commitment last week.

We will not get down to the finer detail of who can put an amendment to a motion and so on. I will simply call for the Labour Party motion to be proposed.

I am sorry to interrupt the Chairman. Deputy O'Hanlon suggested that the proposed meeting be held in private. My colleagues and I have had a quick discussion and do not see any merit in that approach. Everybody else had to make their case before the committee in public session. In fairness to those who have gone through that process, I do not see any benefit——

My original proposal yesterday was that one member from each party would, together with the Chairman, meet the delegates privately. I do not mind whether the meeting is public or private. However, in bringing together representatives of four different agencies, we must be careful to ensure the discussion does not degenerate into a slagging match about who is right and who is wrong. We want to find out for ourselves what the position is. I propose that confining participation to four members of the committee would facilitate meaningful business. These four can report back to their colleagues.

I propose that the presentation from the groups take place in public session, as usual, so that each party can set forth its position. Some of us have expressed reservations about getting into the detail of industrial relations with particular groups. If members subsequently consider there is merit in a further meeting with the representatives, involving a smaller group of committee members, I would support that. However, for the purposes of establishing the facts, we served the public well by conducting Tuesday's meeting in public session, particularly in terms of the way it was chaired and the questioning that took place. I support the continuance of that approach, although there could be merit in a smaller subsequent meeting.

I took it yesterday that the reason Deputy O'Hanlon sought a meeting involving a smaller group of committee members was that there was such urgency in the case that the timeframe did not allow for an open meeting. Such an approach would make it far more likely that the wholesalers' representatives would agree to attend. They did not want to meet the HSE delegates. I do not know what their position was in terms of meeting formally with the IPU. We have a better chance of securing their agreement to a meeting if the group involved is smaller and it takes place in private session. Such a meeting could take place tomorrow or Monday as we would not have to wait until Tuesday when the information technology support is in place.

We are going off the point. I propose that the party convenors speak to the Chairman after the meeting to decide the way forward.

Yes. Not everyone will be satisfied with what is agreed.

On a point of order, the Chairman said he would offer clarity on voting on addenda and motions.

To be fair, we had the original motion from the Labour Party, our own motion, and the addendum to our own motion from Fine Gael. Am I correct so far?

The addendum was proposed by Fine Gael and the Labour Party.

The original one was from Fine Gael.

Yes, then we went back to the composite motion, then back to our second motion again. I remind members that there are no rewards for getting in first or second; let us just proceed. We will deal with the motion first and then move through the process.

Does this mean the Chairman is withdrawing the first Government motion?

Yes, the motion before us is the motion proposed by Deputy Jan O'Sullivan. I presume there will be a division on the motion and that a show of hands will not do.

For clarity, may we have the names of the substitutes?

The clerk, Ms Áine Breathnach, has arranged that. I thank Áine and her colleagues, Mary and Marie, for all their work this week. I greatly appreciate the efforts of all the back-up staff who have been tremendous. Within an hour of yesterday's meeting, Áine had spoken to the relevant staff in the HSE and all the documentation we requested was on its way.

To clarify, will each name be called out and we must indicate for or against?

Yes. The ushers are on the way and no one should leave as the vote will be taken. Before we proceed to the vote on the Labour Party motion, I remind members the joint committee is in public session. I will clarify the reason some members are missing for the benefit of people or outside agencies. Senator White and Deputies Flynn, Allen, Lynch and Connaughton had arranged pairs weeks ago for urgent business in their respective constituencies, and were unaware this meeting would take place.

Deputy Allen is chairing another committee meeting at present.

All members have been mentioned. Procedurally, we must wait for the ushers. There are no bells as Christmas is over and members are back in business. There is no need for bells with a full house and all members are present.

I know members are eager to get away and that we promised the meeting would conclude by 11 a.m.

Question put.
The Joint Committee divided: Tá, 8; Níl, 9.

  • Durkan, Bernard.
  • Costello, Joe.
  • Fitzgerald, Frances.
  • Flanagan, Terence.
  • Neville, Dan.
  • O’Sullivan, Jan.
  • Prendergast, Phil.
  • Reilly, James.

  • Aylward, Bobby.
  • Blaney, Niall.
  • Conlon, Margaret.
  • Feeney, Geraldine.
  • McGrath, Finian.
  • Moloney, John.
  • O’Connor, Charlie.
  • O’Hanlon, Rory.
  • Phelan, Kieran.
Question declared lost.

We will move to the Fianna Fáil motion.

I move:

That this Committee calls on both the HSE and the IPU in the interests of patients and as a matter of urgency to work constructively and agree a formula to resolve this issue.

I second the motion.

I move amendment No. 1:

After "issue." to insert the following:

"and in the meantime, no changes in the current contract or remuneration will take place."

I second the amendment.

Amendment put.
The Joint Committee divided: Tá, 8; Níl, 9.

  • Durkan, Bernard.
  • Costello, Joe.
  • Fitzgerald, Frances.
  • Flanagan, Terence.
  • Neville, Dan.
  • O’Sullivan, Jan.
  • Prendergast, Phil.
  • Reilly, James.

  • Aylward, Bobby.
  • Blaney, Niall.
  • Conlon, Margaret.
  • Feeney, Geraldine.
  • McGrath, Finian.
  • Moloney, John.
  • O’Connor, Charlie.
  • O’Hanlon, Rory.
  • Phelan, Kieran.
Amendment declared lost.

We will proceed to the Fianna Fáil motion.

As there is no disagreement on the Opposition side with the Fianna Fáil motion, there is no need for a vote.

Members should be clear in this regard.

In the interests of the joint committee agreeing on a motion that will go some way towards moving the process forward, Opposition members will not oppose the Fianna Fáil motion. It should be agreed unanimously by the joint committee. Opposition members would have preferred the stronger motions that they had proposed.

The problem with the Fianna Fáil motion is that it allows the Health Service Executive to continue on its way to the deadline of 1 March, which is regrettable.

Very well.

However, in the interests of unanimity——

I wish to——

Chairman, one cannot let that remark go. The motion does not give a free hand to anyone.

(Interruptions).

The motion refers quite clearly to the interests of patients, which spells it out for everyone because that is the priority. Second, it refers to this issue as a matter of urgency.

Members, please.

If members intend to agree unanimously to this motion, for the sake of the joint committee they should do so in a good spirit.

The remarks made by Opposition members make it clear they would have liked a stronger motion than that proposed. However, in the interests of moving forward and continuing the work of the joint committee, they are prepared to agree to it. It should be taken in that spirit.

The good intentions expressed should not be dissipated. To clarify, from the Chair's perspective I appreciate the manner in which this issue has been handled by all sides. In particular, I refer to the fact that members are not simply going into the nitty-gritty of who voted for what. It is very important to put that on the record. One message must be sent from here. Regardless of whether people think it should be treated with greater urgency, the reality is a message is being sent from here today. Some people want the 1 March deadline to be moved, while others are urging the HSE to enter meaningful talks. Based on the committee's meeting with the HSE in November and last Tuesday, I think this is a real test of whether the HSE wants to enter into talks and negotiate. People have also suggested to us that because the motion is being dealt with does not mean everything stops from our perspective. We must prove our interests, bona fides and integrity in ensuring talks begin as quickly as possible. I thank everybody for the way in which they have handled this.

Question put and agreed to.

The joint committee proposes to send a letter to the Minister for Health and Children informing her of the motion passed and stating that it hopes to get a very early response. The clerk to the committee will then report and note the motion to the Houses of the Oireachtas. Is that agreed? Agreed.

The joint committee adjourned at 11.10 a.m. until noon on Thursday, 21 February 2008.
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