The way in which the Health Service Executive (HSE) agrees fees with pharmacists for dispensing drugs to medical card holders will have to change in future if it is to comply with the Competition Act, it has emerged.
The executive has written to the Irish Pharmaceutical Union (IPU), which represents 1,600 community pharmacists, in recent days stating that for it to negotiate fees with the union in future on behalf of its members would be in breach of competition legislation and could be regarded as price fixing.
At present more than one million people are covered by medical cards and pharmacists are paid set fees by the State to dispense prescribed medicines to them. The HSE plans to review this contractual arrangement with them but no deadline has been set for its completion.
In its letter to the IPU, the HSE said that if it entered into an agreement with the IPU it would expose pharmacists as well as their representatives to the risk of criminal prosecution.
"The HSE is still considering its options for progressing the issues arising from this advice but will contact pharmacy contractors as soon as these are determined. In the interim the HSE is now proceeding with the establishment of new arrangements for the provision of wholesale services to the pharmaceutical sector," it added.
The IPU said the change threatened the continued sustainability of the working arrangements between pharmacists and the HSE in respect of the medical card and drug payment schemes.
The IPU also said it was an attack on the right of pharmacists to be represented by a trade union. And it claimed its legal advice was contrary to that of the HSE.
IPU president Michael Guckian said the HSE's move threw the future of a range of State-funded schemes such as the medical card scheme, the drugs payment scheme and the long-term illness scheme into doubt and would "cause chaos in the health service".
He urged the Minister for Health, Mary Harney, to intervene. "The position being adopted by the HSE and the Department of Health may also have implications for other healthcare professionals, such as consultants, general practitioners and dentists. Indeed, the stance being adopted by the HSE means that it cannot enter into discussion on prices with any similar organisation. It also calls into serious question the standing of recent agreements made by the HSE and the Department with organisations which represent the pharmaceutical industry which fixed the price of medicines," Mr Guckian said.
The HSE said it would meet the IPU tomorrow to discuss the situation. Prof Kamal Sabra, head of the corporate pharmaceutical unit of the HSE, said it planned to conduct a public consultation programme during which pharmacists could individually make submissions.
The HSE would then decide itself, with the advice of independent experts, what to pay all pharmacists. Every pharmacist did not have to accept it, he added. He said this was the way prices would also be reached with the wholesalers of drugs.
The public consultation programme involving them is currently under way.