Pharmacies Closed Aug 1, 2009?

DublinTexas, Truthseeker,

are you saying that you or people you know have been paying more than the DPS limit each month for presciption drugs?

I cant say Ive had a terribly expensive prescription month recently but last year I can remember one month where between expensive antibiotics and some other bits it did come to more than 100 euro.

Surely the pharmacy should tell you?

Yes, thats what I was thinking.

Also, I can't believe that people don't know about this scheme. It's mentioned in the Budget each year, as the Govt often increase the limit.

I never knew about it before the recent publicity. I have certainly heard the term DPS in the past but had no idea what it was about or that I was eligible.

By the way, people can also get tax relief on the 80 or 100 cash payment that they have to pay each month.

I knew about that, but only in the past couple of years, I had never even heard of a MED 1 up to a couple of years ago.

I accept its my own responsibility to find out about these things, I suppose for the past 10 years or so I just worked, got my wages, paid for medical stuff if it came up and went along in blissful ignorance that there was any alternative but for me to pay my own way.
 
People should vote with their feet.

I for one will be walking by nearest pharmacy which is not dispensing and going to the one that remained open.

Its time people stood up to this bull****
 
I know someone who's a pharmacist and saw this thread. They feel there are many misunderstandings and questions here, and would like an opportunity to answer them. However, they do not have the capacity to post in Letting Off Steam. They therefore asked me to link to some information that is part of another discussion on boards.ie, and encourage people to raise any questions they have over there, so they can answer them.
The posts on boards.ie that they felt would help answer many of your questions are copied below. However, the overall thread on boards has far more detail and can be found here. It's a huge thread and growing fast. As it started back at the beginning of July, you may wish to skip to the last few pages to focus on what is going on at present.

Radia on boards.ie:
The pharmacists aren't striking. They were given only two choices by the HSE - keep your contract, with a reduced payment (typically 34% reduction) or give 30 days notice to end your contract.

Depending on the mix of business and the ability to take the hit, some pharmacists stayed in (Boots being an example; I presume they have huge bulk buying power for things like hair colours etc which is the bulk of their business and can afford to take a hit on prescriptions). Others (especially small rural pharmacies who rely on prescriptions for the majority of their business and don't have enough cosmetics etc to cross-subsidise it) rejected the contract. They simply wouldn't receive enough money from the schemes to pay their rent, staff wages, electricity bills etc. Continuing to trade, knowing you are doing so at a loss, is called reckless trading and is illegal.

They gave their 30 days notice. The HSE knew they would no longer be in the schemes. They had a month (more than a month when you consider any sensible manager would anticipate not everyone would accept the new terms) to put contingency arrangements in place. It is the HSE's responsibility to have health services in place. So they said they would prepare a contingency plan and all would be well.

And the HSE said - and continue to claim - that their contingency arrangements are working very well. According to them, everyone is getting their medicines, there are no unnecessary delays, everything is fine. According to the HSE we don't need any of those pharmacies who have withdrawn, look around, see all the pharmacies that are open and happily dispensing away. In fact, according to the HSE it would be far better if we stuck to the lower number of pharmacies we have now - there were far too many before. It doesn't seem to matter to them that this would represent about 5000 extra people on the dole queues - not just those 'greedy' pharmacists but their staff. It doesn't seem to matter to them that people are queueing down the street at the pharmacies that still have contracts. It doesn't seem to matter to them that people now have a 2-3 day wait in many cases for simple, common and essential items.

Pharmacists gave notice they were pulling out. They warned the HSE that they didn't think their contingency plans would be sufficient. They have fully co-operated with the HSE's contingency plans, referring their patients to the contingency dispensaries, and in some cases even arranging transport to them. Many are still continuing to provide advice to patients who have obtained their medicines elsewhere, and to check them for safety - without any recompense at all. What else can they do?

The HSE continues to insist they are on top of the situation and everything is fine. Clearly this is rubbish. They claim that 75% of pharmacies are still open and dispensing normally. Clearly this is rubbish too. So if they are so blatantly telling lies about this, do you not think it's time to question some of the other statements they are making? We know their record of patient care in the hospitals, and the lies and spin they have come out with in relation to numbers on trolleys. This is no different.

I don't know what work you do, but imagine for a moment that you are a pharmacist. You receive enough money to cover your business expenses, pay your staff, take home a salary to pay your mortgage. Then one day you hear - by a press release, not even a letter to you - that the payments made to you will be cut by 34%. This is not enough to cover all your outgoings. Are you seriously saying that you would accept these new terms and just keep going until you were bankrupt and prosecuted for reckless trading?

Frodi on boards.ie
Just further to the earlier question as why are pharmacies closed.

I am a pharmacist who has terminated my contract and I am closed. (This is why I now have time to read and post here again)
I opened my pharmacy 6 years ago and have built it up since. I don't do the snake oil/pseudo science products or cosmetics. My business is/was based on 80% prescriptions and 15% OTC meds. Without a GMS contract I am in a reckless trading situation (as would be lot of other recent owners). Company law says that I have to stop trading immediately if there is no prospect of a return to profitability.

It absolutely kills me to have to do this. But with the 34% cuts (actaully it is worse for me) I no longer can stay in business. This is aside from 12 days notice of the changes by way of a press release, the Dept of Health ignoring two of it's own reports (paid at tax payers expense) becuase Harney did not like what they said.
Pharmacists are willing to take cuts but it must be proportionate. 8% for other professionals and 34% for pharmacists. The Dorgan report said that any changes must be phased to allow for the industry to adjust. The current payment set up was 30 years in the making and should not be changed overnight. The HSE gave me 12 days notice but I had to give them 30 days. I and many other did and the HSE choose to ignore it/call it bluffing and did not make proper contingency plans. Even as late as last week they were threatening us that if we went ahead with our terminations that it would take 21 days to allow us to start dispensing HSE schemes again. So as things stand even if I wanted to accept their diktat I and all other pharmacies would have to wait 3 weeks to start dispensing as before.

All we want is proper talks with the IPU who I have paid to represent me. An independent arbitrator with binding arbitration with terms of reference not dictated by Harney. I am 48 years of age and this is the first time that I have been involved in any industrial dispute. All I want to do is to go back to running my pharmacy and serving my patents. It's not a lot to ask.

This previous thread here on AAM has information from pharmacists about the financial side of things which should address some of the questions and misunderstandings above.

Hope this helps.
 
I think the above is a load of one sided PR.

Question for pharmacists?

1. How come a load of independent companies want to collectively negotiate prices? What about competition law?

2. Why do we need loads of small pharmacies - in my area there multiple examples of small pharmacies trading next door to one another and loads of small pharmacies within walking distance of one another all with very similar prices? How come the prices are similar? How come the better ones havent come out on top and expanded - do we really need to have pairs of pharmacies next door to one another?

3. Why cant I get my prescriptions at a pharmacy counter in my local Tesco, Dunnes, Superquin etc. from a PAYE pharmacist and pay for them at the till with the rest of my groceries?
 
If you want answers, I think you really need to post in the boards thread where pharmacists can respond. I don't think any pharmacists are able to post here in Letting Off Steam.
 
If you want answers, I think you really need to post in the boards thread where pharmacists can respond. I don't think any pharmacists are able to post here in Letting Off Steam.

This issue was originally posted in the threads but was shifted to letting of steam. I am sure that pharmacists can post their own Q&A thread.... and if they feel the need to re-hash stats go ahead.... but maybe they could answer why the pharmacies who are listed on the HSE website as participating in the GMS and community drug scheme are closed since Saturday... tell us have these pharmacists withdrawn from the GMS/community drug scheme, yes or no.... and if yes why are these pharmacies not open to private non-DPS patients? Was the letter that these listed pharmacists gave to the HSE giving notice of their intention to renew/or not renew their contract of participation in the community drug scheme ambiguous? Did patients not have the right to know that pharmacists were shutting their doors on Saturday and where was pharmacists "duty of care" to patients so that they could make alternative arrangements? Have any pharmacists who are members of the IPU actually noticed errors and flaws in the dispensing of medication from the HSE emergency dispensaries... do they have a professional obligation to report these incidents under their code of conduct.... and what action did these pharmacists or the IPU take to actually report these incidents either to HIQA or the Pharmaceutical Society of Ireland who regulates your practice?
 
Seriously annet, if you want answers from pharmacists you need to ask these questions over on http://www.boards.ie/vbulletin/showthread.php?t=2055608548 (or read the most recent pages at the end of that thread). There's a very vigorous debate going on over there. Brendan and the other AAM mods have previously made it very clear that people can't just post in other sections to overcome the fact they haven't got posting rights in the Letting off Steam section.
 
Had a look at boards.ie ... and might just post and ask these questions. There's a similar thread on politics.ie.
 
I think the above is a load of one sided PR.

Question for pharmacists?


2. Why do we need loads of small pharmacies - in my area there multiple examples of small pharmacies trading next door to one another and loads of small pharmacies within walking distance of one another all with very similar prices? How come the prices are similar? How come the better ones havent come out on top and expanded - do we really need to have pairs of pharmacies next door to one another?

No price competition as:
  • Govt and suppliers agree on ex-factory price
  • Govt set the wholesale margin
  • Govt set the pharmacy cost price
  • Govt set the retail margins
I suppose a pharmacy is free to not charge the full margin, but I doubt this happens.
 
DublinTexas, Truthseeker,

are you saying that you or people you know have been paying more than the DPS limit each month for presciption drugs?

Surely the pharmacy should tell you?

Also, I can't believe that people don't know about this scheme.

Group me in the didn't knows and found out the hard way. I largely didn't know because I've never needed prescriptions until late last year. This is somewhat relevant to the debate, at least in my opinion.

I needed a month's prescription of what turned out to be an expensive medications. It would be €120 for the month. Just on that price: cost price for the pharmacist here for that specific drug is €20 per pack, 2 week supply in the pack therefore for the month's supply cost to pharmacist €40 cost to me €120. Incidentally the cost over the border for the same drug and in the same quantity is €1.20, and incidentally again the drug is now generic, wonder if the generic versions are being prescribed.

So that's the cost and mark up on that drug. when I went to pick up the drug, it was the last week of the month and the pharmacist (not the actual one he was filling in for holidays) stated in a concerned voice that this was a very expensive drug and why don't i just get half now so I only pay €60 and then get the rest in two weeks. Sounded fair enough so did as advised.

Of course only when picking up my second half did the usual pharmacist mention the scheme and gave me a leaflet. Unfortunately it had to be over €80 in a calendar month and as the pharmacist had advised half and half, I didn't qualify. Caveat Emptor.

I still think a mark up from €40-€120 isn't bad business. This doesn't include the rebates from the supplier to the pharmacist either.

All this fuss is about the medicard scripts. What proportion of the pharmacists' business is actually from medicard scripts?
 
Whatever anyone thinks about who is right, the bottom line as far as I'm concerned is that once again Mary Harney has failed in her job. As the manager she is reponsible for this farce and it has proven once again that she cannot manage. Anyone with a bit of cop would not have let it get to this stage, they would have ensured that everyone bought into whatever change was coming, through dialogue, long before the change came to pass. She tried to railroad this change through by bullying and now has a mess on her hands. I don't really care which side is right, as the manager she is responsible for sorting it out and she is failing miserably.
 
Whatever anyone thinks about who is right, the bottom line as far as I'm concerned is that once again Mary Harney has failed in her job. As the manager she is reponsible for this farce and it has proven once again that she cannot manage. Anyone with a bit of cop would not have let it get to this stage, they would have ensured that everyone bought into whatever change was coming, through dialogue, long before the change came to pass. She tried to railroad this change through by bullying and now has a mess on her hands. I don't really care which side is right, as the manager she is responsible for sorting it out and she is failing miserably.

Sometimes as a manager though, you have to force things through. It's not always possible to manage through concensus and agreement. Her job is to manage the health services as she sees fit. I am glad to see her stand up to the pharmacists if she thinks what she is doing is right. Now I wish she would do the same with the other vested interest groups in Health.
 
No price competition as:
  • Govt and suppliers agree on ex-factory price
  • Govt set the wholesale margin
  • Govt set the pharmacy cost price
  • Govt set the retail margins
I suppose a pharmacy is free to not charge the full margin, but I doubt this happens.

My understanding is that the core of this dispute is that the Government would prefer to tender for pharmacy services throughout the country. If it is tendered, it would lead to lower prices due to competition between pharmacies as obviously not all pharmacies would be successful in a tender competition.

The current position is that every pharmacy in the country has a "right" to be in the scheme and there is no real competition between them - they charge a margin which is agreed centrally with their professional body. Pharmacists see that a move to a competitive situation would mean lower prices and hence lower profit margins and also a large proportion of them getting nothing if unsuccessful in the tenders. The pharmacists are trying to protect their positions and this is essentially at cost to the State and their customers.

Now I also believe there are some side issues in the dispute that are adding to the confusion such as the mark-up on drugs. The use of wholesalers instead of buying direct from the drug producers - therefore creating an artificial wholesale market with consequential artificial mark-ups. And the usual issues such as restrictions on entry into the pharmacy business which mean that you dont have pharmacy counters in your local supermarket as happens in other countries.
 
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