So peace has broken out again

Not so much peace in our time but another ceasefire to allow both sides to re-group. The Dáil (read Fianna Fail, Greens and odd job independents) have voted confidence in Mary Harney’s tenure as Minister for Health. Were they ever going to do anything else? At least Ned O’Keeffe has some balls. Not a lot, he only stood down from the Parliamentary Party and not Fianna Fáil itself.

But it’s only a ceasefire, the cuts have been postponed (no mention until when) and not cancelled. They are back talking with the IPU via the Shipsey process but we have been there before. How are we to trust anything that is agreed this time. They reached agreement so many times only to rip them up the next day. Even if they were to produce a written agreement signed in blood over a stack of bibles in front of a bishop I would still take it with a pinch sack of salt.

I met with some colleagues last night. Out of that meeting the key word to come out was respect. Honest common decency. For the HSE eaten bread is soon forgotten. We got them out of a pickle when we took on the methadone scheme, we have been operating the medical card at break even at best for a long time and now they don’t even reply to or acknowledge our letters. Mary Harney wanted more pharmacies for more competition, she got them. Then what does she do but cut the base out of the business model. Any one in business will tell you that you can’t give stock away at less than cost. You can’t give stock away at break even unless there is some come back some where else. For the GMS at break even the DPS and LTI are the recompense. I like many others did out a business plan when I went to the bank to re-mortgage my home and take out a business loan. That business plan is now meaningless. How many other business people could re-structure their business at less than 3 months notice? This presumes that the business is still viable under the new scheme of things. How many would let their customers dictate what price they are going to pay without any negotiations?

I going to stop now. I’m making myself sick in the stomach the more I write. I want to at least enjoy my tea and sandwich that I will eat at my dispensary counter. For some reason today I don’t have the time to go to Thorntons on the Green for truffles and foie gras washed down with a cheeky burgundy.

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Labour Motion Off

The Labour motion for next week that was to be used for an amendment to the Competition Act has not been put back. They are going to use their private members time to table a motion of no confidence in Mary Harney.

😦

It still doesn’t change the chaos that is likely to happen on December 1st.

The Labour Party has tabled a motion in the Dáil for next week. the purpose of the motion is to exempt the state provided health services from the Competition Act. The Dept. of Health and the HSE have always said that the Competition Act stops them from negotiating with pharmacists (and dentist and opticians and doctors). Here is a way out of this for them. Lets see if they really want to talk or is this just another smoke screen.Meanwhile we have come up with another letter for patients, a bit simpler and straight to the point.

The General Medical Services (GMS) & Medical Cards

Currently the H.S.E. pay me for the cost price of your GMS medication , they also pay me a dispensing fee of €3.26 per item dispensed.

So if your medication cost me €50 to purchase from the wholesaler, the HSE would pay me €50 plus a dispensing fee of €3.26.

From 1st December, the HSE propose to reduce the amount paid to me by 8.2%. This would mean that the HSE would only pay me €45.90 for medication which would still cost me €50 to purchase from my wholesaler. The dispensing fee would remain the same.

My concern is that your local pharmacy cannot sustain dispensing GMS prescritpions while each prescription dispensed is losing money.

Please contact your TD’s about this worrying situation.

Sean Ardagh F.F. 01 4568736

Michael Mulcahy F.F. 01 4546223

Mary Upton Lab. 01 6183756

Aengus Ó Snodaigh S.F. 01 6259320

Catherine Byrne F.G. 01 6183083

Revised letter

After a bit of discussion and working out a few we have come up with a revised patient letter. It is quicker to prepare and reads easier.

Dear Customer,

For your prescription today my wholesaler will charge me €……………… The H.S.E. (Medical card) will pay me €…………….. plus a dispensing fee of €3.26 per item.

From December 1st the H.S.E. have decided to pay me €………………….. (cost price less 8%) plus a dispensing fee of €3.26 per item. My wholesaler will still be charging me €……………..

I cannot operate the Medical Card scheme at a loss.

In order to maintain your level of service please contact your local representatives, The H.S.E. And the Minister for Health.

Thank you

David Jordan

Local T.D.s

Sean Ardagh F.F. 01 4568736

Michael Mulcahy F.F. 01 4546223

Mary Upton Lab. 01 6183756

Aengus Ó Snodaigh S.F. 01 6259320

Catherine Byrne F.G. 01 6183083

Mary Harney 01 6354148

Prof. Drumm 01 6352500

Letter for our patients

Below is a copy of a template that I have prepared and printed on headed note paper. Thanks to Geraldine who did up the first draft. I think that it sets out starkly for individual patients how we are going to be affected.

Please feel free to copy & paste and use it yourself. I won’t claim copy right! 🙂

“Dear Customer,

For your prescription today my wholesaler will charge me €……………… The H.S.E. (Medical card) will pay me €…………….. plus a dispensing fee of €3.26 per item which amounts to €………….. for this prescription.

From December 1st the H.S.E. have decided to pay me €………………….. (cost price less 8%) plus a dispensing fee of €3.26 per item which will be €…………….. for your prescription. My wholesaler will still be charging me €……………..

I cannot operate the Medical Card scheme at a loss.

In order to maintain your level of service please contact your local representatives, The H.S.E. And the Minister for Health.

Thank you

Local T.D.s

Sean Ardagh F.F. 01 4568736

Michael Mulcahy F.F. 01 4546223

Mary Upton Lab. 01 6183756

Aengus Ó Snodaigh S.F. 01 6259320

Catherine Byrne F.G. 01 6183083

Mary Harney 01 6354148

Prof. Drumm 01 6352500″

So December 1st is still on!

Statements from the HSE indicate that the December 1st cuts are still on. Did my ears deceive me when I heard that in the Shipsey process that they were to be postponed until February 1st to allow for discussions. Ross Hathaway is quoted in today’s Irish Times as saying that the cuts MAY be deferred if agreement is not reached by December 1st.

This raises two issues. Firstly it now means that the HSE cannot be trusted to keep to anything they say. How can we have any faith in what ever they may offer in future negotiations.

Secondly where stands the IPU on all this? I don’t expect them to tip their hand for future discussions but a little reassurance would be nice.

I can’t spend any more time here, I have to go back to earning some money to pay the next instalment of my bank loan.

The substance of the motion.

I got a phone call from the IPU yesterday afternoon telling me how I could use a proxy for Wednesdays vote. I explained that how a single person used a proxy wasn’t the issue. Custom and practice has been for proxy forms to be sent out with notification of the SGM. The fact that no effort was made to alert members to the possibility or means of using a proxy if they were unable to attend calls into question the validity of any vote taken. I would politely call it “a procedural irregularity”. Also calling the SGM for a Wednesday afternoon in a city centre while being within the constitution is certainly outside the spirit of the IPU. Again the custom and practice has been to have AGM and SGMs on week end, usually a Sunday to enable the largest possible attendance. Holding it on a Wednesday strikes me as wanting the smallest possible attendance (probably all committee members) and having the least amount of debate. How does this stand with the IPUs calls for a full debate with the HSE. Do as we say and not as we do.
I’ve just got this months IPU Review and GM. There is a five line mention of the SGM tomorrow. No mention of proxies for those who cannot attend. The editorial in the Review is entitled “Who will represent us?” You could say the same for the SGM tomorrow. Who will represent those who want to attend but cannot? The silence on proxies makes one think that the IPU were trying to conceal from members that they could actually use a proxy.

Anyway to the substance of the proposed amendments. Most of them I do not have any great objection to. A bit of house keeping is always needed. However I do have a problem. Where I do have a problem is the proposal to limit membership in future to only those pharmacists who declare on their PSI return that they are primarily involved with retail/community pharmacy. In the past one of the strongest claims of the IPU is that it represented all pharmacists. I have been on many committees in the IPU where there was huge input from pharmacists who were not directly involved with community pharmacy. Indeed in the past we have had a president of the IPU who was not a community pharmacist. Did the sky fall in? Was there panic on the streets? No. It was a very good presidency. The IPU says that it cannot represent them fully, yes this is so. But those pharmacists are aware of this when they joined. However the way the SGM works is all or nothing, so for this reason I would oppose these changes.
I will not be using a proxy tomorrow as I feel that this would give credibility to an illegal vote. My feeling from this is that the executive is going to push ahead with this come what may. I would call on each and every member of the executive to stand up and say how they feel about the failure to alert members to the possibility of proxies. I would also ask the President to directly tell tomorrows meeting why proxies were not issued.

Where do we go from here, well that all depends on what happens at tomorrows meeting.

The proposed amendments themselves are not earth shattering but the way that it was handled makes it a black day for the IPU.