September ’11 Article in IP

Is Dr Reilly a Patriot?

When Dr Reilly was first appointed as our latest Minister for Health I wished him well in one of my blog postings. After the tragedy that was Mary Harney any new incumbent was going to have a tough time. His first round of FEMPI cuts while not quite bursting my bubble did leave a noticeable dent in my optimism. My (forlorn) hope at the time was that he was just implementing policies agreed by the previous administration. However his more recent decisions/actions has left me with the belief that we now have Mary Harney with a beard as Minister. The added twist is that while Mary just wanted an efficient HSE (pity it had to deal with all those patients) the good Doc doesn’t want to upset his mates while he is gutting the nations health service. The Dentists have been decimated by the cuts in the PRSI and GMS dental services. Pharmacists are in the midst of our own evisceration with lots more to come by the look of things. But I have yet to hear any of the docs complain much.

As I sat thinking about the cuts it occurred to me that they are in essence unpatriotic. Let me elaborate. The most straight forward definition that I came across of a patriot was “A person who vigorously supports their country and is prepared to defend it against enemies or detractors.” So I asked myself who is most affected by these cuts. Yes all pharmacies in the state are affected but one group in particular is being hit hardest. The small independent. The bigger chains can demand better discounts and have more lee-way to absorb cuts and good luck to them. It is the small independents who will be hardest hit by round after round of cuts. These are the folk who live in the communities that they serve, pays their taxes to Enda & Co and then spend whatever money that they have left over locally. Not so for the foreign owned chains. Yes their employees spend their money locally but the corporate profits leave these shores.

But why would the hairy faced doctor bring in a policy which favoured foreign owned chains over Irish owned independents. Those of you who know me would be aware that I have a fairly jaundiced view of politicians. If I saw one lying on the side of the road I would most likely reverse back over them to be sure, to be sure. I don’t believe that any politician would take a decision like this without first thinking it through. “What are the ramifications of this decision?” or cutting to the bone “Will this lose me any votes?” If they did not think like this then they would not be worthy of our support. I think that somewhere within the Department of Health that some mandarin has done this thinking and this is what they have come up with. I think that the Department or the HSE would like to see a pharmacy sector dominated by chains. Why? Go back to the dispute of several years ago. Who were the pharmacies who handed back their contracts? Small Irish Independents that’s who. Who gave the HSE a lifeline? Foreign owned chains. Have a guess which the HSE would like to prosper and which would they like to fail? No I doubt that this is official Department or HSE policy. I do not think that you will find this in writing anywhere. But this is Ireland and we are all well aware how these things operate. Where it is in their control they steer new patients towards the chains. While I might decry this from here the tactician in me tells me that this makes sense from a HSE point of view. Concentrate as much of your business as possible with those who will not strike out against you in any shape or form. Kill off the weaker elements and consolidate the sector into stronger units. Sure patient service will fall as smaller pharmacies are killed off by being made uneconomic. But compared to the fall off in public services generally and small hospital closures this will be trifling. Anyway who is going to notice pharmacies closing down and going out of business when all sorts of other concerns are going to the wall on a daily basis.

The gist of this argument took a small step backwards when the hairy Doc announced that pharmacists would be able to administer the flu vaccine this year. This, if it happens, will be a great step forward for pharmacy professionalism. However the cynic in me popped up over the parapet and said that this is just a bargaining ploy to get the docs to agree to a lower fee for vaccination. Already the docs are making noises about patient safety and what happens if there is an anaphylactic reaction. However the fact that Department officials met with IPU personnel has to be seen as a positive move.

That is why I feel that Dr Reilly is unpatriotic. I doubt that he is being consciously so but if it walks like a duck and it quacks like a duck I’ll get the orange sauce ready. He is standing over decisions and policies which are to the detriment of service levels to the Irish public and which favour foreign companies over Irish men and women. All of the above assumes that the good doc is actually in charge of the Department. It could be that he is just a figure head applying the policies determined by the IMF or the EU. Even if this is the case there is still a lot which could be achieved on a friendly basis if he just sat down and talked turkey with the various representative bodies. The European Court has already held that these meetings are not in breach of the competition law. It’s time for him to stop hiding behind the Competition Authority. It’s time to stand up for yourself. Are you Mary Harney with a beard or James Reilly in a frock?

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