February 2013 Article in IP

Manpower, where are we and where are we going?

In last months article I wrote that there was no longer a shortage of pharmacists. Certainly any pharmacy owner looking for a locum or new staff will tell you that. What I hope to do in this piece is to find just what is the situation in relation to pharmacy manpower in Ireland. I am using the term manpower generically as pharmacy in Ireland has a very high rate of female participation compared to other industries.
So how many pharmacists are there in Ireland? To find out I turned to the organisation who should know, you’ve guessed it my favourite quango, the PSI. So I sent them an email asking if they could tell me the number of pharmacists and pharmacies in the register at the start of each year going back to 1998. I didn’t even want them to have to do any work. If it was available on their website then I would dig it out myself.
“The full information you are looking for is not readily available but we can provide you with the following details-
There are currently 1707 Community Pharmacies registered with the PSI…..”
No mention of the number of pharmacists currently on the register at present never mind in the past few years. But I don’t want this to be a rant about the PSI so I’ll move on.
FÁS and the various Pharmacy Technician organisation were much more helpful. FÁS reported that in 2004 there was 2,500 pharmacist/pharmacologists employed. In it’s report it stated that the shortage at that time was not being addressed and was being made worse by the elderly age profile. In short there was a lot of elderly pharmacists and they were retiring or dying off. By 2006 they reported that the numbers employed were 2,800 and they wrote that the shortage seemed to be addressed by the opening of a second school of pharmacy. By 2012 they reported numbers employed at 3,300 with 68% of them female and a growth rate of 0.4%. The low growth rate was probably a reaction following the explosive growth of 33% since 2006. But will this low rate continue? I doubt it. There are currently three schools of pharmacy in the Republic. Between them they have in the region of 175 graduates each year. In the absence of deaths or retirement this represents an additional 5% to the workforce each year. FÁS estimates that in normal circumstances a replacement rate of 2.8% is all that is necessary. Going back to 2006 we had an elderly profession, but now we have an age profile skewed towards the young. Basically deaths and retirements are going to be lower and a replacement rate of 5% is way too high.
These figures alone should be ringing alarm bells but I haven’t even mentioned pharmacy technicians. The first courses for technicians started about 20 years ago. I think that this was partly a response to the shortage of pharmacists particularly for hospitals. Also with the reduction in the numbers of extemps being dispensed means many prescriptions could be easily be assembled by technicians before being checked by the pharmacist. There are currently 1,346 technicians reported to the PSI on annual returns. Of these approximately 215 are working in hospitals. At present I know of four courses for technicians in various regional I.T.s as well as the IPU’s distance learning course. There about 1,600 who have gone through the IPU’s course so it would appear that many technicians are not reported as such to the PSI. Between all the courses I estimate that there is somewhere in the region of 150 new technicians graduating each year. Again this is a replacement rate way above what is needed. While technicians cannot directly replace a pharmacist it is the case than particularly in larger pharmacies which may employ several pharmacists that it may be possible to employ two technicians for the same salary as one pharmacist. Perhaps this may be part of a plan by the PSI to require the presence of two pharmacists in each pharmacy at all times. It is the case that many of the added value services such as M.U.R.s and Vaccinations, that many pharmacists are looking at effectively require double cover while they are being carried out. But I’ll save my conspiracy theories for another forum.
So what are the implications? Well there has been downward pressure on salaries as a response to straight forward supply and demand economics. This is combined with the downward pressure being exerted due to the HSE cutbacks which have hit pharmacy disproportionally and the recession that exists with retail generally. This is particularly hard for those who studied pharmacy as a second degree. They would have funded this themselves from savings or loans and now are finding it difficult to make things pay. FÁS does not report the figure for unemployment for pharmacists but I suspect that those not working are smart enough to turn their expertise elsewhere. I know of some who did pharmacy as a second degree returning to their first profession.
And what of the colleges? I would expect to see a drop in the CAO points needed for pharmacy. Not immediately but certainly over the medium term it will no longer be necessary to achieve seven A1s to study pharmacy. I feel that there will be an increase on those studying pharmacy because it is what they want to do rather than because of the exaggerated salaries that have been reported.
There is also an implication for the Department of Education. In the UK the NHS funds and effectively decides how many places that there will be in universities for pharmacy. The PSI and HSE would not have similar input here but the Department of Education currently funds three schools of pharmacy. In these recessionary times does it want or need to continue this? From a government point of view could the money be better spent elsewhere? I feel that the time has come to discontinue pharmacy at one of the three universities. But which one? If this decision is taken I have no doubt that there will be much back stabbing and in-fighting and we will see the survival of the politically fittest but not necessarily the best.
I am reminded of a conversation that I had with a colleague about the School of Pharmacy in U.C.C. “Why does Cork have a school of pharmacy?” I asked. “Because Dublin has two boy!”

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