May the force be with you. A walk on the dark side.

There’s a wonderful article by Richard Collis in this month’s IPU Review.  I would love it if the IPU would make a pdf of it available and I could post it here.  (Or maybe they might post a copy on line themselves.)  He writes about his experiences on the PSI Council and the dysfunctional attitudes that seem to hold court there.  Things like despite the Corbally judgement the reluctance to use mediation because they want to be seen to be tough.  No regard to costs.

I am impressed by one of the closing statements.  “One final reflection: could it be that the culture of control among the Executive also reflects a lack of confidence in their ability to sustain their own views in a more open and combative forum?”

If you have a copy of this months Review I would recommend reading and studying it.  If not, get a copy.  It vital to all of our professional futures that we understand what is going on in Fenian St.

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A minor illness scheme

Here’s a nice piece from The Pharmacist, a UK journal for pharmacists.  It talks about the benefits of a minor illness scheme in the UK.  There has already been a trial here in four towns but little more seems to have come of it.  There is huge potential for improved services for patients and savings but I doubt that the HSE will be able to see beyond the end of next month’s budget.

PSI Practice Reviews

So this is the latest whizz bang crock of shit that the PSI has come up with.

“Selected” pharmacists have to undergo a review of their practice in the RCSI over a weekend soon.  Now these are not pharmacists who have had any issues raised over their competence.  Just everyday Joe Soaps who have declared on their annual return that they are in a patient facing role.  And what do they get in return?  Nothing! Not even expenses.  We have a quango regulator with fees that are more than 10 times the equivalent anywhere in Europe, sitting on a reserve of more than €10 million and they can’t even pay the expenses for a self employed pharmacist to travel to Dublin.

This assumes that they can get to Dublin and back in one day.  Bad luck if you live and practice (and provide a necessary service) in some of our beloved islands more extreme regions.  These poor sods can throw in an overnight stay as well.  And what happens your pharmacy while you have this jolly to Dublin?  Closed?  No, you’ll have the PSI down your neck for that.  No, it’s a days locum presuming that you can get locums in your part of the world.  More expense.

Why just Dublin?  Why can’t they have this interrogation in any other part of the country?  Woe betide that these semi-civil servants may have to leave their plush surroundings and get their feet dirty.

There is no other profession, certainly in Ireland at least that has to put up with this crap.  Remember as I said above this is not for pharmacists who have had any complaints or concerns raised about their abilities just Joe and Josephine Soaps taken at random from the register.

What will they think of next?  Sitting in on patient consultations, charging us for inspections, publishing inspection reports in the media, publishing review reports in the media?  I ‘ve no doubt that some of the geniuses in there have already considered these.  This is regulation gone mad.

What if you decided not to attend or cooperate?  Well that’s just what a GP did recently.  http://mobile.medicalindependent.ie/page.aspx?contentid=100086 The Fitness To practice committee made no adverse findings against him so it seems that powers are limited in this.  The worst that seems can happen is just bullying by the PSI.  “We’ll put you through the ringer and make you sweat even though there is little we can do in reality.”  Classic bully boy tactics.  CORU who regulate the other professions have put their CPD of registrants on hold bacause of legal concerns.

This is regulation run mad.  The PSI has 10 times the number of staff of it’s equivalent in Northern Ireland and 10 times the fees.  They have to dream up shite like this to justify their existence. Things like the Pharmacy Assessment folders are another example of them trying to find ways to spend money.

All of this is overseen by a Fine Gael Minister for Health.  Remember FG are supposed to be the party of business.  Here they sit content to watch mainly small businesses being pommelled to the ground by a regulator running out of control.  Normally here I would finish by saying “Shame on you” but I’ve no doubt that politicians and civil servants have long since lost the notions of shame.  Don’t get me started on what has the IPU done for pharmacists is this situation.

HSE Wastes More Money On Consultants

The HSE are set to spend a load of public money on consultants basically to get them to say what they want to hear.  The tender looks for a review of pharmacy fees using amongst other things comparisons with other countries and discussions with key stakeholders.   Surprisingly enough the key stakeholders don’t include pharmacists or our appointed representatives the Irish Pharmacy Union.  Neither do the terms of reference include FEMPI which is still in force for pharmacy along with many other parts of the public service.  They might even want to have a look back on the Dorgan Report that did exactly this several years ago.  I guess that they are a bit afraid of their own expert groups opinion.

How much money will be wasted on this self serving report which will in all likelihood have to be scrapped because they won’t even talk to those at the coal face.

 

Link to tender document

 

 

Phased prescriptions

Just a quick piece of background.  When pharmacists dispense a medical card prescription in phases (usually weekly) we get paid an extra fee of €3.27 per phase.  Over the last few months the GMS have been making us jump through hoops to get this.  Despite meeting all the GMS’s self imposed requirements they currently reject payment for about 20-25% of these claims.

Today they introduced a new hoop.  I will quote from another pharmacy forum.

It gets better.
The circular says that a pharmacist can apply for phasing where they carry out an assessment of the patient’s needs and decide that, in their professional opinion, phasing is needed. This professional judgement must then wait until the next working day (i.e. 4 real days in the case of a bank holiday weekend. Days when a patient needs medication.) for the approval of a person who has never met the patient and knows nothing about them except what can be conveyed in a few sentences. If the application is rejected it can be appealed to the local HSE pharmacist who will need written evidence of the assessment which was carried out. Apparently we need to take out a sheet of paper and write down the factors that made us think a confused elderly person living alone on a pick-mix of medicines might not be able to manage. We should also write down the dates of previous occasions when they got mixed up and took too much or too little of their meds. We really have nothing else to do when we get a 10 item hospital discharge script late on a Friday evening.

Meanwhile a doctor can get automatic approval without even having to give a reason and without making any attempt to reduce or rationalise the drug regime in order to make it easier for the patient to manage. In many cases the need for phasing stems from inappropriate prescribing that we have no ability to tackle.

Perhaps they are happy for a confused patient to get a full supply of their medicines, lose them or get mixed up and then have to get duplicate supplies or perhaps for an unstable psychiatric patient to get a potentially lethal quantity of tablets.

It seems that they are doing their best to get the whole medical card system to implode.