Press Statement By PAA

Rules approved by the pharmacy regulator today will result in some pharmacies having to close on Saturdays. Thursday 20 September 2018
Today the Pharmaceutical Society of Ireland Council approved rules that will restrict the work practices of pharmaceutical assistants. If the new rules are signed into law by the Minister for Health, pharmaceutical assistants will no longer be able to provide professional cover for pharmacists’ day off. “It is not possible to get locum cover so if the pharmaceutical assistant can’t cover I may have to remain closed some Saturdays…It’s fairly disastrous for pharmacy in Ireland”, a pharmacist explains in research carried out to assess the impact of the rules on pharmacy services.
The report, Human Rights and Equality Impact Assessment of the Proposed Draft Pharmaceutical Society of Ireland (Temporary Absence of Pharmacist from Pharmacy) Rules, published today, points to a reduction in the availability of pharmacy services, with 76 per cent of pharmacist respondents reporting that the implementation of the PSI Rules will make it difficult to maintain the current services.
The impact will be greatest in rural areas, as reported by this pharmacist: “My qualified assistant has worked with us for 26 years and has always been highly professional in her work keeping up with developments. She is extremely capable. We have great difficulty in obtaining pharmacist relief, as the younger pharmacist prefers an urban workplace. If my workload increased I would strongly have to consider putting my pharmacy up for sale or failing that closing which would impact on the local community especially as our local GP has recently retired and his practice is looked after by a GP practice in the nearest town which is over 20Km away”
In addition, 248 pharmaceutical assistants will be deprived of their right to earn a livelihood, having worked in pharmacies dispensing medication for customers for over 35 years. Pharmaceutical assistants like Sarah explain how “I will be out of a job. I am only 60 and state pension only available at 67…I have two children in college…it will be a financial disaster…I need my work and my money “, Marie spoke of how “I still have a mortgage so am worried about keeping my family home as I am a widow with a disabled adult living with me”.For more information contact Deirdre Lynch, secretary of the Pharmaceutical Assistants Association (PAA) on 087 4103599.
The full report is available on the PAA website; the Irish Pharmacy Union (IPU) website, the National Women’s Council of Ireland website


PCRS Restrict Access By Claims Checker

The HSE has requested that Axium temporarily suspend access to the Primary Care Reimbursement Service claims analysis module of iGnite.  I understand that a similar move has been made in relation to McLernons claims checking system.  Call me an old fashioned conspiracy theorist but first we have the PCRS stop sending out paper copies of the claims and now they are restricting access by claims checking software.
It’s almost as if they didn’t want us to check that they are paying us properly.  (Which they don’t in the first place.)
And then again this might be all one big coincidence.

Savings on Biosimilars

The NHS is starting to achieve significant savings by switching to biosimilars.
Meanwhile we are knocking a few cent of the reference price of generic drugs in the hope that it will somehow generate millions in savings with no impact on continuity of supply.

If I didn’t know better I would say that the Dept of Health and the Government are frightened of Big Pharma.

Proposes Code of Conduct.

In a move worthy of Sir Humphrey the PSI announces not one, not two but three public consultations over the summer period.  Probably hoping that nobody would notice.

Here is a copy of my submission in relation the the Proposed Code of Conduct.

I wish to make the following comments in relation to the proposed code of conduct.

1. Always put the patient first.

Does this direction include the situation whereby the pharmacist may be making a (significant) financial loss by supplying a prescription. Many pharmacists are also company directors and as such have a fiduciary duty not to trade recklessly. Employee pharmacists have a duty similar to their employers. This would happen primarily with prescriptions paid by government schemes as private patients could just be asked to pay and then it is their decision if they wish to pay the extra. This gives rise to a clash of interests between the welfare of the patient and the viability of the pharmacy.

“3. Must recognise and respect patients’ values, diversity, beliefs and cultural identity and make sure they are treated fairly.

5. Must respect the right of the patient to refuse treatment or services”

Patients must also recognise and respect the pharmacists’ values, diversity and beliefs and respect the pharmacists’ right to refuse treatment or services. This should be qualified with a duty on the pharmacist to refer the patient to another pharmacist where they may receive the treatment or service.

Be Professional

” at all times, both inside and outside your work environment, ”

“2. Should look after your own health and well-being.”

Does this imply that pharmacists who choose to smoke tobacco, drink more alcohol than recommended, are obese and decline to diet, do not partake in the recommended amount of exercise per week, engage in risky sexual behaviour or partake in recreational drugs in jurisdictions where it is legal would be considered to be in breach of the code of conduct?

What if a pharmacist should decline medical treatment even if it would shorten their lifespan? Do we give up free will when we become pharmacists?

Pharmacists’ behaviour outside of the work environment is their own private business. When pharmacists hold themselves up as health professionals in their work environment then they should be subject to higher standards. When they are private individuals they are just that, Private!

“6. Should use social media and other forms of electronic communication appropriately and responsibly, both professionally and personally”

I repeat When pharmacists hold themselves up as health professionals in their work environment then they should be subject to higher standards. When they are private individuals they are just that, Private!

Demonstrate Leadership

“10. Should facilitate student learning to help them develop their professional knowledge, competence and confidence.”

Should indicates a strong recommendation. There must be no obligation to take part in any training of students or interns. It must be voluntary. Also it should be properly recompensed. A student would not go to college expecting free tuition. A lecturer working in a college would not expect to work for free. This should not be in the code of conduct rather it would be more appropriate to a contract of employment.

Maintain Competence

“1. Must comply with Continuing Professional Development (CPD) requirements.”

It follows that CPD requirements must be reasonable and rational.


Valsartan Recall

It must be slightly ironic that an email arrived this morning from the HPRA giving us a list of interchangeable Valsartan medicines.  All the more so since none of them are available or likely to be available for the foreseeable future.  It was best summed up on a pharmacy forum.

The following is a summary of the handling by the state quangos of the Valsartan withdrawal saga:

1) The Chinese are saying there’s an issue with one of their manufacturing plants processes. We know they definitely make ingredients for a few generic companies version of valsartan on the Irish market. Let’s announce on the airwaves that people using any of the generics listed should bring back their medicines to their pharmacy to be replaced with one of the ones that aren’t on the list.
2) We better tell the doctors and pharmacists about this as well , now that we put it on the news.
3) One of the generics that we thought wasn’t on the list might be affected as well now. We better quarantine that stock until they can prove otherwise.
4) We better say that other products may be added in the coming days as the picture becomes clearer(good thinking…that will cover our asses)
5) Excellent ..job well done.
6) Hmmm….pharmacies are reporting to us that there is no alternate “safe” stock available…interesting. Perhaps quarantining the stock we said was safe has contributed to this…hard to say
7) We better say that we never meant for anyone to bring back their tablets for switching , and clarify that we wanted them to bring the tablets with them for a show and tell day.
8)It’s now ok for patients to keep taking the contaminated possibly cancer causing tablets , but it’s not ok for pharmacies to keep supplying them….but if you have them already , keep taking them.
9) Wait, medicine management says to switch to candesartan.
10) The HPRA is now closed for the weekend, please call back Monday.

As for alternatives
Now the Medicines Management Programme have weighed in with their advice to switch to Candesartan, except post-MI, when specialist advice should be sought, as if making work for GPs and pharmacists isn’t enough.…nce-for-prescribers-on-valsartan-shortage.pdf
I would predict a Candesartan shortage, because I’m guessing they didn’t check if there were sufficient stocks to treat 25,000 additional patients, but given how much attention doctors usually pay to their advice (like simvastatin being the preferred statin) it might be premature to stockpile
Better batten down the hatches.

More On Garda Vetting

I’ve been thinking a bit more on this.

Many years ago the PSI stated that the ability to speak English (or Gaelige) was the responsibility of the employer.  Now they have finally got around to making it a condition of registration.  How many more years before they make Garda vetting a condition of registration.
I’m guessing 10 years.
I’ll have a running bet with myself.  Which will come first, Garda vetting carried out by the PSI or my retirement?  A pint for the winner.