Mary washs her hands of Pharmacists and medical card holders

For the past week many medical card holders in the state have had significant difficulties collecting prescription medicines because of a dispute between the Department of Health and the pharmacists association (IPU). Effectively the minister has unilaterally cut payments to those chemists who administer drugs to medical card holders. Nobody likes when a unilateral cut in income has been imposed by a minister, as any public servant paying the pensions levy will quickly tell you. Minister Mary Harney has been her own worse enemy on many matters for some time and she has lost the confidence of the people because she has no mandate from the people.
However that does not necessarily mean that the chemists have the full support in the community. For a few weeks I’ve watched from the sideline while their medical card patients have had to endure great hardship to get medication. Essentially the patients have been used in a row about money to see who’ll blink first and come to the table. The facts are that the state has got poor value for money from administering, purchasing and dispensing drugs to medical card holders. It seems that for a long time the gravy train chugged along merrily. At one stage restrictive practises prevented competition between chemists and pharmacies had to be located a minimum distance from one another serving a verifiable need.
The market has changed hugely since towns have expanded and farming has reduced somewhat. The increase in competition from chains like Boots or McCaughley’s, increased rents on Main St and the establishment of a new school of pharmacy increasing the number of entrants to the market have led to extra outlets in the business. To set up a chemists shop needs compliance with the law in terms of premises location as well as the need to provide a qualified pharmacist on site. There are enormous costs but as long as the population climbs there’s something there for everyone. As part of the business mix, toiletries, drugs to medical card holders as well as non holders of cards and veterinary medicines will contribute to the chemists income. A pharmacist is a business person first and foremost.

However it is not sustainable to continue funding the drugs scheme as it is. Other professionals providing services to the state have seen professional fees cut and in some cases payment deliberately retarded. Pharmacist revoked their contracts to provide medical card holders with drugs, as is their right, to protest against how the department had treated them. If teachers had gone on strike when the pension levy was brought in, we’d have been accused of holding the children’s future hostage (as we were once accused by a parent’ rep). Chemists say that their income will be cut by 34%. I accept that they have overheads, staff to pay and so on but any chemists who I’ve passed by in the last few weeks are doing very little business as most of their customers are down in Boots getting their medication. How sustainable is it to tell the bank that is itself crucifying business by refusing to release money that you’re paying staff the same amount to do less work on an ongoing basis? Chemists feel that they have the department by the throat and that to set up an alternative outlet dispensary the HSE must locate enough qualified chemists and suitable premises to comply with the law. A hard job for the department, but not impossible. During the 2001-02 teachers dispute the Department of Education found a way round our threats on substitution and supervision and I would argue that teaching has suffered since. Chemists should learn from the mistakes of others before they irreversibly damage their industry. Once changed it’ll never return to the way it was before.

My sympathies are entirely with the patients on this one. As long as the stand off continues the more likely it is that chemists will lose good customers and that rationalisation of the industry will see the consolidation of chains at the expense of family run pharmacies in Ireland. There are other issues such as the use of generic drugs in place of branded one and the relationship between the industry and the HSE but these won't get discussed during the dispute. It’s time for the pharmacists to re-open, take up their contracts again and offer to negotiate with the minister. Anything else causes hardship to those who need it least.

Skin and hair fly over Harney hair do!

I just wonder if Mary Harney's discomfort at revelations that FAS paid for her hairdressing during her visit to NASA in 2004 has not given some early Christmas cheer for FF backbenchers. I suspect that the timing of these revelation is entirely connected with the reality that Ms Harney no longer has the support of a political party and she remains in cabinet at the plesaure of An Taoiseach Brian Cowen.

Ms Harney is particulalry vulnerable on this issue given that she is marreid to the then chairperson of the FAS when she undertook the trip. My only interest in this mater is why was the bill not paid by the minister and covered on her own expenses? Ministers have their own genreous expenses schemes, indeed the sum which Ms Harney is now facing sleepless nights is much less of the amounts paid by the state to powder Bertie Ahern's nose while he was Taoiseach. Mr Ahern seems to have gone from strength to strength in the meantime.

Anyhow, judge for yourself whether the haircut was worth it. The accompanying picture was taken at the time of the minister with her entourage and is available on the NASA website.

Prevention always better than a cure

A couple of years ago when I first heard of the anti-cervial cancer jab my immediate response was that with 2 young girls in the family there could be no better life long gift parents could give than the anti-cervical vaccine. The cost of about €350 per child was I thought well worth it as I could (and still can) well afford it. Every year about 80 women die of cervical cancer and while the vaccine is not effective against 100% of the causative agents of the cancer, I believe that any parent would want to protect their child’s life, long after the child has become an adult and indeed well into later life. When I grew up I lived near a polio hospital and played football against the teenage residents. It is quite extraordinary that due to scientific advances and vaccine, polio is now effectively extinct in Europe within the last 35 years. It is natural for a parent to do what they can to protect their child regardless of cost.

That’s why many parents are astounded by the latest cut back announced by Mary Harney, the Independent FF Minister for Health & Children. Taking advantage of the media spotlight on the US presidential election, Minister Harney announced the axing of the programme to immunise 12 year old girls against cervical cancer. Her reason? She can’t spare the €10M. It's not so long go during the Foot and Mouth Crisis of 2001 that when the suggestion of vaccinating livestock against FMD was floated and there was no suggestion of a prohibitive cost.

The matter was raised this week in the Dail and the FF/Green response was that instead there will be a screening programme for cervical cancer. This line was successively pushed by FF, Green and independent TD’s including one who recently resigned from FF. Where have these TD’s been for the last year? Were there not a number of inquiries precisely because cancer screening has failed due to the lack of investment? In one case Mary Harney’s office had been contacted by a specialist in Port Laoise outlining his concern at his equipment. Would it not be more efficient to both screen those who are outside the age cohort that are best suited to the vaccine with up to date equipment and vaccinate all 12 year old girls? Why should we tolerate the inevitability of contracting a condition when it can be prevented.

The view that you take the cheap option wasn’t thankfully that of Barry Desmond when he sanctioned the MMR. We had a case in this country where the blood bank took the cheap option and haemophiliacs contracted AIDS as a result. FF of course have form in this area, calling an early general election 20 years ago rather than give money voted by the Dail to the same haemophiliacs organisation. At the back of it all is the reality that someone like me who can stick their hand in their pocket can protect their daughters while those that cannot will never be sure that their daughter’s can be safe.

When Noel Browne discussed his Mother & Child scheme with the hierarchy they grudgingly accepted that the “necessitous poor” could be protected. The new right in FF & the Greens don’t even concede this. Dr James Deeny, Browne’s Departmental Secretary, wrote about his experience in the Department of Health in “To Cure is to Care”. Fundamental to his approach was a view that no woman should be at the mercy of extreme poverty and lack of care. He concluded that when people talk about closing beds and hospitals what they are really talking about is ending services that sick people need. One wonders how long more Minister Harney has to serve but it’s certain that in years to come we won’t be reflecting on her time as a golden era where services flourished.

Electorate deserve better PD exit than Grealish's farce

Recently when I’ve listened to discussion about the PD’s viability I’ve remembered how when I was a child my father brought me to see Vanessa Redgrave in “Mary Queen of Scots”. As the inevitable execution scene appraoched at the end I closed my ears and covered my ears as Mary climbed the scaffold. After what seemed an era had passed I nudged my father and asked at the top of my voice “Is Mary's head off yet?”. The audience broke out laughing. Lets be blunt about the PD’s. The party’s over since May 2007. No party could recover what happened to them. The absence of a grass roots structure accelerates the inevitable. Society has moved on. The will he won’t he farce of the last few weeks only prolongs the agony.

To be fair they’ve had achievements; Harney banned smokey fuel, Liz O’Donnell raised ODA, Bobby Molloy deregulated taxis. McDowell defended Mary Robinson when she was the victim of a crass attack by Padraig Flynn. Their support for divorce, O’Malley’s stand by the republic speech was important. But in recent years the decision to accept Justice & Health in the 2004 reshuffle seemed to have promoted the terminal decline. Co-location defined them and a Fianna Fail that is happy for the PD’s to take the flack for the HSE. They also provided the cover for FF to drive privatisation, tax cuts and to prioritise economic activity at the expense of societal activity.
What intrigues me is that recently they are in negotiations with Fianna Fail and reports are that they will merge with FF. In the unlikely event of these breaking down where will they go? Whatever about the PD’s what does this say about Brian Cowen? This is the politician who told the FF faithful “When in doubt leave them out”. Now it seems that soon we’ll see a permanent temporary little arrangement. Where does this leave Fianna Fail?

What does Fianna Fail actually get? Happy to facilitate the demise of a party that doesn’t threaten it, allowing Mary Harney the plum job of commissioner, perhaps gaining about 20 council seats and the post of Health Minister, the very department that Brian Cowen once described as Angola because there were so many landmines. I must admit to being bamboozled as to why the 2 parties are in negotiations. What is there to talk about from a Fianna Fail point of view? In 2004 FF did so poorly they surely cannot go lower in 2009. So why do they need to merge potentially upsetting FF candidates with new running mates when they could hope to see them off in the election. As any Labour member will tell you a merger doesn’t mean that the voter will follow the party they supported before the merger.

I suspect that while the parliamentary party may want to merge that ordinary members will be reluctant to go into FF. I understand how they might feel. I think the charade engaged in by Noel Grealish makes ordinary members less enthused about merging. For any member of a party that’s in its death throes the final obsequies should be their own business, however would ordinary ex-PD members be welcome in Labour? If they were happy to support our policies, I could live with that and wouldn't loose my head. Unlike poor old Mary Queen of Scots!