22 March 2007
Dr. Henry: The Minister has gone a long way towards addressing the concerns expressed by many Members during the Second Stage debate regarding both the enormous profits that can be made by individuals and public safety. As the Minister has recognised, it is essential to have a division between the prescriber and the dispenser. I am concerned as to whether the legislation will be retrospective, as a significant number of premises have already been built. For example, amendment No. 62 refers to "premises which, although separate ... are such that public access to the one is available only by way of the other, or ... share a common public entrance with each other". I know of several such arrangements. Will this provision cover them?
Key money, that is, money given to get close to health care centres in the first place, appears to have been a major issue. While it may be included in the Minister's amendment, I have not yet managed to pick it out. Key money appears to have cost between €1 million and €3 million. This would constitute a good start.
I was alarmed by a comment I read in an interview given by a former adviser to the chief executive of the Health Service Executive regarding the Touchstone project in Carlow, which Senator Browne has mentioned. He stated that in respect of the project, he was faced with the opportunity of being able to buy suites at a cost of 20% of their value. As an investment opportunity, it could not be matched by doing things privately. Who is paying the other 80%? Why are such suites being sold off so cheaply? There is no such thing as a free lunch. Such a development alarms me and I do not know whether the legislation covers it.
I am not being picky with the Minister regarding the lateness of the amendments. However, they are vitally important and at the nub of the issue. However, I cannot find a mention of either issue in them. Moreover, is it necessary to specify who will describe what constitutes reasonable rent in an area? Reasonable rent for a newsagent would not be the same as for a pharmacy, in which one stocks goods of a much higher value and so on and for which greater security is needed. This is of some concern to me.
The Minister has attempted to cover, to the best of her ability, the juxtaposition of pharmacists and doctors by getting their respective professional bodies to deal with them. However, I am concerned that the issue of key money does not appear to be covered and I am worried about the retrospective position. Who is paying for the suites being sold at such a cheap price? How will the issue of reasonable rent be worked out?
With regard to Senator Browne's final point I did not think an economic link would exist between the doctor and the pharmacist. I want to know why such generosity is shown by selling the suites at 20% of the market value. Somehow the other 80% will be paid. I support the Minister with regard to generic drugs. Senator Ryan is correct to state this may reduce competition enormously. From what the Minister stated, I feel she is not in a position to stop a pharmacy opening in the same building as a medical centre so that is that and there is nothing we can do about it.
I am also concerned about the fact that many medical centres are built on the fringes of towns because property is not so expensive there. We will have a situation whereby a pharmacy within a desirable medical centre will receive far more business due to convenience. The matter of allowing key money is very important.
Dr. Henry: I wish to discuss the definition of a retail pharmacy business. Am I clear in understanding a retail pharmacy business will cover hospitals?
Ms Harney: No. We are not making hospitals retail pharmacy businesses. What we are covering is a situation where hospitals supply drugs to outpatients, as happens with certain drugs. A person has to come back to hospital for a certain anti-depressant drug called Clozaril, which requires the taking of a blood test every two weeks because it can be highly dangerous. This can only be done in a hospital environment. There are issues surrounding premises and the pharmacy in a hospital for which we are not legislating. It will be a major task, probably to be dealt with in the next Bill or perhaps through the licensing regime we hope to introduce for hospitals. A pharmacist practising anywhere is covered by the provisions of this legislation but we are not making hospital pharmacies into retail community pharmacies. Somebody asked me the other evening if that was the case; we have had the issue clarified and it is definitely not the case.
Dr. Henry: Will all hospitals--
Ms Harney: They will be included in the register.
Dr. Henry: Will people working in all hospitals be encouraged to register with the society?
Ms Harney: They must do so under this legislation. As I understand it, they notify the society but will now have to register.
Dr. Henry: Will smaller clinics such as fertility clinics be included?
Ms Harney: Yes.
Mr. Leyden: It is important to clarify that hospitals have two types of pharmacies. For example, in St. James's Hospital, there is a public--
Ms Harney: The retail pharmacy will be covered in the normal way.
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