National Pharmacy Summit - Opening Address

Good morning Minister, members of the Oireachtas, distinguished speakers, guests and colleagues.

On behalf of the Council of the Pharmaceutical Society of Ireland, it gives me great pleasure to welcome you to this first ever, National Pharmacy Summit.

I am particularly pleased that the Minister has taken this opportunity to address us at such a crucial time for the future of the profession of pharmacy and pharmacy services in Ireland. Since taking office Minister you have dedicated considerable time to legislative reform within the healthcare sector and the proposed Pharmacy Act promises to be the most significant piece of primary pharmacy legislation for nearly 50 years. Outdated Victorian legislation has no place in a modern high-tech health system. A new, enabling, robust and modern single composite piece of legislation is now imperative if patients and the public are to be properly safeguarded into the future.

The profession of pharmacy contributes significantly to the health of our people. It is a unique and valuable resource within the health service that provides a high quality service to patients and communities. Medicine utilisation is complex and the profession of pharmacy is centrally positioned to ensure the minimisation of risk and the optimisation of benefit to patients. Pharmacy provides a highly accessible resource for the public who continue to enjoy high levels of confidence in the profession and the service they provide in the community, in hospitals and in industry. Pharmacy in Ireland is now at a crossroads and it is our objective today to clearly identify the way forward for the profession and address some of the issues that must be at the core of the Minister’s legislative programme.

Minister, we are in a position to support the enhancement of access to care and treatment for patients. We are the profession best placed to support new home-care and self-care systems. We have the potential to lead the development of best care solutions in the community, in hospitals, in nursing homes, and in prisons. We bring real professional expertise to all of our patients, especially to those with complex medical conditions such as heart disease, endocrine disease, and chronic illness. We contribute to animal health in veterinary pharmacy practice. We make a significant contribution to the Irish pharmaceutical industry. In truth, it can be said that pharmacy services and pharmacists contribute significantly to the health and social well-being of this country.

How the health professions are regulated and held accountable in Ireland is due for modernisation. The Society’s Council is conscious of the recent health scandals both at home and abroad that are amongst the catalysts for this long overdue change. The Judge Harding-Clarke Report into Our Lady of Lourdes Hospital in Drogheda, the Dame Janet Smith Report into Shipman and the Kennedy Report into the Bristol affair all place great emphasis on proper clinical governance arrangements that are essential to ensure such scandals are avoided. Pharmacy is no different. We know that change is essential and we welcome it. We require and endorse the necessity for a modern legislative framework that protects patients and the public – one that fully addresses their needs and one that provides for accountability across the whole system of care.

From the perspective of patient safety and public protection, a modern pharmacy regulatory system must include modern Fitness to Practice provisions for pharmacists and corresponding Fitness to Operate provisions for pharmacies. A Fitness to Operate regime will ensure all pharmacies in the State meet the minimum required standards necessary to protect patients and the public. These regimes of Fitness to Practice and Fitness to Operate must cover community, hospitals, nursing homes, and prisons, and any other location where pharmacy services are provided and must be provided for in the same Pharmacy Act. The current law governing pharmacies and their ‘keeping open shop’ does not protect patients in hospital networks; in prisons or in other residential facilities. To have effective patient safety and public protection, the environments in which professional health services are provided must be licensed and regulated. The lessons from the reports I mentioned earlier clearly illustrate the need for the Minister and the Oireachtas to deal not only with the health professionals but with the environments in which they practice in a single composite Pharmacy Act. It is highly likely that further scandals will emerge unless there is a joined up approach to the regulation of both the professional and their practice environment. It is quite simply unworkable to regulate the pharmacist without the regulation of the pharmacy. It would be the equivalent of regulating only the pilot and leaving the aircraft, the air-traffic control, the airspace and ground-space unregulated. Our veterinary colleagues and veterinary services are already regulated by such comprehensive legislation. Surely the patients and public of Ireland are entitled to have similar safeguards applied in healthcare.

The pharmacy sector will soon be subject to fitness to practice and fitness to operate provisions. However, whenever a professional becomes subject to a fitness to practice hearing, the system has failed. It has failed for the patient on whom some calamity has occurred that has triggered a fitness to practice case. Any system of fitness to practice or fitness to operate must be aligned with a competency assurance regimen that provides an early warning system for the professional and the regulator so that shortcomings in a professional’s performance can be identified and addressed before such calamities and failures occur. At present competency is only measured at the point of registration. This is not sufficient for pharmacists involved in irreversible care and treatment regimens who may practice for 50 years or more. The advent of technologies and therapeutic regimes of increasing complexity such as pharmacogenetics requires the profession to embrace continued professional development and lifelong learning. Competency must be demonstrated and maintained. Such competency assurance provisions must be robust, reproducible, inclusive of all pharmacists, universally applied and tailored to meet the needs of the Irish healthcare system. The public deserve nothing less.

There are significant challenges for all of us in the pharmacy sector. Going forward the Pharmaceutical Society of Ireland must be fit for purpose and fit for a leadership role. We welcome public interest participation and patient participation in the regulation of our profession and pharmacy services.

We, as pharmacy professionals, face the future with confidence. We recognise that there will be new roles, developing roles, and new players in front-line care in the decades to come. Pharmacy too will continue to be at the front line and requires a modern enabling legislative framework. Proven regimes of care, supported by effective regular clinical audit and effective clinical governance, will be the norm in the Irish healthcare system of the future. This will undoubtedly enhance the quality of care and treatment available to Irish patients. This could be further enhanced were there formal links between the various regulatory and governance frameworks for healthcare professionals in this country. In introducing new legislation to regulate the practice of pharmacy, medicine and other healthcare professions in this country, I ask you, Minister, to consider including provision to allow closer, appropriate and effective collaboration between the regulators. In that way, patients can be assured of having issues that span a number of professions and services addressed in a coherent and effective manner.

The Pharmaceutical Society of Ireland wants to work with you, Minister, the Department of Health & Children and the HSE in leading policy development in pharmacy and to ensure that the potential of pharmacy is harnessed. This, together with the appointment of a Chief Pharmacist at the Department of Health & Children and supporting policy development resources will ensure that pharmacy plays its part in enhancing patient experiences and improving care and outcomes.

To conclude, Minister, the Society will assist you and your Department in whatever is necessary in order to introduce the required legislation. The responsibility rests with us all to ensure that proper patient and public safeguards are in place to facilitate the profession of pharmacy and pharmacy services to move into the 21^{st Century.}