This content has been automatically generated from the original PDF and some formatting may have been lost. Let us know if you find any major problems.
Text in this format is not official and should not be relied upon to extract citations or propose amendments. Please see the PDF for the official version of the document.
2024.04.16.
4.2 Deputy M. Tadier of St. Brelade of the Minister for Health and Social Services regarding difficulties at the Hospital pharmacy (OQ.62/2024)
Will the Minister explain why the public are experiencing difficulties at the hospital pharmacy; and what actions, if any, are being taken to address any problems?
Deputy T. Binet (The Minister for Health and Social Services):
I am reliably informed that the number of prescriptions being dispensed at the hospital pharmacy has been increasing gradually in recent times and this, combined with the shortage of staff, has resulted in queues extending to thoroughly unacceptable levels. Fortunately, through a commitment to deploying more staff, several existing staff who had announced their intention to leave have decided to stay on. This is going to cost a little bit more money, but I am intending to address this and some more considerable funding matters over the course of the next few months. In addition, along with my small team, I have had several meetings with the Minister for Social Security and her officers, all of whom have been extremely helpful in coming up with ideas to tackle some of the more difficult problems involved in facilitating the collection of at least some prescriptions from external pharmacies. I hope that helps to cast a little bit more light on the situation.
- Deputy M. Tadier :
Is the Minister certain that the only reasons for the long queues and delays are staffing issues and the number of prescriptions involved? Is it not also to do with the system that is being used? What steps has he or will he take to make sure that any system is expedited and efficient?
Deputy T. Binet :
I had hoped to have covered that in the third paragraph of my last response. I am working closely with the Minister for Social Security, and so are the 2 teams on our sides to get through what is a little bit more of a complicated matter than appears on the surface, given that the funding for pharmaceuticals comes from 2 different funds, and there are some prescribing difficulties in that the hospital pharmacy does hold some medications that cannot be distributed from other pharmacies.
- Connétable M.K. Jackson of St. Brelade :
The Minister outlined the funding issues, but would he confirm whether the issues over the Health Insurance Fund and who holds the purse strings for that?
Deputy T. Binet :
The Health Insurance Fund rests with Social Security, hence the discussions that I am having with the Minister for Social Security.
- The Connétable of St. Brelade :
Would he agree that the queues, particularly for elderly people who do not know when they are going to be able to pick up their particular prescriptions, is entirely unacceptable? Would he be taking some short-term actions to alleviate the queues?
Deputy T. Binet :
I think I described in my first response that the queues were thoroughly unacceptable and we have had several emergency meetings to do what we can. The first thing we can do is put more staff and, at the end of last week, we carried out some checks and the queues had tailed off a little bit. We are working as quickly as we can to introduce some short-term measures, just to take a bit of pressure off. To get it done properly will take a little bit longer.
- Deputy L.K.F. Stephenson of St. Mary , St. Ouen and St. Peter
Is the Minister aware of concerns around culture, morale and even allegations of bullying in the pharmacy workforce? If so, what is being done to address those concerns?
Deputy T. Binet :
I am aware of some issues, but they are employment matters and I do not think they are for me to comment upon. But every issue at pharmacy is currently being dealt with, I am comfortable to say that.
- Deputy L.K.F. Stephenson :
Given that the Minister’s first answer to the original question, the solution seemed to be to have more staff stay, does that not suggest that there should be a concern around recruitment and retention to the pharmacy? Does the Minister have any views about if these concerns around morale and bullying could be impacting that?
Deputy T. Binet :
To be honest, I think I answered that question with my last response.
- Deputy S.M. Ahier of St. Helier North:
The hospital pharmacy used to open at weekends. I know now it is only for Monday to Friday, 9.00 until 5.00. Would there be a possibility of opening on a Saturday for outpatients, because it was open until September 2023?
Deputy T. Binet :
It is something that is under consideration. But when you are a little bit short-staffed, that is sometimes difficult and it is more expensive. But it is under consideration.
- Deputy I. Gardiner :
Can the Minister confirm there is no pharmacy in the Enid Quenault Centre at St. Brelade? If it is correct, does he think it is reasonable to travel from St. Brelade to St. Helier to get a prescription?
Deputy T. Binet :
I think we require a law change to have a situation where medicines can be prescribed from other pharmacies. But we are working on that as quickly as we can because it is too far a distance, and we want medications to be distributed in the community wherever possible.
- Deputy I. Gardiner :
Would the Minister agree that the Enid Quenault Centre in St. Brelade is different from the private pharmacy? Can anything be done to provide pharmacy services at St. Brelade , at the first instance, before we all go into the private pharmacies.
Deputy T. Binet :
I am very happy to have a look at that.
- Deputy L.M.C. Doublet :
My panel questioned the Minister a month ago on this and we were told it was a priority, which was reassuring, but we were told that there were complications around finding a solution in this area. Could the Minister please give some detail into what those complications are and what the potential timeline might be for solving them?
Deputy T. Binet :
I had hoped I had drawn attention to some of them. The timeline is difficult. It is going to take as long as it takes, and we can only go as quickly as we can go. So I cannot put a precise time on it. There are several issues, not least of which pharmaceuticals purchased by external pharmacies are more expensive because the hospital purchasing system brings in those products more cheaply and they are funded from different sources. The law does not allow, as I understand it, the Health Insurance Fund to subsidise pharmaceuticals from outside of the hospital pharmacy. Those are the issues that we have to overcome.
- Deputy L.M.C. Doublet :
I want to zero in on one particular condition, which I know around 250 Islanders, potentially more, are facing waits. That is around A.D.H.D. (Attention Deficit and Hyperactivity Disorder) medication, which has to be accessed on a monthly basis due to the controlled substance. Could the Minister look at this area, in particular, because it is very much a public interest and the numbers of people that are facing the issues there, to see if there is a bespoke solution to that area that could be put in place a bit quicker?
Deputy T. Binet :
I think we are all very aware of the A.D.H.D. situation. It has been treated as a priority, along with all the other issues with pharmacy, but there is only so much you can do at any given point in time.
- Deputy B.B. de S.DV.M. Porée of St. Helier South :
With regards to the long queues for collection of medication, I believe some of the issues have to do with the fact that the names, when the names are called by workers or by the staff, they are not easily identifiable by the patients waiting for their prescription. Can the Minister confirm if patients are asked to bring documentation with them on the picking-up time of their prescriptions?
Deputy T. Binet :
I have been caught a little bit off balance. I was not aware of that, so I will certainly have to have a look at that. It is not something I was aware of.
- Deputy B.B. de S.DV.M. Porée :
Or possibly just change by rather than calling people by their own names, have a different system and number system which should be much easier to identify.
Deputy T. Binet :
I just thank the Deputy for pointing that out.
- Deputy T.A. Coles :
One of the issues that many patients find, and it was highlighted briefly by Deputy Doublet , that certain medications are controlled and therefore can only be issued one month at a time. Could a practical solution be to allow clinicians at the hospital to prescribe certain medications for more than one month at a time, to prevent repeat queuing?
Deputy T. Binet :
That has been under discussion, but I do not think that is allowed.
- Deputy M. Tadier :
Earlier on, the Minister did not seem to answer my question about systems. I know that there are certain things out of the Minister’s control but there are things I think he can control. One constituent told me that there was only one queue when he went to collect his medicine. So there was one queue for handing in your prescription and one queue for collecting the medication, which was the same one. Of course, people were getting confused because they did not know who was in front of them. That was a problem that was leading to longer queues. Would the Minister make sure that there are logical systems in place that are expedited so that, whatever the other problems are, we have the most efficient system that is workable within the parameters that exist?
Deputy T. Binet :
I am not aware that the current system is illogical, but when I come away at lunchtime I shall go and make that inquiry.