Cork Today

The Irish government’s promise of free hormone replacement therapy (HRT) has gone from a triumphal announcement to a sticky mess, leaving women and pharmacists alike frustrated. The scheme, heralded last October as a win for women’s health, was meant to roll out in January. Instead, it’s become a case study in how not to deliver public health policy.  

Pharmacist Sheena Mitchell didn’t mince her words: “It’s almost embarrassing working in this kind of health system.” Speaking on C103, she revealed that community pharmacists were blindsided by the announcement, hearing about it on the radio like the rest of us. No guidance, no infrastructure, and no communication from the government.  

“It was welcome in theory,” said Mitchell, noting that 70% of pharmacists in Ireland are women, many of whom would benefit directly from the scheme. But theory isn’t practice. “The model is completely unworkable,” she added, pointing out that the government doesn’t even seem to understand how pharmacies are paid under state schemes.  

Women were told HRT would be free starting January 1st. But when they turned up at their local pharmacies, they were met with confusion, embarrassment, and bills. Louise, a frustrated taxpayer and HRT user, shared her experience: “It was the only thing us single women were getting. I was delighted, but it’s been a disaster. I feel like it was just a vote-grabbing stunt.”  

Louise’s pharmacy, like many others, has tried to soften the blow, charging her less than they could. But at €45 a month, it’s still a hefty cost. If she went elsewhere, she’d be paying €80. “It adds up to a lot of money,” she said, especially during a cost-of-living crisis.  

The Irish Pharmacy Union (IPU) has proposed a solution: mirror the successful free contraception scheme. That programme covers GP visits and has a functioning IT system in place. Why not use the same model for HRT? It’s a no-brainer, but so far, the government hasn’t acted.  

Mitchell also highlighted a critical issue: stock shortages. “Today, I can’t get any licensed oestrogen patches,” she said. The unlicensed versions are twice the price, and the state will only reimburse pharmacies if the Health Products Regulatory Authority (HPRA) confirms the licensed ones are out of stock. But drug companies don’t always notify the HPRA. It’s a logistical nightmare.  

The HRT debacle is just the tip of the iceberg for Ireland’s community pharmacies. Chronic underfunding and outdated fee structures are pushing them to the brink. “Pharmacies are an essential part of our primary healthcare system,” said Mitchell, noting that they administered over 57% of children’s flu vaccinations this year.  

But without proper funding and communication, their ability to provide vital services is under threat. “We can’t keep doing this,” Mitchell warned.  

With a new female Minister for Health, Jennifer Carroll MacNeill, there’s hope the government might finally start listening. But for now, women like Louise are left waiting—and paying—for a scheme that was supposed to be a lifeline.