Pharmacists who have withdrawn from the state community drug schemes could lose hundreds of thousands of euro in revenue if the HSE decides not to readmit them to the scheme.

As the first day of the protest got underway yesterday, the HSE and the Irish Pharmacy Union (IPU) continued to disagree about the number of pharmacies still filling prescriptions under the scheme. However, in a letter to pharmacists who have withdrawn from the schemes, the HSE's Laverne McGuinness last week warned they could face a "time delay" in processing applications into another community pharmacy contractor agreement.

Although any decision to re-admit a pharmacy to the schemes is assessed on a "case by case" basis and subject to strict criteria, the Sunday
Tribune understands the HSE will not necessarily guarantee that all of those who have withdrawn from the schemes will be re-admitted.

This could leave individual pharmacies who have withdrawn from the schemes facing long-term losses of hundreds of thousands of euro a year if they are not able to gain readmission.

It could also lead to a significant number of pharmacies, who are already facing difficulties due to the economic downturn, being forced to close down. The move is likely to increase the pressure on them to withdraw from the boycott.

The revelation comes as a HSE spokeswoman yesterday said it had received around 140 further notices from pharmacies informing it of their intention to withdraw from the boycott overnight, bringing the overall total of pharmacies who had done so to 340. As a result, the HSE said around 1,160 pharmacies have now agreed to continue to operate the schemes.

However, the IPU said problems with lists of participating pharmacies published by the HSE last week had shown it had "no credibility" on the issue. It said in the region of 800-900 pharmacists have withdrawn from the scheme.

"The HSE is trying to suggest that pharmacists, maybe coming up to today, were reconsidering their position. But we're not getting any evidence of them doing this, if anything it is simply hardening their resolve," an IPU spokesman said.

"You would expect the situation to deteriorate as the days go on. Early indications anecdotally is we're hearing of serious problems with the HSE contingency plan, including dispensaries not opening when they were supposed to."

He described McGuinness's letter as a "fairly crude attempt to frighten pharmacists", which he said reflected the HSE's "aggressive attitude" on the issue.

Eamon Timmons of Age Action Ireland yesterday said there were clear problems with the HSE's list of pharmacies still participating in the scheme, and it was advising patients to check with their pharmacy themselves.