Do You Believe in Magic? Improving the Quality of Pharmacy Services Through Restricting Entry and Aspirational Contracts, the Irish Experience

A constant refrain of policy makers and public representatives is the necessity of improving the quality of public health services. In this paper, two inter-related policies designed to raise the quality of pharmacy services in Ireland are considered. The first was to restrict the opening of new pharmacies, the second to increase the quality of pharmacy services through contract specification. While the first policy restricted entry and raised returns to existing pharmacies, there is no evidence it raised service quality. Equally, the second policy appears to have had little effect on the quality of pharmacy services. The contractual provision itself is largely unenforceable, does not recognize the conflicting motivations of a pharmacist and results in no measurable output. Drawing on this experience, several lessons as presented as to how service quality can be improved, which are likely to have application beyond Ireland.