When long-time pharmacist Tom Murray stepped into the presidency of the Irish Pharmacy Union in May 2024, he expected a steep learning curve.
He knew he was inheriting an organisation without a CEO or secretary general — and a profession emerging from 17 years of political freeze-out.
“It’s been an incredibly busy two years,” he says.
“You spend the first six months trying to find your feet. When I took over, we didn’t have a secretary general or a CEO, so I was effectively acting in an executive role as a non-executive director. This meant working very closely with our senior management team to oversee the organisation and although I didn’t fully have the authority, but nobody else was in a position to do it.”
That instability coincided with the most ambitious reform agenda in Irish community pharmacy history — culminating in the landmark Community Pharmacy Agreement 2025 (CPA 2025).
Tom is set to outline that journey at APP2026, where he will speak about how Ireland secured unprecedented recognition, remuneration and scope expansion for pharmacists.
But he is clear about the real story: Ireland’s success wasn’t luck. It was strategy.
Breaking through
For nearly two decades, Irish community pharmacy had been locked out of meaningful negotiations with the country’s Department of Health and the Health Service Executive.
A pay freeze imposed during the 2007 financial crisis remained untouched for 17 years.
“We were essentially locked out of the political landscape until two years ago,” Tom says. “We had to start from scratch.”
The IPU launched a coordinated, grassroots lobbying campaign. Every pharmacist received tailored briefing sheets.
Every local politician — in a country where elected representatives are highly accessible — heard directly from their community pharmacists.
“All politics is local in the Republic of Ireland,” Tom says. “So we used the fact that everybody loves their local pharmacist.
“And we encouraged pharmacists to tell politicians: if you don’t look after my pharmacy, I am at risk of closure or reduced hours.”
The message landed. Within two years, all five of the IPU’s demands appeared in every major party’s election manifesto, and all five were adopted into an official program.
“For the first time ever, the government was determined to deliver with pharmacy,” Tom says.
COVID’s impact
Tom is blunt about the catalyst.
“COVID changed the political disposition towards pharmacy,” he says. “GP colleagues were less accessible, getting an appointment was difficult. Pharmacies stayed open. And pharmacists and their staff put themselves at risk. We became the single access point for patients and public”
Public trust soared. Annual independent surveys consistently ranked community pharmacy as Ireland’s most trusted profession, with approval ratings of 96 to 97 percent.
“When the state realised they couldn’t reach patients through general practice alone, they saw pharmacy as essential infrastructure and our accessibility could deliver,” Tom says.
“And we said: We’ll do the work — but only once you remunerate us properly for our core role.”
Core role
While many countries have expanded pharmacy services by diverting funding from dispensing, Tom said we refused to let Ireland follow that path.
“Our greatest achievement hasn’t been the extended roles and extended practice. Although they’re all brilliant,” he says.
“Our greatest achievement has been getting recognition of the core clinical role of the safe and appropriate supply of medicine, or as everyone calls it, dispensing,” he says.
“Dispensing is the most common intervention in healthcare. If it’s not done professionally, the consequences are enormous.”
Ireland became, Tom believes, the first country in the world to secure a dedicated budget allocation for new pharmacy services and a 12 percent increase in core dispensing fees — without funding one at the expense of the other.
“Everybody else is seeing diminishing dispensing fees,” he says. “We refused to let extended practice be funded by cutting our core role.”
This principle underpins CPA 2025 — and Tom will emphasise this strongly at APP.
CPA 2025
Ireland’s administrative burden is notorious.
Pharmacists must navigate 23 separate state drug schemes, drug-specific and patient-specific eligibility rules, and complex tiered fees and co-payments.
“Too much of my job is asking: can I supply this, and will I get paid?” Tom says.
“Administrative burnout is the number one reason pharmacists were thinking of leaving the profession.”
CPA 2025 tackles this head-on through paperless dispensing, electronic endorsement through patient medication record systems, real-time eligibility checks using individual health identifiers, and hardship scheme reforms to reduce underpayment risk.
“These changes will massively reduce the administrative load,” Tom says. “It’s one of the biggest wins for the profession.”
Extended practice
CPA 2025 also accelerates Ireland’s move towards ‘extended scope of practice’ – which is Tom’s preferred way of describing ‘full scope’.
“If you say full scope, that’s not allowing any further development,” he says. “Let’s display the potential there is beyond that.”
Key developments include nine common clinical conditions now managed directly by pharmacists, pharmacist prescribing with supply integrated into the same consultation, state-funded services including vaccinations, contraception, bowel screening and sexual health promotion, and a pathway to full independent prescribing aligned with university training.
“We’re moving towards independent prescribing with no limitations,” Tom says. “It’s ill-defined now, but the direction is clear.”
Vaccination remains a standout success, particularly the school flu program, which Tom describes as “transformational”.
Negotiation mindset
Tom’s approach is shaped by his training at Harvard Law School and his work as a mediator.
“I fully believe in collaborative negotiation and expanding the pie,” he says. “For years we were banging our drums, threatening this and that. Waste of time.”
His philosophy is simple — and it will likely be the line APP delegates remember: “Don’t be the neighbour who only rings when you have a problem. Be the neighbour who rings and says: how are you, can I help you, here are a few solutions.”
Relationship-building with politicians, he says, was “massively important”.
Next steps
Tom is proud of the agreement, but realistic about implementation.
“It’s a very good deal,” he says. “Fee increases, burden reduction, IT advancements, role expansion.
“But some members may be hesitant about delivering new services. That’s normal.”
His message to pharmacists — in Ireland and Australia — is pragmatic: be evidence-based, be professional, be the solution.
“The state knows they need us,” he says. “GPs and hospitals have massive capacity issues. We can relieve so many problems. But you have to identify where you can help the state deliver its goals — and use that as leverage.”
Lessons for Australia
As Australia navigates its own debates around scope, remuneration and sustainability, Tom’s story offers a clear takeaway: pharmacy wins when it positions itself as essential — and negotiates from that position with discipline, unity and strategic generosity.
Did you know?
Ireland’s pharmacy-ownership deregulation, introduced through the Pharmacy Act 2007, ended limits on who could own a pharmacy by allowing non-pharmacists and corporate entities to enter the market while still requiring a pharmacist to manage each premises. The reform aimed to increase competition, lower costs and expand access to care, but it also accelerated the growth of large chains and raised concerns about the future of independent pharmacies, keeping debate active over how to balance market forces with public-health needs.
