2026-01-22

3. Deputy David Cullinane asked the Minister for Health if she will remove charges for blister packs for those with a clinician-determined need; and if she will make a statement on the matter. [5083/26]

There has been quite a degree of confusion on this and so it is very useful to set out the circumstances of it. As part of the community pharmacy agreement in 2025, all the parties agreed to introduce improved controls for phased dispensing. That would ensure that patients on high-risk medications such as antipsychotics or opioids are appropriately targeted with support for phased dispensing rather than getting everything in one go. It is important that I clarify the difference between phased dispensing and what has become known as blister packs. The State has supported phased dispensing because it is a crucial patient safety initiative with antipsychotics and opioid drugs. The State has supported phased dispensing for medical card holders since 1996 and will continue to do so; there is no change in relation to that. Community pharmacies receive an additional service fee for that service. The State does not fund and never has funded blister packs. There is no change to that service. There has been no removal of that service because that service did not exist funded by the State. It is important to say from a patient safety perspective that while I, as a non-medic, anecdotally perceive blister packs as a patient safety initiative, the evidence that I am getting both from the pharmaceutical regulator and from the National Centre for Pharmacoeconomics is that it is not in fact a patient safety initiative and that health outcomes are not in fact changed by blister packs. However, we regard them as convenient and important particularly for elderly people and that is an important part of the consideration. Internationally the guidance is that blister packs should be a last resort with patients being supported by many other interventions. Nevertheless, I recognise that they are helpful but they have never been funded by the State. As I said before in this House, there are three groups of patients. I might come back to it because I am out of time.

I thank the Minister for answering my question. However, my question referred to clinically determined need. For me clinically determined would be the older person as well. Older people need blister packs to ensure safety and to ensure that they manage their medicines safely. It is a cruel move that the Government is not funding blister packs. It is a necessity and it saves a lot of time and effort allowing older people to take their prescription medication in a safe manner. I ask the Minister to reverse this policy and to ensure that blister packs are paid for by the Government.

I really have to address the language here first of all. There is no policy to reverse because nothing has changed. The basic facts are that nothing has changed and therefore nothing can be reversed. While the Deputy and I believe that and I totally understand the reasons for that, the science does not support that. The more important thing from the State's perspective is the degree to which this service was being used incorrectly by some, not all, pharmacists for their own financial benefit. That is what this State and this House must have an interest in. There are people who have always paid for blister packs charged by their pharmacy for convenience and for lots of different reasons as set out by the GP. There are those who have been getting blister packs for free from their pharmacy and have never been charged, and the pharmacist is simply doing this to support them in different ways. There are also people who were receiving blister packs free of charge but the pharmacist was incorrectly charging the State under the phased dispensing scheme for something that was not appropriate, not allowed and not legitimate.

The Minister has again said that the pharmacy was charging the State. I again ask that she would incorporate that cost. It is not fair on the older person or on the vulnerable person that he or she has to pay for it now. I ask the Minister that the State would pay for it and that she would get over this obstacle with the pharmacies. It is not fair to put the cost on older and vulnerable people which is what is happening now. Loads of people have come to me saying that it is costing them €20 some weeks. I ask her to ensure that this cost is not put on the vulnerable and the older person. She and the pharmacies need to work it out.

I am particularly intrigued to see left-wing parties coming in here and asking me to give money to pharmacists to make good what had been done illegitimately. I would like to use the State's money directly for the benefit of vulnerable people but not to reward those pharmacists to keep things even for them for something that they were doing wrong in the first place.

But it is the older person who now-----

There are many older people, including people who have contacted the Deputy - I see it on her social media pages the same as everyone else - who have told her that they have been paying for blister packs for years and they have always done so.

The older person does not have the income.

This is not a back-and-forth and I am trying to set out the facts on it. I would love to see left-wing parties come in here and defend the interests of the State and defend the interests of the taxpayer. Sometimes I think these roles are reversed. Perhaps for Fine Gael, I should come in and articulate the speaking points of the pharmacy union, but I am trying to articulate the position of the State and to get the best for patient safety, get the best for the taxpayer and make sure that we recognise that we are not rewarding activity that was illegitimate.