I welcome the opportunity to speak on this motion. It is a very important issue. I am glad the Minister for Health, as the senior Minister, is here to address this. We are having this conversation in the context of us being just days away from Christmas. This is one of the last sittings of the Dáil. Here we are, discussing a measure and what is up for consideration is a very small amount of money. On the other hand, it is about saving people's lives and looking after people's health. We are also having the debate in the context of supposedly getting near the final furlong in the implementation of Sláintecare, a public health system, and we are nowhere near that, unfortunately. The importance of blister packs and the importance of having monitored dosage systems cannot be overstated. The health and safety of patients is paramount. The withdrawal of this is dangerous and I do not say that lightly. For people with complex medical needs and multiple conditions, this very basic service was provided free of charge. I heard the Minister's interview on Sunday and I know she explained how it is being funded. I get that but we are dealing with people who have multiple medical needs and who are taking multiple medications. I have seen the medications on the kitchen table in households. They are taking two of this a day, four of that and one of those. They could have seven or eight different types of medication. It is very hard for them to keep track of this and this is a simple way of doing it. The majority of them are pensioners, disabled people, or people on very low incomes. We are talking about the most vulnerable. The blister packs are simple and it is a safe way of ensuring people are taking the correct dosage at the right time at the correct time of the day and everything else. Older people, including people with a range of medical conditions, rely on them - as I said, those who have complex medical needs. Chemists can charge between €30 and €50 for them but this is on top of other medical costs. The decision by Fianna Fáil and Fine Gael, and the Minister, to withdraw this now is putting an extra burden on these low-income households and individuals and it is coming at the worst time of the year. The majority of those who are typically dependent on the packs, which as the Minister said on Sunday - and fair enough - are being funded through what is called a phased dispensing reimbursement scheme, are on low incomes. This is coming on top of increasing food and energy costs. There was another announcement of an energy increase today. These are all increasing. Wait until the bills start coming in January. We have not even hit Christmas yet. This comes on top of the high cost of living. The increases are happening right across the board and it will disproportionately hit the poor the hardest. What must also be factored into this is the low income thresholds for medical cards. If you are under 66, the income threshold for a single person is €184. The last time I remember that being increased was back at the start of the noughties, around 2002 or 2003. I am open to correction but it was well over 20 years ago. If you are over 66, it is €201. When you hit that, you are gone. You cannot get a full medical card. For a couple under 66, the income threshold is €201. A couple over 66 - between that and 70 - it is €298. I am imploring the Minister and the Minister of State here to address this. What has also increased in the past 14 or 15 years is the number of items and medications no longer covered by the medical card scheme. Every TD will have heard this over the past 14 or 15 years. People come to us saying that such and such a thing they used to get on a medical card is no longer there as it was withdrawn. A third thing that has come into play in the past 14 years is GPs charging for blood tests. I raised this with James Reilly, Leo Varadkar and every Minister for Health since. That used to be free for people with medical cards but what happened was that the GPs started charging for it. They say they do not have to do it, according to their contracts. However, the Fine Gael Government, which the Minister was not part of at the time, negotiated a new contract with the GPs and this was not addressed in it, despite the fact it was pointed out on the floor of the Dáil to Leo Varadkar, James Reilly and others. I remember standing here in this same spot pointing it out to them, as did others at the time. I had pensioners coming to me about it at the time. That needs to be sorted out. There is all of that. There is the low income threshold, increasing medical card costs, the number of substances not covered and then GPs charging medical card patients for blood tests. When the Government negotiated the agreement with the pharmacies this year, this was not included. The State always paid for the phased dispensing and that was used as a safer way for different people. Some pharmacies were using it to cover the costs, and that is fair enough. There are two ways to resolve this. One is to allow the pharmacies to cover the costs under the existing scheme, what is called a phased dispensing scheme. The other is to pay the pharmacies a modest fee to dispense this using the monitored dosage system and the blister packs. There has been a giveaway budget for the big hotels, McDonald's and Costa. They got nearly €1 billion. The tiny amount of money that would fix this was not thought of. This needs to be fixed. We are nearly on the eve of Christmas. I ask the Minister to do one good thing for Christmas. I ask her to sort this out, cover the cost of the blister packs and keep our patients, elderly and vulnerable people, safe.

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