I was not in the Seanad.

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Believing.

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We are not opposing the motion and we are grateful for the opportunity to clarify what has been a very confused and inaccurate set of comments over the recent period. It is really important that we take the opportunity because a lot of people have been very frightened by this debate. I note from the comments that have been made in the first 20 minutes of the debate that not one of the Deputies referenced the many constituents who have been paying for blister packs for some time. I know they have that information because my colleagues also represent those constituents. I also know from their social media accounts how many people have contacted them to tell them they have already been paying for blister packs for some time. They have been paying fees of €10 or €20 for some time. This is, and always has been, a private service. It was never funded by the State and there has been no removal of that service by this State. The Irish Pharmacy Union, IPU, confirmed that in a statement on Friday. I will outline what is different. There have been three groups of people. The first is those people who know they have always been paying for blister packs as a private service. They know that, we know that and Sinn Féin knows that because much of the commentary on Deputies' social media posts have told them that if their constituents have not. They have not taken the opportunity to reference that during the debate. Those people have been paying for blister packs as a private service. Another group of people have been getting blister packs for free because their pharmacists are giving them blister packs for free. I thank those pharmacists. There is a third group of people whose pharmacists have been giving them blister packs for free but charging the State under a different heading, as Deputy Cullinane referenced. They have been charging under the phased dispensing scheme, which is a very different scheme. Charging like that is wrong, inappropriate and contrary to numerous circulars that the HSE has issued. There is litigation to this effect against a sizeable private company that was wrongly doing this. There have been two sets of litigation and the State won on both occasions. It is wrong to give a service to someone and to charge the State wrongly under a different scheme. That is wrong, and I am glad that we have the opportunity to highlight that very wrong practice that some pharmacists in the State have been carrying out. This afternoon, I spoke with the regulator. It, along with the HSE, will be looking at this issue very clearly. They will be looking at the primary care reimbursement service, PCRS, data. People have received letters. There should be no change for those first two groups of people. If you have already been paying for blister packs, there will be no change under the community pharmacy agreement. If it has been free, I ask people to go in and speak to their pharmacists. Will it continue to be free? If it has been free, it will probably continue to be. If people have received letters, perhaps they want to share them with the regulator. It might be a scenario where a pharmacist who had previously been claiming under the wrong scheme is now trying to put the cost on the patient. As everybody here has correctly said, that is wrong. We are responsible for the money that taxpayers pay the State, which is then given to pharmacists. We are giving new funding of €50 million for pharmacists, as well as the funding within the pharmacy scheme. It is wrong for taxpayers' money to be used in a way that is not allocated. It is really important for me, even though it might not be as glamorous as simply just solving the problem, to take the time to get to the bottom of the issue and fix it over time, as I did with hormone replacement therapy, HRT. The many women who are enjoying their completely free HRT are the beneficiaries of that little extra time it took to do the job properly. In the same way, we will get to the bottom of the information here and find out who has been charging this inappropriately and how the regulator or others purport to deal with that. There are many people who have been charging. Phased dispensing is a really important protection for people, particularly those getting psychotropic drugs, opioids and codeine. Those drugs are dispensed, and pharmacists are paid to dispense them, on a weekly basis or even in some cases on a daily basis. That is for the safety of the patient. Although we assumed together and I certainly assumed in relation to blister packs that it was a patient safety measure and a convenience - a whole range of different good things - actually the evidence is quite different. That is something we could talk about if we had more time or if we were more committed to the details of science. I really hope we have that conversation. We all agree here as public representatives that where somebody has gotten used to having a blister pack or chooses to have a blister pack, I can completely see how that has been a good and positive thing, even if some of the medical perspectives are very different. The groups we would be most concerned about are already the groups that pharmacists and GPs are most concerned about. If someone is getting phased dispensing, for example, as Deputy Cullinane has said, it is already the case that a GP has to sign off on that. There needs to be evidence in a pharmacy that it is being correctly done on a weekly or daily basis as appropriate. That body of evidence should be there if phased dispensing is being used correctly. That might sound very technical to people watching tonight, and I totally get that, but it is taxpayers' money. We cannot have any profession using taxpayers' money in a way that has not been allocated, especially where that has been repeatedly communicated to them. It is an important marker. It is the responsibility of the Government and everybody here who is responsible for taxpayers' money. It is a different thing from making sure we continue to reassure people. Of all of the constituents who got in touch with the Deputies opposite on their social media, not one of them said they were already paying €50, because I checked. That is something that came into the vernacular last week, which was frightening for people and it was wrong. Whoever had an incentive to put figures like that into the media or into the debate knew what they were doing and knew it was not reflective of the practice that exists currently, where we are seeing fees of between €5 and €20, as reflected on the Deputies' own social media. That was a wrong thing for those people to do; it was frightening and wrong. I can completely understand why people would be so upset about that, especially when times are hard, especially in the winter and especially where it is perceived to be a new charge somebody is imposing and people do not have the information as to what has gone on in the backdrop. I am very glad for this opportunity to clear this up; I think it is the right thing to do. I am also glad we have taken the opportunity to put a pause on this to get the best information and to work out with the clinical community which people need blister packs and for whom they should be provided, and how we as a State make sure our resources are going to protect the most vulnerable and not everybody. Some of the commentary and what has been said already may imply that we should reward those pharmacists who have been using the State's money wrongly for this by simply covering it off. I would rather show the Irish people what was going on first and then protect the vulnerable. Some of the commentary refers to people who are already paying it. What is going to happen to them? What have they been doing for some time? That was a private service. It was never a State-funded service. There was nothing to withdraw. There was no Fine Gael and Fianna Fáil withdrawing from anything because it was never funded by the State. We have to have transparency in a developed State. We have to have the ability to set things out clearly and honestly. I am very glad for the opportunity Sinn Féin Deputies have provided with their time for us to be able to do that and place real clarity on it. I thank the Deputies for their engagement and for highlighting this important issue so that we can get to the bottom of what is truly a risk to people who are vulnerable and something that has perhaps been inflated by those who might have an incentive to cover what was done in the past and create very scary figures for private services for the future. I had a very important conversation with the regulator today. There will immediately be an analysis by the PCRS which the regulator may be involved with at any stage, and then we will lean into it in a much deeper way as the process goes on with an analysis of the phased dispensing claims that have been made to the HSE in a specific timeframe. This will be to examine what the criteria might be for any outliers in the phased dispensing scheme that may help to highlight those pharmacies that are in difficulties, and to have a very suitable, targeted probity process and targeted interventions and actions as may be appropriate, to be determined by the regulator. If there is a person in this House who disagrees with that course of action, I would like to hear about it. It is very important. Separately, the Pharmaceutical Society of Ireland, as the regulator, will support with any necessary follow-up actions. We are introducing transparency in pharmacy. There are so many good pharmacists who are going above and beyond for their patients every single day. We all know who they are. They are absolutely brilliant. Their first concern and one of their obligations is to put patient safety first. That is what they do. They are obliged by their profession to take care of their patients. They are obliged to make sure that patients understand their medication and receive their medication in a way that is capable of being understood and is going to keep them safe. That is their obligation. There are so many pharmacists who are doing that well. It is also true to say that there has been too much hidden in the charging in pharmacies, whether it is dispensing fees, as was shown through the HRT debate, or transparency on other things like private services that are reasonably paid for, like blister packs, BMI and a whole range of different things. That is why, along with the pharmacy regulator, I have required detailed receipts outlining the cost of every professional service that pharmacists should be allowed to charge for their expertise, including dispensing fees and a whole range of other things that Deputies Cullinane, Sherlock, Rice and I have discussed a number of times. Pharmacists are entirely entitled to charge for their expertise, but it should be transparent to their customers. This debate has helped to shine another light on the need for transparency in pharmaceutical services and I thank the Deputies for bringing this motion tonight.

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Did the Deputy not hear what I said?

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No, it was not.

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Sorry, a Leas-Cheann Comhairle, this has gone too far.

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It is not accurate in any sense.

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That is true, but that is just not accurate.

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Withdraw what?

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It is a basic set of facts.

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