When I worked in a pharmacy during school holidays many years ago, a different policy of dispensing tablets operated according to whether the patients were private or public. For those who were paying for the prescription themselves, we were instructed to pop out any tablets that came in a blister pack and dispense them in one of those little brown plastic medicine tubs, labelled with the name, date and directions for use. If, however, the patient had a medical card, we just stuck the label on the sheet of pills and handed them over.<\/p>\n
Alas, no records exist of the number of our private patients who died because they forgot to take a pill, or took too many by mistake. I presume the reasoning for the practice was that we were sparing patients, especially older folk with poor eyesight and arthritic hands and only if they could afford it, the fiddly business of popping a tablet out of a blister pack, without a thought to the potential carnage that might result.<\/p>\n
It\u2019s one of the reasons now being cited by critics of \u201cblistergate\u201d, the political storm that has blown up out of nowhere over the dispensing practices of the country\u2019s pharmacies. Our older population will be decimated, it seems, by taking the wrong pills at the wrong time or accidentally overdosing, because they\u2019ll no longer be receiving their prescriptions in customised, Fisher-Price grade blister packs labelled with the dates and times that doses are due.<\/p>\n
It seems that the practice of pharmacists dispensing medication in single-use packages goes back to 1996. A phased dispensing system was introduced to ensure that certain strong drugs could not be issued in dangerous quantities. Instead of getting a six-month supply at a time, patients got their drugs on a monthly basis, which obviously involved increased dispensing costs. And it was under this model that the pharmacists were also reimbursed for issuing the blister packs. But from spring 2026, only a limited number of drugs will be covered by the scheme, meaning that anyone wanting medication in blister packs for other prescriptions will face charges of up to \u20ac12.50 per week for the service.<\/p>\n
Much like the blister packs themselves, though, there\u2019s a lot to unpack here. As the taoiseach pointed out last week when this issue first arose, the government had never undertaken to fund this service and the state can\u2019t be expected to pay for absolutely everything. <\/p>\n
If pharmacists are already charging a dispensing fee, isn\u2019t that intended to cover the safe, professional dispensing of medication in a form that is appropriate for the patient\u2019s needs? We complain about a nanny state that takes far too many basic decisions out of our hands and yet we\u2019re up in arms and warning of widespread fatalities if the state doesn\u2019t help us count our daily medication doses, at an estimated cost of \u20ac40 million a year to continue the scheme. <\/p>\n
Having worked in a chemist\u2019s shop, I am always baffled at why you\u2019re routinely told, when you go into an empty dispensary with a straightforward antibiotics prescription, that you can expect to wait at least 20 minutes. Apart from the age-old challenge of reading doctors\u2019 handwriting, what exactly are they doing back there, when all they\u2019ve got to do is take a bottle off a shelf, print a label and pop it in a bag? If some more vulnerable patients need extra care around the dispensing of their medication, that ought to come within the responsibilities of the professionals being well rewarded to dispense it.<\/p>\n
There\u2019s a wider question here, though, regarding what we see as our responsibilities to elderly or vulnerable family members. I accept that the blister pack system gives patients a measure of agency over their medication use, as they don\u2019t need to seek help in determining what to take and when to take it. But is it too much to ask that a relative or a carer of a patient with dementia or Alzheimer\u2019s, for example, might take a few minutes once a month to divide up their medication into those clearly labelled and reusable containers that are readily available in pharmacists or discount stores? Is there any element of the care of our most vulnerable citizens that we don\u2019t expect to outsource?<\/p>\n
Jennifer Carroll MacNeill, the minister for health, is said to be resolute on the issue, and determined not to back down on this unforeseen consequence of the new deal between the state and community pharmacies, which delayed the implementation of the free HRT scheme while they thrashed it out.<\/p>\n