Thomas Gould (Cork North Central, Sinn Fein) | Oireachtas source

I echo the comments of my party colleagues in support of this Bill. I take the opportunity to speak on it and raise a number of issues.

I acknowledge the great work done by pharmacists in my constituency and right across the State. They are often a person's first port of call. They provide compassionate, educated advice on many issues. This is invaluable.

I request that the Minister give consideration to extending the needle exchange programme. In many areas, this works really well. However, it is a postcode lottery. Will the Minister consider extending this programme to ensure that services are available in all areas? The programme is particularly important in rural areas, where people have to travel long distances to pharmacies.

I understand that only GPs can prescribe methadone. Pharmacists have a role to play in this regard, particularly as they are likely see people more often than GPs and therefore would be in a better position to help prescribe or to work with patients. This is something that could be looked at. It would take some of the pressures off GPs and place it on pharmacies. This is something that should be looked at. I am hearing about issues such as this. Some people get weekly prescriptions and others get them daily. This would give the people on the ground who know what is happening the ability to make the right decisions. Will the Minister consider naloxone as a drug that could be provided without prescription? We have seen in Dublin and Cork recently the vital work done by groups where we had a series of heroine overdoses. Because people had access to naloxone, lives were saved. Community groups and those on the ground have reacted really well. They have done Trojan work. There is no doubt that they are saving lives every week. In the current system, many services have found ways around ensuring naloxone is always available for people but groups should not have to find workarounds. This is something that the Minister and the Department can change. We know naloxone saves lives and that it has to be prescribed, but there are groups and families who would use it if they had access to it. That is something we could maybe look at with pharmacists. Perhaps naloxone might not have to be prescribed by GPs.

Deputy Cullinane touched on medical cards and the income threshold. The means test for the medical card is probably a fairer system than others, but the threshold has not been increased in 20 years. It takes into account outgoings and financial burdens that are vital to truly understand a person's means. A person's means are not always their income. What their outgoings and expenditure are has to be taken into account to have a true reflection of where a person is. When we look at the recent inflation and the cost-of-living crisis of which we are in the middle, and at the same time, there has not been a review in almost 20 years. Eight Governments have held office during that period. Just for people to try to get a grip of what 20 years is, it is a generation. We had no Facebook, YouTube, Spotify, Twitter, or iPhones 20 years ago. That is how long ago it is. If you ask anyone, they could not imagine living without any of those services or items now. That is how long it has been since we have had a review. We have had referendums on the eighth amendment and on Lisbon and we cannot increase the medical card threshold. The Minister has to seriously look at that. People's incomes have changed in 20 years and that has to be respected.

I will finish by making one further point. There are no primary care centres in Blarney, Tower, Mayfield or Glanmire, even though they were promised. I ask the Minister if those centres can be delivered, particularly as they are vital for the communities in question.

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