Emer Higgins (Dublin Mid West, Fine Gael)
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I thank the Minister of State for taking this Topical Issue debate. Despite the fact that there is no register for coeliac disease in Ireland, the condition is estimated to affect up to 75,000 people in this country. I thank the Coeliac Society of Ireland, which is based in my constituency of Dublin Mid-West, in the heart of Clondalkin. It makes a huge contribution to the data we do have on coeliac disease in Ireland. It provides information and support and even the opportunity to purchase gluten-free food locally in Clondalkin. We have made great advances in the availability of gluten-free foods in Ireland. That can be seen in cafés and restaurants, where there are so many options and choices now. However, the fact stands that some gluten-free foods can cost up to 75% more than foods containing gluten. The cost of following a gluten-free diet is €444 more expensive for adults and €903 more expensive for parents of children with coeliac disease. That is not even counting the additional costs of healthcare. Following a gluten-free diet is more expensive. That is a fact. It is particularly so for low-income families and individuals.

We currently offer one tax refund of up to 20% of the cost of gluten-free products purchased but there are some difficulties around that. One issue is that many products that are gluten-free are not specifically marketed as coeliac-friendly foods. They may not even say that on the package. This causes problems for people because the products do not fall within the scope of the tax refund. The system needs to be simplified. Another issue is that the tax refund does not benefit those outside the PAYE system.

A survey by the Spanish Federation of Coeliac Associations in March revealed that Ireland was an EU outlier in terms of providing support for coeliac patients who fell outside the PAYE system. Will the Minister of State examine this matter?

Fergus O'Dowd (Louth, Fine Gael)
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Coeliac disease is a serious, lifelong illness. There is no cure for it and any person diagnosed with it must go on a gluten-free diet. The costs are clear. According to the Coeliac Society of Ireland, this food costs approximately €1,000 more per year on average. If you have a family, it affects the types of food that the whole family eats. It affects where you go for recreation and to eat.

I welcome the Revenue Commissioners' letter to me in May, in which they acknowledged that progress was being made. The Minister for Finance has stated that he wishes to make it easier for people suffering from coeliac disease to claim tax relief or, where they cannot and do not pay tax, to provide an additional benefit to them in terms of social welfare or whatever the case may be.

This is over to the Minister. The chairman of the Revenue Commissioners has stated that he is studying whether additional measures can be introduced to ease the administrative burden on the taxpayer who is asked to provide additional documentation. What progress has been made in this regard? I understand that there is a willingness on the part of Revenue and the Minister for Finance's office to deal with this issue in an appropriate and caring way.

Seán Fleming (Laois-Offaly, Fianna Fail)
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I thank the Deputies for raising this matter. I should point out that the issue of subsiding gluten-free foods for those with coeliac disease is a matter in the first instance for the Minister for Health. However, if the Deputies are suggesting that gluten-free foods for those with coeliac disease should be subsidised via the tax system, I will point out that decisions regarding tax reliefs and incentives are normally made in the context of the annual budget and Finance Bill process. Such decisions must have regard to the sound management of the public finances and to the Department of Finance's tax expenditure guidelines. The guidelines make clear that any policy proposal that involves tax expenditures should only occur in limited circumstances where there are demonstrable market failures and where a tax-based incentive is more efficient than a direct expenditure intervention.

Regarding the issue of simplifying the process of claiming tax relief on gluten-free foods, this is an issue that the Minister for Finance has addressed previously through parliamentary questions. By way of background, section 469 of the Taxes Consolidation Act 1997 provides for income tax relief where an individual proves that he or she has incurred costs in respect of qualifying health expenses. Furthermore, only health expenses incurred in the provision of healthcare that has been carried out or advised by a practitioner will qualify for income tax relief. To be clear, "health care" is defined as the "prevention, diagnosis, alleviation or treatment of an ailment, injury, infirmity, defect or disability". "Health expenses" are defined as "expenses in respect of the provision of health care" and may include, but are not limited to the services of a practitioner; diagnostic procedures; maintenance or treatment necessarily incurred in connection with the services or procedures carried out by or on the advice of a practitioner; and drugs or medicines supplied on the prescription of a practitioner.

I am pleased to state that coeliac patients may claim income tax relief in respect of the cost of foods that have been specifically manufactured to be gluten free. I am advised by Revenue that, in such cases, a letter from a medical doctor stating that the taxpayer is a coeliac sufferer is generally accepted as proof of entitlement to tax relief on such costs. However, I should point out that the arrangements exclude costs incurred in respect of gluten-free alcohol, which people will appreciate. I am further advised by Revenue that, as with all claims for tax relief, a taxpayer may be asked to provide additional supporting documentation to prove his or her entitlement to the tax relief claimed. The type of information that a taxpayer will need to provide will depend on the nature of the expense involved.

It is important to point out that, if a taxpayer is requested to provide receipts to support a claim for income tax relief on the cost of gluten-free foods, the receipts and documents provided should contain sufficient information to satisfy the Revenue office dealing with the claim that the costs incurred by the taxpayer relate to foods that have been specifically manufactured to be gluten free. In verifying claims for tax relief on gluten-free food, Revenue officials may accept either a chemist or supermarket receipt or evidence from food packaging in support of a claim if the information provided clearly demonstrates that the foods purchased have been specifically manufactured to be gluten free and show details of the expenditure incurred.

It is also worth pointing out that some multiples provide a service for coeliac sufferers to receive an annual statement showing details of any expenditure that they incurred on specific gluten-free products during the year. This statement can be used to validate a claim to Revenue. Revenue officials may also accept information from the Coeliac Society of Ireland's annual food list if it is provided by a taxpayer in support of his or her claim for tax relief, together with proof of the expenditure incurred.

Revenue has engaged directly with the Coeliac Society of Ireland and, in correspondence earlier this year, invited the society to engage with it on the matter if the society had further queries.

Emer Higgins (Dublin Mid West, Fine Gael)
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There are six EU countries in which monthly aid, averaging €67.66, is provided to coeliacs. Following a gluten-free diet as a coeliac can be costly. In light of the rise in the cost of living and other inflation, this is an issue that we need to examine. We need to simplify and expand the current process.

I am grateful to the Coeliac Society of Ireland in Clondalkin for raising this issue with me and Deputy O'Dowd. I will remind my constituents that they can purchase gluten-free products in the society's shop in Clondalkin and use those receipts as part of their tax relief process.

I hope that we will see supports for coeliacs improving. The budget will form part of that plan in the context of non-PAYE supports and potentially expanding the tax relief.

Fergus O'Dowd (Louth, Fine Gael)
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I am unhappy with the Minister of State's reply. I reject it absolutely. I know he was only reading from a script that he was given, but he said "the arrangements exclude costs incurred in respect of gluten-free alcohol." I do not know who wrote that, but if he or she believes that people who suffer from coeliac disease are guzzling alcohol and looking for a subsidy for that, then nothing could be further from the truth. People are concerned about the health impacts on them and their families for their whole lives: osteoporosis; amnesia; vitamin B deficiency; and various cancers. That script had a callous writer – the Minister of State did not write it – and what was in it was unacceptable. I reject its first paragraph, according to which this "is a matter in the first instance for the Minister for Health." As I told the Minister of State, the chairman of the Revenue Commissioners has made it clear that he accepts his responsibility. He went further, writing that the Minister for Finance had stated that he would ask his officials to discuss this matter with Revenue. He also wrote that Revenue was engaging with the Coeliac Society of Ireland.

The Minister of State has been given a bum steer. It is not good enough that someone would send him into the Dáil with that rubbish. I want to know what is happening and what progress is being made on Revenue's commitments. The script's writer would be hauled over the coals if he or she was in my office.

Seán Fleming (Laois-Offaly, Fianna Fail)
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I thank the Deputies for their comments. I apologise for the insensitive reference in my script.

Fergus O'Dowd (Louth, Fine Gael)
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It was absolutely unacceptable and offensive.

Seán Fleming (Laois-Offaly, Fianna Fail)
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The issue mentioned is probably dealt with in legislation, but I accept that the context in which I read it out was insensitive. I hope that the Deputy will accept my bona fides in that respect.

I stated that the question of subsidising gluten-free foods for those with coeliac disease was a matter for the Minister for Health in the first instance, but let me explain. If it is not handled in that manner, Revenue and the taxation side can play a role. If it was handled by the Department of Health in the first instance, though, then people might not need to go through the tax system. Since it is not being done through the Department of Health, the tax system is coming in as a safety net for some people. As Deputy Higgins pointed out, that does not address people who are not in the tax net, who are not covered by Revenue's intervention. Perhaps it should all be dealt with more holistically through the Department of Health and not require Revenue or taxation interventions. That is a longer term policy issue, but it would be a better solution and would not need to involve the Revenue Commissioners at all. I take Deputy Higgins's point.

People need to keep receipts and so on, but it can be done in a simplistic way. Most people's income tax returns are on a self-assessment basis. They just put down the figure for their medical expenses on a form each year. Only if they are subject to an audit must they produce receipts.

It is not normal to have to send in all those receipts or go through all that paperwork. I take on board the importance of the issue from a health perspective. Where the Revenue Commissioners or the Department of Finance can help those income tax payers, we are happy to do so as best we can.