Donnchadh Ó Laoghaire (Cork South Central, Sinn Fein)
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1591. To ask the Minister for Health when the long-term illness scheme will be reviewed under the Sláintecare implementation strategy. [17380/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Long-Term Illness (LTI) Scheme was established under Section 59(3) of the Health Act 1970 (as amended). Regulations were made in 1971, 1973 and 1975, prescribing 16 illnesses covered by the Scheme. These are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide.

Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.

My Department is examining all of the issues around the scope of the Scheme.

However, it is also important to remember that the LTI Scheme exists within a wider eligibility framework.

This Government has put a significant focus on improving access to and the affordability of healthcare services, advancing substantial policy, legislation and investment to deliver expanded eligibility.

The significant investment in Budget 2023 will facilitate better access to affordable, high-quality healthcare for people at a time when the cost-of-living crisis is impacting on everyone.

In 2023 this will mean:

an expansion of GP care without charges to people earning no more than the median household income

all public in-patient hospital charges will be abolished

an extension of free contraception to 26-year-old women since 1 Jan 2023, and further extension to 27-30 years old women from 1 September 2023.

These measures will continue to create a health and social care service that offers affordable access to quality healthcare.

In addition, people who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. Medical card eligibility is primarily based on an assessment of means and is not granted on the basis of any particular condition.

In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness. In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.

Under the Drug Payment Scheme (DPS), no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS is not means tested and is available to anyone ordinarily resident in Ireland. The DPS significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.

Individuals may also be entitled to claim tax relief on the cost of their medical expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.

Stephen Donnelly (Wicklow, Fianna Fail)
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At present, the HSE Public Dental Service provides a screening and necessary treatment for children approximating to second and sixth class and, in some cases, fourth class. Emergency care is provided for children of all ages up to 16 and for those with complex and additional needs.

There are challenges in the provision of oral healthcare services and patients of all ages are waiting longer than they should have to, to access care. I am responding to this by an unprecedented allocation of an additional €15 million in Budget 2023 to enhance the provision of oral healthcare services. This includes €5 million allocated on a one-off basis to support the HSE Public Dental Service to provide care this year, including to address backlogs in the targeted primary school programme.

In the longer term, the Government recognises that substantive reform of oral healthcare services is required, as set out in the National Oral Health Policy, Smile agus Sláinte. The Policy will support the provision of all levels of care, by appropriate healthcare professionals and in the most suitable settings, to all children and adults regardless of age. The Policy fundamentally aspires that all Irish people will have their own ‘dental home’ where they build a life-long relationship with a local dental practice or practices of their choosing for continuity of care from birth to old age, reflecting how services are provided in general medical practice. For the majority of the population, this ‘dental home’ will be a local general dental practitioner. General dental practices who participate will have a State contract reflecting how general medical services provide care for children. Therefore, parents will be able to choose where and when to bring their child to access crucial, prevention-focused oral healthcare.

€4.75m has been allocated in Budget 2023, as part of an unprecedented additional allocation of €15m for oral healthcare services in 2023, for the development and roll-out of these comprehensive oral healthcare packages to the first cohort of children, aged from birth to 7 years.