Marie Sherlock (Dublin Central, Labour)
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1400. To ask the Minister for Health for an update on the review of the long-term illness scheme included as part of a review of the current eligibility framework carried out under commitments within the Sláintecare Implementation Strategy; to provide a timeline for the publication of the review; and if she will make a statement on the matter. [29496/25]

Barry Heneghan (Dublin Bay North, Independent)
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1641. To ask the Minister for Health if she will initiate a comprehensive review of the long-term illness scheme, in view of the fact that the list of eligible conditions has remained unchanged for over 50 years, despite major advances in chronic disease management; if she will ensure that such a review includes consideration of high-burden chronic and rare diseases that require lifelong treatment and monitoring but are currently excluded; and if she will make a statement on the matter. [30729/25]

Barry Heneghan (Dublin Bay North, Independent)
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1642. To ask the Minister for Health if she will ensure that any forthcoming review of the long-term illness scheme will explicitly address the equity gap for patients with lifelong chronic or rare conditions who face substantial out-of-pocket costs despite not qualifying for the drugs payment scheme or a medical card; if she will acknowledge that these fallback mechanisms are income-restricted and do not guarantee cost-free access to essential medication; if she will outline how her Department intends to align national supports with the goals of the 2025 World Health Assembly Resolution on Rare Diseases; and if she will make a statement on the matter. [30730/25]

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I propose to take Questions Nos. 1400, 1641 and 1642 together.

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 conditions 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. While there are currently no plans to extend the list of conditions, it is important to remember that the LTI Scheme exists within a wider eligibility framework.

There has been a significant focus on improving access to and the affordability of healthcare services over the last few years. This includes reductions in the Drugs Payment Scheme threshold, expansion of access to free GP care, and the abolition of all public in-patient hospital charges for children and adults. These measures continue to create a health and social care service that offers affordable access to quality healthcare.

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 under the General Medical Services (GMS) Scheme. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE.

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.

The issue of granting medical card eligibility based on having a particular disability or illness was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card.

Prescription charges under the GMS Scheme were introduced in the Health (Amendment) (No. 2) Act 2010. On 1 November 2020, prescription charges were reduced to:

• €1 per item with a maximum charge of €10 per month, for those aged over 70.
• €1.50 per item with a maximum charge of €15 per month, for those aged under 70.

• From €114 to €100 on 1 January 2022.
• Fromm €100 to €80 on 1 March 2022.

Consideration of further changes to the DPS threshold or to prescription charges will be made in the context of current healthcare priorities and the budget available.

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%.