Health (Amendment) Bill 2026: First Stage

Deputy Louise O'Reilly

I move:

That leave be granted to introduce a Bill entitled an Act to amend the Health Act 1970 and to provide for related matters.

I will share my time. The Bill amends the Health Act 1970 to ensure the effectiveness of the provision without charge of drugs, medicines or medical or surgical appliances to persons suffering from the precise disease or disability of a permanent or long-term nature through a review every three years. The long-term illness, LTI, scheme has been a success since its establishment and has assisted many people across this State. However, it has not been updated for a long time and as a result, we now know about many disabilities, ailments and illness that would not have been known about when the Bill was first introduced. They are long-term and lifelong but in some instances they are not covered by the scheme. In order to know if this scheme is fit for purpose and is delivering for those who need it, it is important that it is monitored and reviewed and that this is done on a consistent basis.

Conditions such as endometriosis and polycystic ovary syndrome, PCOS, should be covered by the scheme. However, women find themselves having to find the money for treatment in some instances and shop around, as it were, and go to multiple appointments to be prescribed drugs. This can have a very severe impact on their pocket. Obviously, there is the drugs payment scheme but, again, that does not always work and sometimes acts as a barrier for these women.

In order for any Government scheme to be effective and for us to know it is working and delivering in the way intended, it should be reviewed on a regular basis. It is important that the review is then placed before the Dáil so that we have a chance to have that debate but also so that the findings of any such review are incorporated into ensuring any scheme is fit for purpose, delivering, modern, effective and capable of taking into account any illnesses that might arise. It is important that there is a periodic, mandated review, which will give us a chance in this House to have a discussion but will also give the Minister for Health of the day the opportunity to engage with the review and update the scheme as appropriate. We believe the scheme is a good scheme but not reviewing it for decades does not make it effective. It is becoming less effective with time.

Deputy David Cullinane

The long-term illness scheme was established under section 59 of the Health Act in 1971. The last time a condition was added to the scheme was in 1975. In the meantime, 51 years of advancement in medical knowledge has been ignored and those suffering from chronic or long-term conditions who cannot get a medical card have been left without support. This, of course, would not have been an issue if the Government had advanced universal health care, but the medical card thresholds have not been touched in over 20 years.

We all agree that the long-term illness scheme should not be needed because anyone who needs care should receive it on the basis of need and not the ability to pay. This is a principle we all signed up to but, unfortunately, there has been little change in medical card entitlements since 2005, and there is no commitment in the programme for Government to address this. This is why we are introducing this legislation. We have no faith that the Government will take any meaningful action to deliver universal healthcare that is free at the point of use. People with long-term and chronic conditions cannot be left on the long finger for another decade while they wait for change.

This Bill is straightforward. It requires the Minister for Health to undertake periodic reviews of the conditions, medications and equipment on the long-term illness scheme to make sure it is fit for purpose. It would require the first review to start within a year and subsequent reviews to take place every three years. There are so many conditions that are not on the long-term illness scheme but should be. One major example of this is endometriosis. Endometriosis is a serious chronic disease and can cause severe pain, heavy and painful periods, infertility, internal scarring and damage to organs including the bowel, bladder and kidneys. It affects at least one in ten women in Ireland and yet it can take years to receive a diagnosis. Steps have been taken to address this under the endometriosis framework. We are all working across this House to improve access to care in Ireland for women but supports for medication and equipment for non-medical cardholders is a major emission from the work under way in the HSE.

Endometriosis is not short term and it is not cheap to manage. It is a long-term condition with a profound impact on quality of life, work, relationships, fertility and mental health. This is exactly the kind of condition the long-term illness scheme should be capable of recognising. I hope that when we move this Bill on Second Stage, the Government will be in a position to support it and add other illnesses to the scheme.

Dáil Éireann debate -
Wednesday, 17 Jun 2026