Healthcare Policy
Seanad Éireann — 2026-06-16
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Kieran O'Donnell (FG), Limerick City

I am taking this matter on behalf of the Minister for Health, Deputy Carroll MacNeill. I thank the esteemed Senator for raising this matter.
The long-term illness 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. There have been no changes to the list of 16 conditions since that time.
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 no plans to extend the scope of this scheme, it is important to recognise that it exists within a wider eligibility framework.
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. Eligibility for a medical card is determined by the HSE, primarily based on an assessment of means. 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. The HSE affords applicants the opportunity to furnish supporting documentation to determine whether undue hardship exists and to fully take account of all relevant circumstances that may benefit them in assessment, including medical evidence of costs and certain expenses.
The issue of providing a patient with medical card eligibility on the basis of illness or a disability was previously examined in 2014 by the HSE's expert panel on medical need and medical card eligibility. The group concluded that it was not feasible, desirable or 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. However, over the past several years, there has been a significant focus on improving access to, and the affordability of, healthcare services. This has been advanced through substantial policy, legislation and investment to deliver expanded eligibility and services in line with Sláintecare.
Major expansions in eligibility include the following: the removal of public inpatient charges in public hospitals for children in 2022 and for adults in 2023; in 2023, the provision of free GP visit cards to include children aged six and seven, and those earning no more than the median income, and these changes had an impact on up to 500,000 people; and the reduction of the drugs payment scheme, DPS, threshold, which caps monthly expenditure for approved prescribed medicines. The DPS threshold was reduced to €80 per month in March 2022, which is a 35% reduction since 2020 when it was €124 per month. The DPS is not means-tested and is available to anyone ordinarily resident in Ireland. Taken together, these significant changes and expansions in eligibility continue to create a health and social care service that offers affordable access to healthcare to more people.
In respect of the points that the Senator made about Addison's disease, these are matters that I will bring to the attention of the Minister for Health and her Department officials.

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Record URI: https://data.oireachtas.ie/akn/ie/debateRecord/seanad/2026-06-16/debate/main
Retrieved: 2026-08-14T04:55:03+00:00
Sitting date: 2026-06-16