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.

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