Dáil Éireann Debate, Tuesday - 26 September 2023
172. Deputy Fergus O'Dowd asked the Minister for Finance to respond to concerns and proposals from a person (details supplied) in respect of the exclusion of permanent fillings on root canals from the MED2 process; and if he will make a statement on the matter. [41267/23]
View answerSection 469 of the Taxes Consolidation Act 1997 (TCA 1997) provides for tax relief where an individual proves that he or she has incurred costs in respect of qualifying health expenses.
Only “health expenses” incurred in the provision of “health care”, which has been carried out or advised by (in certain circumstances) a “practitioner”, will qualify for tax relief.
Health expenses are defined as “expenses in respect of the provision of health care” and may include, but are not limited to, the following:
• the services of a practitioner,
• diagnostic procedures carried out on the advice of a practitioner,
• maintenance or treatment necessarily incurred in connection with the services of a practitioner or diagnostic procedures carried out on the advice of a practitioner, and
• drugs or medicines supplied on the prescription of a practitioner.
A practitioner is a person who is:
• registered in the register established under section 43 of the Medical Practitioners Act 2007,
• registered in the register established under section 26 of the Dentists Act 1985, or
• in relation to health care provided outside the State, entitled under the laws of the country in which the care is provided to practice medicine or dentistry there.
Health care is defined as the “prevention, diagnosis, alleviation or treatment of an ailment, injury, infirmity, defect or disability”.
Excluded from the definition (i.e. meaning that tax relief is not available), amongst other treatments, is “routine dental treatment”. Revenue has no discretion in relation to the items excluded from the relief, as the meaning of routine dental treatment is defined within section 439(1) TCA 1997 as “the extraction, scaling and filling of teeth and the provision and repairing of artificial teeth or dentures ”.
These “routine dental treatment” items are excluded from relief even if there is an underlying medical condition that gives rise to the dental treatment. These defined items are excluded also where the treatment in a particular case is considered to be of a non-routine nature, for example, if of a non-routine orthodontic nature, involving the extraction of a tooth as part of that treatment, relief would be allowed for the cost of the orthodontic treatment excluding the cost of the extraction.
The rationale behind income tax relief for health expenses is broadly intended to provide assistance for those expenses of a significant or exceptional nature. The exclusion of expenses incurred in respect of routine dental treatment has been in place since the relief’s inception in 1967 and I am satisfied that the legislation as drafted and implemented provides sufficient flexibility for expenses that should qualify. There are no plans to change these arrangements at this time.
In this regard, I note that tax relief for medical expenses is a commonly availed of relief – the most recent data (from 2021) highlights that (excluding nursing home fees) 567,900 taxpayer units availed of the relief at an Exchequer cost of €172 million. If routine dental expenses, were tax relieved, it would inevitably lead to calls for other treatments to similarly qualify for relief. This could greatly increase the overall cost of the tax relief.
However, the Deputy will be aware that in recent years there has been an increase in the level of dental benefits available through the social insurance system administered by the Department of Social Protection. In this regard, it is noted that tax relief is only of assistance to individuals who have sufficient tax liability and so direct expenditure may be a more effective way of targeting assistance to those who may need a specific support.
In relation to the Deputy’s request regarding consolidation of the Taxes Consolidation Act, I would note that the Commission on Taxation and Welfare also made this recommendation. However, the Commission’s Report recognised that this would represent a large undertaking and would require significant resources to be allocated to the Department of Finance, the Revenue Commissioners and the Office of the Parliamentary Council. I would further note that it is clearly set out in the Commission’s report that the recommendations are not intended to be implemented all at once, but rather provide a clear direction of travel for this and future Governments.
In respect of resources currently available to the general public by which they can track the evolution of the law, the Office of the Attorney General provides the electronic Irish Statute Book, an online database which includes Acts of the Oireachtas and Statutory Instruments. This website allows members of the public to track amendments to and commencements of legislation, access the Constitution and a selection of pre-1922 legislation while also providing links to external legislation resources.
