pay a government levy for each item dispensed. The levy is €2.00 up to a maximum of €20 per family per calendar month. Those who are suffering from one of a list of 16 long-term illnesses do not have to pay for medicines or medical appliances related to their conditions. Ireland has below-average use of generic medication according to the OECD, despite being a major exporter. The levy was reduced to €1.50 from April 2019 for medical card holders over the age of 70, and will be further cut to €1 from April 2020. All immunisation vaccines for children are provided free of charge, in schools, health clinics and hospitals. Recovering heroin addicts can receive methadone treatment free of charge under the Methadone Treatment Scheme. Information technology The health service was said to have a ‘frail IT system’ and a ‘very-low level of cyber security maturity’ in a report by PricewaterhouseCoopers on ransomware attacks in 2021. Coombe Women & Infants University Hospital was targeted on 15 December 2021 forcing its IT services to be shut down. Other services The HSE provide dental, optical (vision) and aural (hearing) health care. Medical Card holders and their dependents, Health Amendment Act Card holders and children get these services free. Other people can get these services free or at a reduced cost from the Treatment Benefit Scheme or private insurance. People who pay the full price to private practitioners can claim tax relief. The HSE also provide mental health services, and treatment and rehabilitation services for alcohol and drug addicts. The Irish healthcare system is often criticized for not providing sufficient services for those with mental health issues, leading to a rapidly growing suicide rate, and ineffective services delivered to young people. Payment schemes Those and their dependants without a Medical Card or private health insurance can receive medical services free or at a subsidised rate from the Treatment Benefit Scheme, which takes into account the compulsory Social Insurance Fund (PRSI) contributions they have made. People can also claim tax relief on medical expenses not covered by the State or by private health insurance. Those with private health insurance are provided with tax credits, which are passed directly to the insurance company and lower the customer's premium. Visitors to Ireland who hold a European Health Insurance Card do not have to pay for emergency treatment from a general practitioner or specialist, emergency dental, oral