Do I need to repent before ruqya will work?

Repentance benefits you regardless, and consistent prayer genuinely does make recovery easier. Someone maintaining their obligations gives treatment far more to work with.

But treatment must never be made conditional on it.

Telling a sick person they will only be cured if they pray is emotional leverage, and it is not a practitioner's to apply. It also produces a cruel outcome: when recovery is slow, the person concludes that Allah has rejected them, which is both false and spiritually devastating.

Healing comes from Allah, who gives it to whom He wills. Ruqya can and does benefit people who pray irregularly, and people outside Islam entirely.

The right framing

• Encourage prayer and repentance because they are good in themselves
• Treat the person regardless of where they currently stand
• Never suggest that slow recovery indicates divine displeasure
• Never withhold treatment as leverage

Trials are not evidence of rejection. Some of the most beloved to Allah were tested most severely.