Dáil Éireann Debate, Wednesday - 18 April 2012
1215 Deputy Simon Harris asked the Minister for Health the position regarding the current funding situation for the selective dorsal rhizotomy operation; if orthopaedic consultants working for the Health Service Executive are authorised to refer children for this operation; and if he will make a statement on the matter. [17874/12]
View answer1216 Deputy Simon Harris asked the Minister for Health if he will confirm if procedures have been put in place to ensure young children who have travelled to either the United Kingdom or the USA for the selective dorsal rhizotomy operation will be able to avail of the physiotherapy services necessary to ensure the success of the operation on their return to Ireland; and if he will make a statement on the matter. [17875/12]
View answer1217 Deputy Simon Harris asked the Minister for Health if his attention has been drawn to the discrepancy between the number of young children with cerebral palsy who have been recommended for the selective dorsal rhizotomy operation by Enable Ireland’s specialist service, and subsequently approved by the surgical teams carrying out the operation, and the number who have been able to secure a formal referral from their Health Service Executive consultant; if his attention has been drawn to the implications of this discrepancy under the terms of the treatment abroad scheme; and if he will make a statement on the matter. [17876/12]
View answer1218 Deputy Simon Harris asked the Minister for Health the number of children who have been referred by the Health Service Executive for the selective dorsal rhizotomy operation to date; and if he will make a statement on the matter. [17877/12]
View answerI propose to take Questions Nos. 1215 to 1218, inclusive, together.
The HSE operates a Treatment Abroad Scheme (TAS), for persons entitled to treatment in another EU/EEA member state or Switzerland under EU Regulation 1408/71, as per the procedures set out in EU Regulation 574/72, and in accordance with Department of Health Guidelines. Within these governing EU Regulations and the Department of Health and Children's Guidelines, the TAS provides for the cost of approved treatments in another EU/EEA member state or Switzerland through the issue of form E112 (IE).
The TAS allows for an Irish based consultant to refer a patient that is normally resident in Ireland for treatment in another EU member state or Switzerland, where the treatment in question meets the following criteria:
(a) The application to refer a patient abroad has been assessed and a determination given before that patient goes abroad.
(b) Following clinical assessment, the referring consultant certifies the following:
They recommend the patient be treated in another EU/EEA country or Switzerland;
The treatment is medically necessary and will meet the patient’s needs;
The treatment is a proven form of medical treatment and is not experimental or test treatment;
The treatment is in a recognised hospital or other institution and is under the control of a registered medical practitioner;
The hospital outside the state will accept EU/EEA form E112 (IE).
With specific reference to your question as to the numbers of children who have secured referrals by their treating consultant for the procedure I hope the following will explain the rationale that must be considered by any consultant making a referral for this irreversible treatment. In recent past months the Treatment Abroad Scheme (TAS) of the HSE has had a number of applications for the Selective Dorsal Rhizotomy procedure for which there is an emerging evidence base. The NHS, which provides the treatment for patients that have received approval under the TAS, has published guidance for the provision of same. This guidance states: "Current evidence on selective dorsal rhizotomy for spasticity in cerebral palsy shows that there is a risk of serious but well-recognised complications. The evidence on efficacy is adequate.....During the consent process parents or carers should be informed that selective dorsal rhizotomy....is irreversible...” All applications to the TAS are independently assessed by the HSE Health Intelligence Unit. In consideration of the NHS guidelines for referral for this procedure, the HSE is working with leading paediatric consultants to establish an assessment procedure in Ireland for patients seeking referral for the procedure, prior to the patients’ applications being submitted to the TAS. The aim of this assessment procedure would be to ensure the patient is a suitable candidate for the procedure and to ensure the parent(s) or carer fully understands the procedure and the implications of same.
It is important to ensure that aftercare is provided for patients that undergo this procedure and our aim is to provide this aftercare in Ireland for patients that have been approved and have received the treatment. The HSE's Treatment Abroad Scheme and Health Intelligence Unit are scheduling meetings with relevant consultants early in May to review the matter of referrals for selective dorsal rhizotomy.
