I propose to take Questions Nos. 643, 683 and 684 together.
The HSE records information relating to the Treatment Abroad Scheme based on the treatment for which the patient is being referred outside the state and not on the basis of an identified condition. In compliance with the HSE's guidance on patient confidentiality and data protection, the release of statistical information is based on a volume of cases of five or greater. On this basis, we cannot provide the information requested by the Deputy.
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 Regulations 574/72, and in accordance with Department of Health Guidelines. Within these governing EU Regulations and the Department of Health 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). A decision is made on each application in accordance with this legislation and guidelines and on the basis of a review by clinical experts. The cost of the treatment is not a deciding factor when approving an application. The treatment must not be available within the State or not available within a time normally necessary for obtaining it.
The TAS allows for an Irish based medical consultant to refer a patient that is normally resident in Ireland for treatment, in a public hospital, in another EU/EEA 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).
and wish to confirm that applications for the Treatment Abroad Scheme are assessed on a case by case basis.
As stated above, the HSE TAS processes applications on the basis of the treatment that the patient is being referred outside the state to receive, which is not available in Ireland. The presence of a rare illness, such as Ehlers Danlos Syndrome, is not of itself criteria for availing of treatment abroad: most rare diseases are treated without the need for recourse to services in other jurisdictions.
Patients, in conjunction with their Irish based public referring hospital consultant, have the ability to apply to the HSE TAS seeking access to public healthcare outside the state through model form E112. Applications to TAS are processed and a determination given in accordance with the statutory framework prior to a patient travelling to avail of treatment. Approved applicants/patients' hospital treatment costs are covered through the issue of form E112 (IE) for the specific identified episode of care. Once a patient is discharged from a specific episode of care abroad, their care immediately reverts to their Irish based consultant.
Each application to the HSE TAS is reviewed individually on its own merits and there are no restrictions, regarding age or otherwise, on a person making an application to the HSE TAS for review and decision. Previous approvals or declines are not used as an influencing factor on subsequent applications. Each application is for an individual episode of care unless otherwise specified by the consultant on the application form. Each application to TAS is processed and given a formal written decision. If that decision is one of decline, the reason for that decision is clearly outlined and the option of an appeal is afforded. Furthermore, as above the decision on an application does not restrict future applications for an individual patient or indeed other patients seeking treatment abroad that is not available in Ireland.
It is not possible to give a "blanket" statement on application s to TAS for patients with a particular condition, not least in relation to EDS where its presentation differs from patient to patient. As outlined above, applications are made in respect of a specified treatment not available in Ireland.