Dáil Éireann Debate, Tuesday - 30 September 2014
82. Deputy Clare Daly asked the Minister for Health if he is satisfied with the operation of the treatment abroad scheme department of the Health Service Executive in relation to the making of decisions, the appeal process and new E112 forms which remove the right to voluntary and informed consent; and if he will make a statement on the matter. [36499/14]
View answerThe Treatment Abroad Scheme, operated by the Health Service Executive, provides for the referral of patients to another EU/EEA country or Switzerland for a treatment that is not available in Ireland or where undue delay is experienced in accessing necessary treatment in Ireland. Under the Scheme, the HSE provides for the cost of approved treatments abroad through the issue of form E112.
There are clear qualifying criteria to access the Scheme set out in EU Regulations and in Department of Health Guidelines. Treatment must be medically necessary, must meet the patient’s needs and may not be an experimental treatment. It is also a requirement that the hospital outside the state will accept form E112. The application must be assessed and a determination given before that patient goes abroad. The HSE is not required to approve a treatment which is not available in Ireland where an equivalent treatment which will meet the patient’s needs is available.
The Scheme is operated on an equitable and transparent basis for all applicants and ensures the implementation of the governing statutory framework is applied in a consistent manner.
Each application to the Scheme is reviewed individually on its own merits and there are no restrictions on a person making an application to the Scheme for review and decision. Previous approvals or declines are not used as an influencing factor on subsequent applications. Each application 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.
The application form does not remove the right to voluntary and informed consent. In fact, the application form is specifically designed to secure that consent by notifying the applicant that the HSE reserves the right to access medical records. This access is specific to that required for the proportionate administering of the Scheme.
An application to the Scheme is for the funding of a treatment, not an approval of the treatment sought. In processing an application the HSE must examine the form to decide if the application meets with the rules set for the Scheme. Of necessity the HSE must ensure it has sufficient information to establish compliance with the legislation and guidelines and the veracity of the application. It is considered that the measures undertaken by the HSE in respect of the application process are proportionate, both in ensuring the patient's right to access the Scheme and also in ensuring the Scheme is properly administered.
