Dáil Éireann Debate, Thursday - 8 October 2015
170. Deputy Bernard J. Durkan asked the Minister for Health if he will indicate if the cost of a special hip operation to be carried out on a person (details supplied) in County Kildare who holds a full medical card and whose surgery cannot be facilitated in this jurisdiction but is possible in the United Kingdom, will be borne in full by the general medical services; and if he will make a statement on the matter. [35122/15]
View answerUnder the Health Acts, all persons ordinarily resident in the country are entitled, subject to certain charges, to all in-patient public hospital services in public wards including consultant services. While the General Medical Services covers specific primary services, medical card holders are exempt from the public hospital charges.
The HSE operates two schemes for patients seeking to access healthcare abroad. The Treatment Abroad Scheme (TAS), under which patients have the ability to apply to the HSE seeking access to public healthcare outside the State through model form E112. The application requires the patient's Irish based public referring hospital consultant, following clinical assessment, to certify, among other things, that the treatment is medically necessary and will meet the patient’s needs. The treatment must not be available within the State or not available within a time normally necessary for obtaining it.
The HSE also operates the EU Directive on Patients’ Rights in Cross Border Healthcare (CBD). The healthcare being sought under the CBD can only be healthcare that a person would be entitled to within the public health system in Ireland, which is not contrary to Irish legislation. Referral for care under the CBD can be made by a GP, a hospital consultant and certain other HSE clinicians. It will be a matter for the patient and his/her referring doctor to identify the clinician abroad and satisfy him/herself in relation to the qualifications, quality and safety of the services being availed of in the other jurisdiction. Prior authorisation may be required from the HSE for certain healthcare. The costs must be borne by the individual and he/she then will seek reimbursement for the cost of the healthcare upon return to Ireland. The HSE will reimburse the patient for care, which meets the terms of the CBD, in line with the Directive.
