Dáil Éireann Debate, Tuesday - 15 December 2015
446. Deputy Mary Mitchell O'Connor asked the Minister for Health why the flight cost for only one parent and not for two is covered under the treatment abroad scheme; and if he will make a statement on the matter. [45157/15]
View answer447. Deputy Mary Mitchell O'Connor asked the Minister for Health why transportation fees other than airfare, for example, trains and taxis required to get to and from King's College Hospital in London in England are not included in the reimbursement policy under the treatment abroad scheme; and if he will make a statement on the matter. [45158/15]
View answer448. Deputy Mary Mitchell O'Connor asked the Minister for Health if the lengthy process of reimbursement for flights by the treatment abroad scheme will be substituted with a policy that would allow the Health Service Executive to make the initial payment for qualified flights; and if he will make a statement on the matter. [45159/15]
View answer449. Deputy Mary Mitchell O'Connor asked the Minister for Health why the referring consultant here cannot provide proof of attendance at King's College Hospital in London in England for an expedited reimbursement system; and if he will make a statement on the matter. [45160/15]
View answer450. Deputy Mary Mitchell O'Connor asked the Minister for Health if he will ensure that reimbursement for families under the treatment abroad scheme will be completed in a timely manner, that is, not up to nine months; and if he will make a statement on the matter. [45161/15]
View answerI propose to take Questions Nos. 446 to 450, inclusive, together.
The HSE operates the Treatment Abroad Scheme (TAS) for persons entitled to treatment in another EU/EEA member state or Switzerland under Regulation (EC) No. 883/2004, as per the procedures set out in Regulation (EC) No. 987/2009, and in accordance with Department of Health Guidelines. Patients have the ability to apply to the HSE TAS 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. It is not considered appropriate that a referring consultant here be required to provide proof that a patient attended an appointment in a hospital abroad under this Scheme.
The Scheme as provided for in the EU Regulations and Department of Health Guidelines, does not include a provision for travel and subsistence expenses for patients or their relatives travelling abroad to avail of approved treatments as the primary function of the TAS is to fund treatments for public patients. In keeping with the functions of any state healthcare agency, the Regulation only requires the state agency to fund the treatment. However the HSE, subject to available funding, may provide assistance towards reasonable economic air or sea travel fares for patients, and in the case of a child or where medically necessary one accompanying adult is also funded. This is in recognition of the additional cost that a patient availing of a treatment which is not available in a tertiary service in Ireland may experience in using the Scheme.
The TAS Travel Policy was implemented in November 2009 to standardise and provide equity to the provision of entitlements relating to travel expenses. Expenses other than air/sea fares are not admissible. However, patients who experience difficulty funding any additional costs may apply to the Department of Social Protection for assistance as an exceptional needs payment. It should be noted that, in general, patients do not incur subsistence costs when undergoing treatment abroad as such costs are included in the cost of the care that the patient is receiving.
The HSE fully accepts there have been delays in processing the reimbursement claims for patients during certain periods over the past 2 years, owing to staffing issues in the TAS office including a long-term staff absence due to illness. The TAS office has offered apologies to patients affected by such delays. During those periods, priority has been given to processing applications over travel claims so as to facilitate approved applicants to receive their treatment under the Scheme. The TAS office genuinely regrets this situation and acknowledges the difficulties this can cause for individual patients and/or their families. Arrangement made by the TAS office have permitted the backlog of claims up to 24 November to be cleared and the aim is to ensure that all claims are processed before Christmas.
