Wednesday, 27 November 2019

Questions (142)

Peter Burke


142. Deputy Peter Burke asked the Minister for Health the way in which a person (details supplied) can access treatment for lyme disease when appropriate services are unavailable here; if the person can access the cross border directive to seek appropriate treatment abroad; the options available for persons who continue to suffer from the disease after accessing all treatments available here; and if he will make a statement on the matter. [49248/19]

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Written answers (Question to Health)

Lyme disease (also known as Lyme borelliosis) is an infection caused by a spiral-shaped bacterium called Borrelia burgdorferi.  Lyme borelliosis is diagnosed by medical history and a physical examination.  The infection is confirmed by blood tests which look for antibodies to Borrelia burgdorferi produced by an infected person's body in response to the infection.  These normally take several weeks to develop and may not be present in the early stages of the disease. 

Lyme disease can be very successfully treated using common antibiotics.  These antibiotics are effective at clearing the rash and helping to prevent the development of complications.  Antibiotics are generally given for up to three weeks.  If complications develop, intravenous antibiotics may be considered.  In Ireland, treatment by most clinicians is based on that laid out in evidence-based guidelines for the management of patients with Lyme disease published by the Infectious Diseases Society of America in 2006.   

Testing and treatment for Lyme disease is available in most of the larger hospitals in Ireland, therefore, there is no necessity for Irish residents to travel to other EU Member States for diagnosis or treatment.  

Patients can seek to access health care in another EU/EEA member state via two different  schemes.  

Where a service is provided in Ireland, but a patient wishes to access care in another EU/EEA Member State, this can be possible by seeking treatment under the Directive on Patients' Rights in Cross Border Healthcare, otherwise known as the Cross Border Directive (CBD).  The HSE operates the CBD in Ireland.  Referral for care under the CBD may be made by a GP, a hospital consultant and certain other clinicians.  In line with practice in other EU Member States, the HSE through the National Contact Point (NCP) provides information for patients on the CBD on its website which can be accessed at: and also by phone at (056) 7784551.  

The HSE advises where a patient is in any doubt as to the need to seek prior authorisation before availing of a consultation or treatment abroad to contact the NCP.  

The HSE also operates the Treatment Abroad Scheme (TAS) for persons entitled to treatment in another EU/EEA Member State or Switzerland under EU Regulation (EC) No. 883/2004, as per the procedures set out in EU Regulations (EC) No. 987/2009.  The TAS provides for the cost of approved treatments in another EU/EEA member state or Switzerland through the issue of form E112 (IE) where the treatment is:

- Among the benefits provided for by Irish legislation;

- Not available in Ireland; and

- Not available within the time normally necessary for obtaining it in Ireland, taking account of the   patient's current state of health and the probable course of the disease.

GPs refer patients to consultants for acute care and it is the treating consultant who, having exhausted all treatment options including tertiary care within the country, refers the patient abroad under the terms of the TAS.  The consultant must specify the specific treatment and in making the referral accepts clinical responsibility in relation to the physician and facility abroad where the patient will attend.  Applications to the TAS are processed and a determination given in accordance with the statutory framework prior to a patient travelling to avail of treatment.  The statutory framework stipulates the patient must be a public patient and is required to have followed public patient pathways.  Information on the TAS can be accessed on the HSE website at: and also by phoning (056) 7784551.