Dáil Éireann díospóireacht -
Thursday, 29 Jun 1995

Vol. 455 No. 3

Written Answers - Payment of Medical Costs.

Liz O'Donnell

Ceist:

81 Ms O'Donnell asked the Minister for Health the number and type of medical procedures carried out abroad which were paid for by each health board in the past 18 months; their individual costs; and if he will make a statement on the matter. [12155/95]

Minister for Health (Mr. Noonan,

Limerick East): The detailed information requested by the Deputy is not routinely collected by my Department as under the terms of the Referral Abroad Scheme, the Chief Executive Officer of the referring health board can approve cases without reference to my Department where the total costs involved are less than £10,000. Before a patient is referred abroad, certain procedures must be complied with, including the certification by his-her medical consultant that (i) the treatment concerned is not available in this country; (ii) there is an urgent medical necessity for the treatment; and (iii) there is a reasonable medical prognosis.

The following data on referrals abroad in the past 18 months has been obtained from the eight health boards:

Eastern Health Board	114 patients referred abroad
Midland Health Board	4 patients referred abroad
Mid-Western Health Board	20 patients referred abroad
North Eastern Health Board	35 patients referred abroad
North Western Health Board	13 patients referred abroad
Southern Health Board	11 patients referred abroad
South Eastern Health Board	20 patients referred abroad
Western Health Board	27 patients referred abroad

Detailed information on the individual costs involved is not available as in many instances the invoices have yet to be submitted to the health boards.

The majority of referrals abroad relate to specialised treatment such as bone marrow transplants, heart-lung transplants and liver transplants and are necessary due to the unavailability of the service or the shortfall in facilities for such operations in this country. However, the recent upgrading in services, including the bone marrow transplant unit at Our Lady's Hospital in Crumlin and the new oncology-haematology-bone marrow transplant unit at St. James's Hospital should allow most of the future bone marrow transplantation cases to be treated in this country.

In relation to liver transplantations for adults, the National Centre for Adults at St. Vincent's Hospital has achieved a high success rate since its establishment in 1993. A working group chaired by the Department and comprising representatives from Our Lady's Hospital, Crumlin and St. Vincent's Hospital, Elm Park is currently examining the feasibility of developing a liver transplantation programme for children.

Developments such as these will allow Irish patients to avoid the disruptions associated with travelling abroad for treatment. However, it should be recognised that because of the high cost of some techniques and limited resources it will not be possible to make all highly sophisticated surgical procedures available in this country. It will, therefore, continue to be necessary to refer patients abroad for certain procedures. The position regarding referral abroad for treatment is kept under continuous review by my Department and specialist developments will continue to be made as resources permit.