Bernard Allen
Ceist:595 Mr. Allen asked the Minister for Health and Children the implications of a recent ruling by the European Court of Justice regarding access to treatment in other jurisdictions. [22097/01]
Written Answers. - Hospital Treatment.
Regulation (EC) 1408/71, as amended by Regulation (EC) 2000/83, is the co-ordinating regulation covering the referral of patients abroad for benefits-in-kind, including hospital treatment. This regulation requires that patients seeking hospital treatment in an EU member state other than their own seek prior authorisation from their competent institution – ERHA-health boards in Ireland's case – prior to receiving this treatment. The most recent European Court of Justice judgments in this area have not changed this position in that they reaffirm the necessity for a person seeking hospital treatment abroad to seek prior authorisation from the relevant health board prior to receiving this treatment.
The European Court of Justice has ruled that due to the specific nature of hospital services, member states should not be precluded from restricting the free movement of patients for the receipt of health care where such restrictions can be objectively justified. The "risk of seriously undermining the financial balance of a social security system", "the objective of maintaining a balanced medical and hospital service open to all" and "the maintenance of treatment capacity or medical competence on national territory" are three such objective criteria set out by the European Court of Justice. However, the court has ruled that the granting of such an authorisation must be subject to the conditions that the treatment must be regarded as "normal" in the professional circles concerned and the person's medical condition must require that treatment. In that regard, the court has also ruled that authorisation cannot be refused on the grounds of the treatment not being "normal" where it is considered that the treatment concerned is tried and tested by international science. In addition, authorisation can only be refused on the grounds of lack of medical necessity where similar or equally effective treatment can be obtained without undue delay in the person's member state.
The European Court of Justice has ruled that a scheme of prior authorisation must be based "on objective, non-discretionary criteria which are known in advance, in such a way as to circumscribe the exercise of the national authorities' discretion, so that it is not used arbitrarily". The Department issued directions some time ago outlining the objective criteria which health boards must consider prior to referring patients abroad for treatment.
Referral of patients to countries outside the EU is outside the terms of Regulation (EC) 1408/71. Referrals to the United States, for example, will not be affected by these judgments and will continue to be made based on the Department's directives, as mentioned above. The contracting out of cases to other EU member states, primarily the United Kingdom, and the United States has been a facility used by health boards. These contracts are outside the terms of Regulation (EC) 1408/71.
Question No. 596 answered with Question No. 583.