Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
With regard to whether the patient can avail of treatment through the National Treatment Purchase Fund (NTPF). The NTPF works with public hospitals, as opposed to with patients directly, to offer and provide the funding for treatment to clinically suitable long waiting patients who are on an inpatient/day case waiting list for surgery, having been referred on to such a list following clinical assessment by a consultant/specialist at an outpatient clinic.
The key criteria of the NTPF is the prioritisation of the longest waiting patients first. While the NTPF identifies patients eligible for NTPF treatment, it is solely on the basis of their time spent on the Inpatient/Daycase Waiting List. The clinical suitability of the patient to avail of NTPF funded treatment is determined by the public hospital.
In addition, the HSE operates the Cross-Border Directive (CBD) in Ireland which entitles persons ordinarily resident in Ireland who have an appropriate referral for public healthcare to opt to avail of that healthcare in another EU/EEA Member State. The CBD provides rules for the reimbursement to patients of the cost of receiving treatment abroad, where the patient would be entitled to such treatment in their home Member State, and supplements the rights that patients already have at EU level.
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 https://www2.hse.ie/services/cross-border-directive/about-the-cross-border-directive.html and also by phone at 056 7784551
Prior authorisation may be required from the HSE for certain healthcare so patients intending to access care under the CBD should check with the HSE in advance of travelling. 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.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.