Derek Keating (Dublin Mid West, Fine Gael)
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181. To ask the Minister for Health if his attention has been drawn to the condition commonly known as EDS Ehlers-Danlos Syndrome; if his attention has been drawn to the fact there is no specialist in Ireland who is trained to deal with this life threatening condition; his plans to address this problem; if there is justification for a medical card for those who are diagnosed with this chronic condition; his plans to address the deficit in medical treatment here; if his attention has been drawn to the fact that patients have to travel to the UK for treatment at their own expense; if it could be included on the travel abroad scheme; and if he will make a statement on the matter. [5818/14]

Alex White (Dublin South, Labour)
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Medical cards are provided to persons who, under the provisions of the Health Act 1970, are in the opinion of the HSE unable without undue hardship to arrange GP services for themselves and their dependants. The assessment for a medical card is determined primarily by reference to the means, including the income and reasonable expenditure, of the applicant and his or her partner and dependants. Under the legislation, determination of eligibility for a medical card is the responsibility of the HSE.

The HSE operates a Treatment Abroad Scheme (TAS), for persons to receive treatment in another EU/EEA member state or Switzerland under EU Regulation 1408/71, as per the procedures set out in EU Regulations 574/72, and in accordance with Department of Health Guidelines. Within these governing EU Regulations and the Department of Health Guidelines, the TAS provides for the cost of approved treatments in another EU/EEA member state or Switzerland through the issue of Form E112 (IE). A decision is made on each application in accordance with this legislation and guidelines and on the basis of a review by clinical experts. The cost of the treatment is not a deciding factor when approving an application. The treatment must not be available within the State or not available within a time normally necessary for obtaining it.

The TAS allows for an Irish based medical consultant to refer a patient that is normally resident in Ireland for treatment, in a public hospital, in another EU/EEA member state or Switzerland, where the treatment in question meets the following criteria: (a) The application to refer a patient abroad has been assessed and a determination given before that patient goes abroad; (b) Following clinical assessment, the referring Consultant certifies the following: they recommend the patient be treated in another EU/EEA country or Switzerland; the treatment is medically necessary and will meet the patient’s needs; the treatment is a proven form of medical treatment and is not experimental or test treatment; the treatment is in a recognised hospital or other institution and is under the control of a registered medical practitioner; the hospital outside the state will accept EU/EEA form E112 (IE).

The HSE TAS processes applications based on the treatment that the patient is being referred for, which is not available in Ireland. The presence of a rare illness, such as Ehlers Danlos Syndrome, is not of itself criteria for availing of treatment abroad: most cases of rare diseases are treated without the need for recourse to services in other jurisdictions.

Patients, in conjunction with their Irish based public referring hospital consultant, have the ability to apply to the HSE TAS seeking access to public healthcare outside the state through model form E112. Applications to TAS are processed and a determination given in accordance with the statutory framework prior to a patient travelling to avail of treatment. Approved applicants/patients' hospital treatment costs are covered through the issue of form E112 (IE) for the specific identified episode of care. Once a patient is discharged from a specific episode of care abroad, their care immediately reverts to their Irish based consultant.

Each application to the HSE TAS is reviewed individually on its own merits and there are no restrictions, regarding age or otherwise, on a person making an application to the HSE TAS for review and decision. Previous approvals or declines are not used as an influencing factor on subsequent applications. Each application is for an individual episode of care unless otherwise specified by the consultant on the application form. Each application to TAS is processed and given a formal written decision. If that decision is one of decline, the reason for that decision is clearly outlined and the option of an appeal is afforded. Furthermore, as above the decision on an application does not restrict future applications for an individual patient or indeed other patients seeking treatment abroad that is not available in Ireland.

The Health Service Executive has been asked to examine the specific matter referred to by the Deputy and will reply to the Deputy as soon as possible. The Health Service Executive operates the General Medical Services scheme, which includes medical cards and GP visit cards, under the Health Act 1970, as amended. It has established a dedicated contact service for members of the Oireachtas specifically for queries relating to medical cards and GP visit cards, which the Deputy may wish to use for an earlier response. Contact information has issued to Oireachtas members.