Maureen O'Sullivan (Dublin Central, Independent)
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403. To ask the Minister for Health his views that there should be an appeal process or alternative means to apply for treatment abroad other than consultant only referrals in view of the case load of consultants and the backlog of procedures offered by the Health Service Executive; and if he will make a statement on the matter. [2423/15]

Leo Varadkar (Dublin West, Fine Gael)
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The HSE operates the Treatment Abroad Scheme (TAS) for persons entitled to treatment in another EU/EEA member state or Switzerland under Regulation (EC) No. 883/2004, as per the procedures set out in Regulation (EC) No. 987/2009, and in accordance with Department of Health Guidelines. Patients have the ability to apply to the HSE TAS seeking access to public health care outside the state through model form E112. The application requires the patient's Irish based public referring hospital consultant, following clinical assessment, to certify, among other things, that the treatment is medically necessary and will meet the patient’s needs. The treatment must not be available within the State or not available within a time normally necessary for obtaining it. Once a patient is discharged from a specific episode of care abroad, their care immediately reverts to their Irish based consultant.

Applications to TAS are processed and a determination given in accordance with the statutory framework prior to a patient travelling to avail of treatment. Each application is reviewed individually and a decision is made in accordance with the legislation and guidelines and on the basis of a review by clinical experts. Each application is given a formal written decision and where a decision is one of decline, the reason for that decision is clearly outlined and the option of an appeal is afforded. Previous approvals or declines are not used as an influencing factor on subsequent applications. The appeals process is outlined in each decline letter without exception. Where on appeal a decline decision is upheld, the appeal decision letter advises that the applicant can make a further appeal to the Office of the Ombudsman.

There are no proposals to amend the application process as referred to by the Deputy. It should be noted that, in general, this scheme is one whereby a consultant refers a patient abroad for a specified treatment which is not available in Ireland. The statutory framework stipulates the patient must be a public patient and is required to have followed public patient pathways. 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. Consultants may only refer patients within their area of specialty. Therefore it would be inappropriate and contrary to both the criteria and spirit of the statutory framework for this pathway to be circumvented and could have implications for patient safety.