Tommy Broughan (Dublin North East, Independent)
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388. To ask the Minister for Health further to Parliamentary Question No. 76 of 25 November 2015, the assistance available to patients who wish to receive care under the Cross Border Healthcare Directive 2011/24/EU, including advice on their rights and on the varying policies in European Union countries participating in the directive, if he will establish such an advice service, if any, and how many persons have availed of this option for treatment to date; and if he will make a statement on the matter. [43836/15]

Leo Varadkar (Dublin West, Fine Gael)
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The Health Service Executive operates the EU Directive on Patients’ Rights in Cross Border Healthcare in Ireland. In line with practice in other EU Member States, the HSE, through the National Contact Point (NCP) office, provides information for patients on the Cross-Border Directive (CBD) on its website - - and also by phone. The principal function of the NCP (which is the mechanism specified for the dissemination of information on the CBD by Member States) is to facilitate exchange of information for patients concerning their rights and entitlements relating to receiving healthcare in another Member State, in particular the terms and conditions for reimbursement of cost and the procedures for accessing and determining those entitlements. The NCP also has a responsibility to ensure that all enquirers are informed of the right to healthcare, if any, that they may have through the European legislation on the coordination of social security schemes (EU Regulation 883/04) and which may be more beneficial to them. The NCP is able to inform patients what the cost of their treatments would be in Ireland to allow them make a comparison with the costs they are being quoted for comparable treatment in another Member State.

The healthcare being sought under the CBD can only be healthcare that a person would be entitled to within the public health system in Ireland, which is not contrary to Irish legislation. It will be a matter for the patient and his/her referring doctor to identify the clinician abroad and satisfy him/herself in relation to the qualifications, quality and safety of the services being availed of in the other jurisdiction. In general, healthcare is not routinely advertised and the best options for treatment are most appropriately discussed within the professional setting and advice received as to where services might be sought, including availing of the provisions of the CBD for treatment.

It is also noteworthy that access to healthcare abroad under the Directive is based on patients following public patient pathways; that is, a referral is required in order to be eligible for reimbursement. Referral for care under the CBD can be made by a GP, a hospital consultant and certain other HSE clinicians. This referral is not limited to Irish health professionals but nevertheless the great majority of patients are likely to have consulted an Irish health professional who then referred them for treatment here or, if they wished, within the EU\EEA. As a consequence, a general information campaign regarding the CBD has not been undertaken. It is also noteworthy that Recital 4 of the Directive states “the transposition of this Directive into national legislation and its application should not result in patients being encouraged to receive treatment outside their Member State of affiliation”. The HSE has tried to balance its dissemination of information regarding the CBD with this Recital in mind and has concentrated on informing the clinicians who make the referrals about the Directive. To this end it has met with the ICGP and various consultants at hospital level to inform them of the provisions of the Directive.

The Health Service Executive has been asked to examine the matter of the data requested and to reply to the Deputy as soon as possible. If the Deputy has not received a reply from the HSE within 15 working days, please contact my Private Office who will follow up the matter with them.