Gerry Adams (Louth, Sinn Fein)
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508. To ask the Minister for Health if he is aware that the Health Service Executive application form for the cross-border healthcare directive to access tier 4 residential addiction services places an unfair burden of responsibility on the referring doctor to ensure compliance with public patient pathways, and that this responsibility is not placed on referring doctors in other participating European Union states; if he will consider removing this responsibility from doctors practising in this State; and if he will make a statement on the matter. [6779/16]

Leo Varadkar (Dublin West, Fine Gael)
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The EU Directive 2011/24/EU on Patients’ Rights in Cross Border Healthcare aims to ensure EU citizens may access safe and good quality healthcare across EU borders. The Directive establishes a framework for cross border healthcare between EU/EEA states to facilitate patients to access care in another Member State in accordance with their entitlements in their own country. It is important to note that the Directive does not create additional rights for persons with regard to access to healthcare.

The procedure to obtain healthcare, including Tier 4 residential addiction services, which applies to persons accessing that care in Ireland applies equally to patients seeking to access that healthcare under the Directive. The main purpose of the Directive is to facilitate access to safe and high-quality cross border healthcare and to ensure patients’ mobility, while respecting the competence of Member States for organising their own healthcare systems.

The procedures for accessing healthcare in Ireland are via GP referral or presentation by patients at an acute hospital emergency department. Furthermore the nationally adopted procedures for Tier 4 residential addiction services are in line with standard and accepted medical practice in Ireland. Therefore it cannot be the case that an unfair burden of responsibility on the patient’s referring doctor is created for those accessing services under the Directive by having the same pathway as is employed for those accessing such care in Ireland. This pathway is the long established and appropriate means of ensuring patients access the appropriate care, having had a GP first make the determination of necessary care and then provide the appropriate referral.

The Directive does not provide for or in any way encourage Member States to alter their healthcare systems to mirror those of other Member States.

Gerry Adams (Louth, Sinn Fein)
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509. To ask the Minister for Health to introduce changes to the delivery of the cross-border healthcare directive to remove the burden of prior payment for treatment costs from the patient; whether this burden constitutes a barrier to access for some patients under the directive; and if he will make a statement on the matter. [6780/16]

Leo Varadkar (Dublin West, Fine Gael)
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The EU Directive 2011/24/EU on Patients’ Rights in Cross Border Healthcare aims to ensure EU citizens may access safe and good quality healthcare services across EU borders. Under the Directive, known as the Cross Border Healthcare Directive (CBD), insured patients are entitled to have costs of cross-border healthcare services reimbursed if the healthcare service in question is among the benefits to which they are entitled in their Member State of affiliation. The HSE endeavours to reimburse the cost of treatment incurred or the cost of providing such healthcare in the State, whichever is the lesser, to the applicant within 30 days of receipt of a claim for reimbursement, in line with Prompt Payment legislation.

Each Member State is free to set its own payment policy for cross-border healthcare services; by means of reimbursement to the patient or by direct payment to the healthcare provider. That policy decision is a matter for each Member State under the Directive and, similar to the majority of Member States, Ireland has no plan to introduce a policy of direct payment to healthcare service providers in all EU/EEA Member States for healthcare services provided in their Member State.