Written answers

Tuesday, 21 February 2017

Department of Health

Treatment Abroad Scheme

Photo of Fiona O'LoughlinFiona O'Loughlin (Kildare South, Fianna Fail)
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436. To ask the Minister for Health the procedure that persons must follow to secure funding for lifesaving treatment which is not available here; and if he will make a statement on the matter. [8289/17]

Photo of Simon HarrisSimon Harris (Wicklow, 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 EU Regulation (EC) No. 883/2004, as per the procedures set out in EU Regulations (EC) No. 987/2009, and in accordance with Department of Health Guidelines. Patients apply to the HSE TAS seeking access to publichealthcare outside the State through model form E112. Subject to the EU Regulations and 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) where the treatment is:

- Among the benefits provided for by Irish legislation,

- Not available in Ireland,

- Not available within the time normally necessary for obtaining it in Ireland, taking account of the patient's current state of health and the probable course of the disease.

Applications to TAS are processed and a determination given in accordance with the statutory framework prior to a patient travelling to avail of treatment. 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.

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.

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