John Brassil (Kerry, Fianna Fail)
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622. To ask the Minister for Health if he will sanction funding through the treatment abroad scheme for a person (details supplied); and if he will make a statement on the matter. [11958/17]

Simon Harris (Wicklow, Fine Gael)
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Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

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 public healthcare 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 is 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.

The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.