Written answers

Tuesday, 28 November 2017

Department of Health

Health Care Policy

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Fianna Fail)
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352. To ask the Minister for Health the position regarding Irish citizens accessing health care in Northern Ireland, including for minor and major procedures; and if he will make a statement on the matter. [50038/17]

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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Irish Patients can seek to access health care in an other EU/EEA member state via three different schemes.

Where a service is provided in Ireland but a patient wishes to access care in another EU/EEA Member State, this can be possible by seeking treatment under the Directive on Patients' Rights in Cross Border Healthcare, otherwise known as the Cross Border Directive (CBD).

The CBD provides rules for the reimbursements to patients of the cost of receiving treatment abroad, where the patient would be entitled to such treatment in their home Member State, and supplements the rights that patients already have at EU level. Patients may access the healthcare they require in either the public or private healthcare system of another Member State under the CBD. Access to healthcare abroad is based on patients following public patient pathways, i.e. they must demonstrate they have followed the equivalent public patient pathways that a patient would follow if accessing public healthcare in Ireland. It is important to note that reimbursement is confined to the costs of the care itself and that the rates of reimbursement cannot exceed the cost of provision of the care if it were provided in the Irish public health service.

The HSE operates the CBD in Ireland. Referral for care under the CBD may be made by a GP, a hospital consultant and certain other clinicians. In line with practice in other EU Member States, the HSE through the National Contact Point (NCP) provides information for patients on the CBD on its website which can be accessed at www.hse.ie/eng/services/list/1/schemes/cbd/ and also by phone at 056 7784551. The HSE advises where a patient is in any doubt as to the need to seek prior authorization before availing of a consultation or treatment abroad to contact the NCP.

The HSE also 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. 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; and

- 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.

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.

Applications to the 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. Information on the TAS can be accessed on the HSE website at www.hse.ie/eng/services/list/1/schemes/treatmentabroad/ and also by phone at 056 7784551.

Under the terms of EU Regulation 883/2004, all persons ordinarily resident in the EU are entitled to apply for a European Health Insurance Card (EHIC). The EHIC certifies that the holder has the right to receive emergency healthcare during a temporary stay in any EU country as well as Switzerland, Liechtenstein, Norway and Iceland. This right is guaranteed to all persons who are covered by the public healthcare system of these countries. The EHIC holder has the right to receive necessary treatment in the host Member State's public healthcare system on the same terms and at the same cost as nationals of the State concerned. It should be noted that under bilateral arrangements, an EHIC is not required from Irish citizens when accessing emergency treatment in Northern Ireland and proof of residence (for example passport or driving licence) is sufficient.

Information on the EHIC can be accessed on the HSE website at www.hse.ie/eng/services/list/1/schemes/EHIC/ and also by phone at 061 461 105.

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