Brendan Griffin (Kerry, Fine Gael)
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357. To ask the Minister for Health his plans for those diagnosed with Lyme disease to receive funding for treatment abroad in view of the fact that there is no treatment for the disease available here; and if he will make a statement on the matter. [41787/18]

Michael Healy-Rae (Kerry, Independent)
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367. To ask the Minister for Health if he will address a matter regarding the case of a person (details supplied); and if he will make a statement on the matter. [41876/18]

Simon Harris (Wicklow, Fine Gael)
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I propose to take Questions Nos. 357 and 367 together.

Testing and treatment for Lyme borreliosis is widely available in Ireland in all major hospitals. Lyme borreliosis is diagnosed by medical history and a physical examination. The infection is confirmed by blood tests which look for antibodies to Borrelia burgdorferi produced by an infected person's body in response to the infection. These normally take several weeks to develop and may not be present in the early stages of the disease.

Laboratories in Ireland generally follow the laboratory testing recommendations of the US Centres for Disease Control and Prevention, the Infectious Disease Society of America, the European Federation of Neurological Societies, and the British Infection Association. Whereas Irish laboratories have their own quality assurance methods to make sure the tests are working correctly and are also accredited by the Irish National Accreditation Body to perform the relevant tests correctly, testing which is performed abroad may be performed in laboratories which have not met National or International Accreditation (Quality Standards) to a similar degree, giving rise to a greater degree of risk of diagnosis of a “false positive” result or interpreting equivocal results in a manner that is more likely to give rise to verification bias.

Best practice dictates that if a patient presents themselves in front of a GP or consultant in Ireland with a report/test from another EU member state and they are seeking ongoing treatment for a particular illness, the GP or consultant would examine the patient using both clinical and laboratory diagnostics confirmed before they would be in a position to prescribe a course of treatment for them. The same protocol would apply across most other EU member states as the GP or consultant would need to be totally satisfied that the patient is correctly diagnosed while getting the right course of treatment for their illness.

Patients can seek to access health care in another EU/EEA member state via two 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 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: 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 authorisation 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: hse.ie/eng/services/list/1/schemes/treatmentabroad/ and also by phone at (056) 7784551.