Providing treatment in other EU/EEA countries where that treatment is not available in Ireland is an obligation on the Irish State under 2011 EU Directive 24 called “The application of patients’ rights in cross-border healthcare”. It took until 2015 for the State to nominate the HSE as its “authorised officer” tasked with implementing the Directive.
One would think that with waiting lists as they are, the demand for cross border treatment would be overwhelming, but this is not the case. The problem is that (understandably) hospitals and clinics seek payment for treatments up front.
The HSE insist that payments for the treatment can only be made to the patients by way of reimbursing them, and under no circumstances can be made to third parties.
This means only people that have access to the cost of treatment can avail of it, and rules out any systemised mechanism whereby funding can be paid at the direction of the patient to a funder (for example, to a credit union or other financier).
Notwithstanding that the HSE will and do pay for the treatments, funders will not lend to patients because they have no certainty that loans they might give will be paid back once the patients are reimbursed for the cost of treatment.
Sir Humphrey would be proud of the system as it currently operates; make it available only to those who don’t really need it because they can come up with the cost of treatment elsewhere. In the meantime, the tens of thousands of patients who are suffering from progressive conditions such as glaucoma, or require hip and knee replacements, or are awaiting endoscopies and don’t have access to the cost of treatment up front (from €2,000 for cataract procedures to €15,000 for hips) are left to wither.
If the State and its organs including the HSE and the Ombudsman, were so inclined, this system can so easily be fixed. In doing so, while the treatment abroad scheme budget would inevitably be adversely impacted, longer term costs in terms of acute hospital admissions and treatment will inevitably and dramatically fall, as will waiting lists and costs of care.
It is very unfortunate this element of the scheme as it stands is not even referenced in the Ombudsman’s report, and to this writers’ view illustrates a lack of understanding of the applicable moving parts of the scheme.