Treatment Abroad Scheme needs improvement

Application process can prove difficult
  • Deborah Condon

The HSE needs to improve its administration of the Treatment Abroad Scheme (TAS), as the application process can prove difficult and complex for some, the Ombudsman, Peter Tyndall, has said.

He has just published a report based on his office's investigation into the HSE's administration of this scheme, which was introduced to ensure that all EU/EEA (European Economic Area) patients, including Irish patients, have access to the same level of medical expertise and treatments, regardless of their state of residence.

This means that if treatments and remedies they need are available in the EU/EEA, but not in Ireland, (or are not available within a reasonable time-frame), Irish patients may apply for funding under the TAS to travel for the treatment.

"My investigation into the TAS was prompted by a complaint I received from a patient who experienced significant difficulty and delay in accessing treatment abroad under the scheme. This resulted in his having to endure severe pain for several months longer than he should have.

"This in turn caused deep distress for him and his family. After conducting a preliminary examination of that complaint, I decided to initiate a wider-ranging systemic investigation," Mr Tyndall explained.

The investigation found that while the vast majority of applications are dealt with appropriately by the HSE, the scheme does have some shortcomings, which can have a major impact on patients.

In one case, a woman who sought treatment in Germany was told that she was not eligible for the TAS because the treatment was available in Ireland. This was despite the fact that she had received funding for two previous trips abroad for the same treatment.

When she complained to the Ombudsman, his office discovered that the treatment was not available in Ireland.

"Some people have had difficulties with their applications under the scheme. These are people who are waiting for treatment or surgery, so the impact on them can be particularly severe. I am glad to say that the HSE has co-operated with my investigation and has fully accepted my recommendations ,which are aimed at improving the operation of the scheme," Mr Tyndall said.

His recommendations include:
-To reduce the possibility of a refusal for a patient at the end of the application process, consultants should carry out a ‘pre-referral' check, to ensure that the application meets the criteria set out in the scheme
-To assist consultants with such a pre-referral check, the HSE should develop a comprehensive guide on TAS criteria
-The HSE should improve its appeals system for refused applicants. This system should be independent of the original decision maker
-Reasons for refusal should be clearly explained. This formal refusal should include information on how to appeal the decision and how to complain to the Ombudsman if not satisfied.

The full report by the Ombudsman can be viewed here

For more information on the TAS, click here

 

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