Home or away: it’s your choice now
Irish people, either through necessity or choice, are travelling to other EU countries for treatment
Ann Brehony with her son, Rory Barrett. Photograph: Joe O’Shaughnessy
Padraig Schaler. Photograph courtesy of Reinhard Schaler
When we are sick the vast majority of us would prefer to be treated at home in a familiar environment surrounded by family and friends.
However, for some that is not possible, and every year hundreds of Irish people, either by choice or necessity, make the decision to travel abroad for medical treatment.
The options available to people who travel abroad for treatment are varied.
Some private health insurance companies cover the costs of people who wish to access treatment abroad subject to terms and conditions of their cover and pre-approval by the company.
To date the only option available to Irish patients without private health insurance, however, has been the HSE’s treatment abroad scheme (TAS) but this is due to change shortly following recent changes to EU law.
Under TAS, patients can apply to receive treatment in another EU country but it must be proven that the treatment is not available in Ireland.
In order to access the scheme, the treatment must be approved by the referring consultant in Ireland.
The treatment cannot be an unproven therapy, for example, part of a clinical trial, and it must be carried out in a public hospital within the EU.
Under the scheme, the HSE covers the cost of medical treatment only and it is not required to cover travel costs.
However, in 2010 the HSE introduced a national travel policy which covers some travel costs for the patient, and in certain circumstances the costs of a travelling companion are also reimbursed.
According to the HSE, “the TAS also allows for patients to be referred abroad for a treatment available in Ireland but which cannot be accessed in a timely manner”.
“To use this criteria, the referring consultant must demonstrate the extent to which the patient’s condition will deteriorate beyond that which can be achieved by a more timely intervention.”
Ann Brehony accessed TAS twice for her son, Rory Barrett, who was born in 2003 without any kidneys. As Rory’s condition is extremely rare, he needed specialist treatment in London in 2009 and 2012, and both treatments were paid for under TAS.
While Brehony stated that TAS was initially difficult to navigate and the process itself extremely challenging at times, once she got approval, the scheme worked well for her and her son.
“It is like everything in the Irish health system, once you get in it is brilliant . . . you just bring a form with you to be stamped and you don’t have to think about a medical bill after that.”
Rory was treated successfully in the UK and, according to Brehony, the team in Great Ormonde Street were full of praise for the care Rory had received in Ireland.
Brehony herself was full of praise for the HSE staff who run the TAS office in Kilkenny, saying they were extremely professional and very helpful.
A total of 868 applications were made to the HSE’s TAS in 2012 and, of these, 791 were approved.
In 2012, the HSE spent a total of €7.4 million on the treatment of Irish patients aboard. However, it is important to note that these figures are subject to change as invoices from other countries are received in arrears.
The more common treatments that Irish patients access abroad include deep brain stimulation (used to treat a number of neurological conditions), heart and paediatric liver transplantation, as well as specific cancer care that is not available in Ireland.