Ombudsman Peter Tyndall has called on the Health Service Executive to change how it administers the Treatment Abroad Scheme because it is too complex and difficult for patients to access.

His recommendation follows an investigation by his office into the HSE's administration of the scheme, which provides funding to allow public patients get healthcare not available in Ireland.

The investigation was prompted by 19 complaints from people about the scheme.

It found some people were given wrong information relating to available treatments abroad and were told they did not qualify for treatments in other countries when they were actually entitled to them.

The investigation also found the HSE application process for the scheme is flawed and needs change to make it easier for people to apply.

In the report, the Ombudsman said he "acknowledges the vast majority of applications for the scheme are dealt with appropriately by the HSE".

However, he said his investigation discovered some shortcomings in the scheme that can have a serious impact on patients.


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Mr Tyndall said: "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.

"The main findings are: the scheme is too difficult to access; that it doesn't have objective decision making; it puts an undue burden on the patient and that it doesn't have a proper right of appeal."


'It's just heartbreaking'

Amy Foley, 30, from Midleton in Co Cork experienced frustrations when applying for the Treatment Abroad Scheme.

After complaining to the Ombudsman, the HSE paid for her specialist treatment in London retrospectively with no admission of liability.

Ms Foley has Ehlers-Danlos syndrome (EDS), a group of disorders that affects connective tissues supporting skin, bones, blood vessels, and other organs and tissues.

She said: "My experience with the Treatment Abroad Scheme I can only sum up as being traumatic.

"To have to fight against administration to get the treatment you need ... it's just heartbreaking."

She said the application process for the Treatment Abroad Scheme was traumatic for her.


The 11 recommendations to the HSE in the report include the streamlining of the application process and a formal appeals process for applicants.

It also recommends consultants carry out "pre-referral" checks on applications for patients to ensure applications meet the qualification criteria for the scheme.

It also says a comprehensive guide to those criteria should be developed by the HSE to assist consultants with "pre-referral" checks.

The HSE is accepting the report's recommendations.

John Hennessy, Director of Acute Strategy and Planning with the HSE, said the Ombudsman's investigation is a useful review.

"It has identified some areas for improvement. We are anxious to get on with this now and work with the Ombudsman on implementing those recommendations", said Mr Hennessy.

He added implementing the recommendation would be a challenge in terms of the timeline set out by the Ombudsman.

Under that timeline, the HSE must respond to the report by the end of February this year and from the end of March the HSE will have to provide monthly progress reports to the Ombudsman on the implementation of the recommendations in the report.

"This is about access to healthcare as opposed to administering a scheme. What we want to do is to make sure that patients can access the care they need - and in this instance when it is not available in Ireland that we can assist people to access it overseas. Our interest is the very same one as the Ombudsman's office. We want to make this scheme work well for patients," said Mr Hennessy.

The Treatment Abroad Scheme provides funding to allow Irish public patients get healthcare in other EU countries, the European Economic Area or Switzerland that is not available here.

It is different to the Cross Border Healthcare scheme, which covers treatments that are publicly funded and available in Ireland.