The Department of Health and the Health Service Executive (HSE) are considering the implications of a judgment of the European Court of Justice on reimbursing public patients for treatment they obtain in another state of the EU.
This follows a ruling yesterday by the Brussels court that the UK must repay a patient the cost of a hip replacement operation undertaken in France.
In a judgment that could have implications for public patients on lengthy waiting lists in this State, the court found that a patient should be reimbursed for the cost of treatment abroad if his or her state failed to provide the treatment within a medically-acceptable period.
The case was taken by Yvonne Watts, who suffered from arthritis of the hip.
Her local healthcare trust in Bedford classified her case as "routine", which meant she would have to wait for a year for surgery. Later her consultant said she needed the surgery within three to four months.
She sought authorisation to have the surgery abroad, in accordance with an entitlement following an earlier European Court of Justice ruling, but this was refused.
She underwent the hip replacement operation in France anyway, which cost her £3,900 sterling. Meanwhile she had unsuccessfully challenged the refusal of authorisation to the High Court of Justice in England. She appealed its upholding of the Bedford trust refusal, and the case was referred to the European Court of Justice.
While accepting the principle that a patient should receive authorisation to obtain treatment abroad, the Brussels court ruled that this should not be refused on the basis of established waiting lists. The only consideration that should apply should be the clinical needs of the person concerned.
The considerations to be taken into account are "his medical condition and the history and probable course of his illness, the degree of pain he is in and/or the nature of his disability at the time when the authorisation is sought", according to the judgment.
"Furthermore, the setting times should be done flexibly and dynamically so that the period initially notified to the person concerned may be reconsidered in the light of any deterioration of his state of health after the first request for authorisation.
"The competent authorities of a national health service, such as the NHS, must provide mechanisms for the reimbursement of the cost of hospital treatment in another member state to patients to whom that service is not able to provide the treatment required within a medically-acceptable period."
In a statement on the judgment, the Department of Health said: "Ireland, along with a number of other countries, made submissions in this case.
"We are considering the implications of the judgment for the healthcare system in this country.
"In the light of today's ruling, the department, together with the HSE, will review the mechanism for assessment and approval of applications for hospital treatment in other member states."
The judgment has been welcomed by the Labour Party, whose spokeswoman Liz McManus said it put the relationship between patient and doctor at the heart of European law.
"We know from figures published by the HSE last month that there could be up to 29,000 patients on hospital waiting lists, while more than 6,500 patients are waiting over six months for in-patient treatment.
"The ECJ [European Court of Justice] decision could have even greater consequences were it to decide that the same principle should apply to those waiting to see a specialist."