Seriously ill patients on long waiting lists are suffering financially due to confusion over the operation of a scheme that allows them to get treatment abroad, according to the Ombudsman.
Some patients were left with outstanding bills running into thousands of euro before the intervention of Ombudsman Peter Tyndall, he says.
Mr Tyndall says awareness of the Cross Border Healthcare scheme, which gives people resident in Ireland the option of having public health treatment in another EU country, remains low.
Often, the scheme is used by patients who have spent long periods on waiting lists for treatment in Irish hospitals.
The cost of treatment overseas is paid in advance by the patient, and this is later reimbursed by the HSE in line with published rates for specific procedures.
Last year, 4,600 patients sought information about the scheme but just 93 authorisations to travel were made.
In one case, a 74 year-old woman complained to the Ombudsman when the HSE did not refund the full cost of her hip operation.
The woman had waited over two years on the public waiting list for the operation and had decided to travel to Northern Ireland for treatment under the Cross Border Healthcare scheme.
She paid the full cost of the operation in advance - €12,500, borrowed from a relative - but the HSE repaid only €10,900 of the cost.
This was because she had been approved for a “non-standard” hip operation and the consultant in the North had not confirmed this was the treatment she had received.
As a gesture of goodwill the HSE apologised to the woman and refunded her the shortfall amounting to €1,600.
In another case, the HSE refunded a woman €2,900 spent on inpatient lymphoedema treatment abroad to control swelling on her legs following cancer treatment.
The woman had been incorrectly advised to apply for treatment under the Cross Border Healthcare scheme when she should have been directed to the Treatment Abroad scheme, as the treatment was not available in Ireland.
A third case involved a man who received approval from the HSE for inpatient treatment (involving an overnight stay) for carpal tunnel syndrome in his hands.
The man paid nearly €7,000 in advance for his inpatient care in a Northern Ireland hospital but was well enough to leave the hospital on the same day as his operation.
Therefore, he was deemed to be a day patient and should have received a refund from the hospital.
However, when the man sought a refund from the hospital it was refused.
The hospital said that the cost was the same whether he went home the same day or remained overnight.
