More than 200 HSE reimbursement cases reopened, says Ombudsman

Ombudsman Ger Deering addresses the Irish Patients Association Conference in Dublin on Monday. Pictures: Michael Chester

A patient was made to feel like “a liar and a criminal” by the HSE when trying to get reimbursed for medical treatment abroad, the Ombudsman told a conference today.

Ger Deering recently published a scathing report on the treatment abroad scheme which allows EU patients to travel to other EU countries for medical treatment. The cost is then reimbursed by their national health body.

Over 200 Irish cases where this reimbursement was refused have now been re-opened by the HSE, he told the Patient Rights Day Conference in Dublin, hosted by the Irish Patients Association.

'I was made feel like a liar, a criminal'

He read out an email from a woman they helped.

“Now that you have confirmed getting this refund over the line, I have to be honest and admit I am still holding my breath in case the monies don’t go into my account,” the letter read.

She thanked the Ombudsman’s staff, saying she was “at rock bottom” during the battle with the HSE Crossborder Directive office.

“I was made feel like a liar, a criminal, trying to steal monies which weren’t mine,” the letter read.

Her mental health deteriorated, she said. The issue arose because on the day of treatment her own credit card was declined, and a relative paid. The HSE then disputed the proof of payment.

A common issue

Mr Deering said he shared this to show the impact of decisions taken by administrative offices.

The “proof of payment” was a common issue, he said, with many people borrowing from the credit union or family.

“[In many cases] they had an invoice and a receipt from the hospital, but the HSE decided ‘we need more than that, we actually need to have evidence of where you got the credit union loan, or you have to back to your family and get a letter saying: ‘you gave me this money,’” he said.

“Part of the problem was that the scheme said ‘you must pay for it yourself’, and that was being taken literally — that you must pay for it, not your sister or your mother. 

That was way too narrow an interpretation of that.” 

He discussed cases where patients were told by administrators that their letters of recommendation for treatment were not signed by the right Irish doctors, or not signed appropriately.

However, he also said since the publication of the Ombudsman's ‘In Sickness and In Debt’ report in April, the HSE has committed to implementing its 21 recommendations.

“Already, my office tell me that 11 people who were in that situation of unsigned or inadequately signed, or inadequate referral letters, have their cases overturned, and have now received [their refund],” he said.

He said: “Over 200 cases have been opened and re-looked at in a positive way."

Ombudsman Ger Deering chats with Health Minister Stephen Donnelly at the Irish Patients Association Conference.

Health Minister Stephen Donnelly also addressed the conference.

He said patient’s rights are “central to all aspects of the provision of safe, high-quality healthcare” across the system.

“It is a patient’s fundamental right to have full information about the healthcare they are receiving, even more so in the event something goes wrong,” he said.