An investigation regarding a HSE decision on funding for assistance for treatment abroad

In April 2011 a complaint was submitted to the Ombudsman for Children’s Office by the parents on behalf of the child aged 7 years. The child concerned was born with limb abnormalities affecting his right leg and his arms. The child does not have a left arm

and has abnormalities of his right arm together with a condition whereby the femur on his right leg does not grow on its own. The problem which is currently being addressed for him through treatment in the US involves his right lower limb. He has an absence of the upper end of his right femur including the hip joint and his leg is very short. He needs extensive reconstructive surgery to his right hip and leg. The parents explained that as their son’s right leg does not grow properly, he requires limb lengthening surgery, which they contend can  only be performed in the United States of America.

The parents advised that their son received two such operations in the US in 2006 and 2009 and funding for 70% of the costs associated with the operations and the trip to the USA were provided by the Health Service Executive (HSE) under its Treatment Abroad Scheme (TAS). The cost of the operations is paid by the parent’s private health insurer and currently the cost of physical therapy is also covered by the insurer.

The parents state that their consultant orthopaedic surgeon advised them that their son had no hip and spoke about amputation for him. The parents advise that because the child does not have a left arm a prosthetic limb would be difficult for him to manage. The consultant encouraged the parents to complete their own research in limb lengthening for him. The parents met and contacted doctors in Dublin, Cork, Belfast, the UK, France, Germany, Russia and America. They were seeking physicians who would be experienced enough to undertake leg lengthening for their son. On completion of their research they discovered two doctors one in Baltimore, Maryland, USA and another doctor in Russia.

Having carried out a preliminary examination into this complaint, a decision was made in July 2011 to proceed with an investigation. The investigation focused on the administrative actions of the HSE in regard to the administration of this child’s application for funding made under the Treatment Abroad Scheme.

• April 2013
• Type: Investigation
• Topic: Health