2026-05-20

Since this relates to an individual, I am conscious that we should be mindful of their privacy and their family.

I once more raise the case of a young Arklow Gaelscoil teacher, Eímear Byrne, with the Minister of State and the Government. As the Minister of State knows, Eímear urgently needs life-saving treatment in the US that costs €600,000. Recently, Eímear received devastating news. Doctors discovered three more aneurysms and she now needs a third open-heart surgery procedure. This one is even more complex and urgent, so time is critical and the family and the community of south Wicklow need and want the Government to intervene to get Eímear to the USA as soon as possible. Life-saving treatment can be done there immediately if the money is available. I plead with the Government again to make an intervention under the exceptional circumstances clause, which does exist. Considering the complexity of Eímear's condition and the risks involved, the surgery needs to be carried out urgently in a specialised clinic such as Johns Hopkins in the US, which has the necessary medical experience and the facilities to treat patients like Eímear. Surgery in this hospital will reduce the rate of mortality during the procedure and reduce potentially life-altering complications such as a second stroke. The operation and rehabilitation in America will give Eímear the best chance of survival so she can live a long, happy and fulfilling life and continue educating the children of Arklow in their native language, as she loves to do. In terms of fund-raising, Eímear states: I have been looking for help with the Government for funding since October 2025 and to no avail. This is why my family have had to look for community support by setting up a GoFundMe page. There is a GoFundMe page for Eímear Byrne in Arklow. Dozens of fund-raising events around the town over recent months have so far raised €230,000 of the required €600,000. People had to dig deep because the Government just was not doing anything. Last Friday, I attended an event in Pearse Park, Arklow. It made the Guinness Book of Records. There were 254 people patting each other on the back as a reference to the community having Eímear's back because the Government has not had her back to date but the community has. Local people have been tremendous, absolutely inspiring. However, they can only be expected to do so much. They have done their bit. Will the Department of Health and the Government now do their part and make up the shortfall for an Irish citizen in her time of need for life-saving surgery? We got answers about the treatment abroad scheme. I realise that the treatment abroad scheme covers only the European Union and the European Economic Area. I know that. However, there is the facility for the Department to fund treatment in the US under exceptional circumstances if it cannot be done in the EU, which is on guidance from Eímear's consultants. The Government already funds patients to travel to the US for specialised medical treatment but on an exceptional basis. An exceptional basis, as the Minister of State knows, can be made under three specific conditions. There is the high-cost drugs treatment protocol. Second, there is the out-of-State policy application. Third, is the exceptional circumstances clause, which is what I am asking about. Patients have historically received and secured funding to go to US-based medical centres for rare conditions and for extremely complex procedures when an Irish public consultant provides strong clinical justification that this care is essential and proven. Eímear's case fits the criteria. I have gone through it with HSE personnel. It fits the criteria. All I want to know is whether the Government will step in. It is small money in the greater scheme of things in terms of expenditure. This has to be done as a matter of urgency. I hope the Minister of State and the Department will have a positive answer for us, the people of Arklow and the family.

I thank Deputy Ó Súilleabháin for raising this matter, which I am taking on behalf of the Minister for Health, Deputy Jennifer Carroll MacNeill. The Minister is aware of the case the Deputy referred to and acknowledges the very difficult circumstances outlined by him and how difficult the situation described is for this young teacher and her family. In relation to the EU treatment abroad scheme, the HSE operates the scheme for people entitled under EU Regulation No. 883/2004. The Minister for Health has no role in directing treatment. Section 6 of the Health Service Executive (Governance) Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual. The treatment abroad scheme is a consultant-led scheme and allows for a public consultant based in Ireland to refer a public patient who is normally resident in Ireland for treatment in the public healthcare system of another European Union or European Economic Area member state, the UK or Switzerland. Under the EU regulations and guidelines, the EU treatment abroad scheme provides for the cost of approved public treatments in another EU-EEA member state, the UK or Switzerland, through the issue of form S2, where the treatment is among the benefits provided by the Irish legislation and where it is not available in Ireland, or not available within the time normally necessary for obtaining it in Ireland, taking account of the patient's current state of health and the probable course of the disease. It is important to note that there is no statutory framework for referral of public patients outside the EU-EEA member states, the UK or Switzerland, or for the funding of any such treatment. The HSE has informed officials in the Department of Health that it received an application under the treatment abroad scheme, seeking funding of treatment in the USA, in this case on 1 April 2026 and that it has engaged with the applicant and her family regarding this matter. The HSE has advised that at this time the applicant did not meet the criteria of the treatment abroad scheme, which the Deputy mentioned, on two different grounds, namely, that the treatment sought was not to be provided within the EU-EEA, the UK or Switzerland, and she was not a public patient. The applicant is attending a consultant in a private capacity. The HSE treatment abroad scheme has advised that it suggested to the applicant's referring consultant that he engage with the relevant European reference network, ERN, the European reference network on rare multisystemic vascular diseases. The ERN enables specialists in Europe to discuss cases of patients affected by rare, low-prevalence and complex diseases, providing advice on the most appropriate diagnosis and the best treatment available. Ireland is an active participant in ERNs, with 18 recognised centres involved across a range of networks. Engagement with ERNs is an important step in ensuring that all appropriate EU-based expertise and treatment options have been explored. I assure the Deputy that officials in the Department of Health will continue to engage with the HSE to seek further updates that all avenues within Ireland and the EU that may be open to the young woman in question and her family have been fully explored in response to the very difficult circumstances outlined by him. I will also take on board and discuss with the Minister the clause the Deputy raised in relation to exceptional circumstances which fall outside the scope of the current support that can be provided and to see whether that can be looked at as a matter of urgency.

With respect, that is very similar to a stock answer the family has been given over the past few months. I will not accept the answer and I know Eímear, her family and the community in south Wicklow will not accept this answer from the Government or the Department. It is a stock answer and it is simply not good enough. This involves tiny money. The Minister of State said I referenced the EU and the EEA. I did not. I know that the treatment abroad scheme has certain confinement. What I am talking about is the exceptional clause circumstances for going to the USA. That clause exists, and it is within the power of the Minister to implement it. That can happen if the will is there. I am just not sure the will is there and I want to know if it is on the part of the Department. I am somewhat reassured that the Minister of State indicated that it was at a particular time that the applicant did not meet the criteria and that she will continue to engage with the HSE. I would hate to think the door is closed on this because it is very much not closed. This is time sensitive and I am pleading with the Minister to act on it. The family and community are also pleading with her to do so. They cannot waste more time waiting. Who knows when they are next, if they wake up the following morning. I will not embarrass the Government by going through a list of projects in the country, or even in County Wicklow, where State money has been wasted. This is most definitely pin money to the Government, which could save someone's life and make a massive difference. I plead with the Minister to use the power she has to see that this can be done as soon as possible.

I reiterate that the HSE has advised that it suggested that the applicant's referring consultant engage with the relevant ERN, the European reference network on rare multisystemic vascular diseases. The ERN enables specialists in Europe to discuss cases of patients affected by rare, low-prevalence and complex diseases, providing advice on the most appropriate diagnosis and the best treatment available. Ireland is an active participant in ERN, with 18 recognised centres involved across a range of networks. Engagement with ERNs is an important step in ensuring that all appropriate EU-based expertise and treatment options have been explored. That said, the Department recognises, and I recognise, having listened to the Deputy, how difficult this individual case is for the applicant and her family. I assure the Deputy that officials in the Department of Health will continue to engage with the HSE and seek updates to ensure that every possible avenue within Ireland and the EU that may be open to the applicant and her family has been fully explored. As I said, I will bring to the attention of the Minister the exceptional of circumstances clause. I have no doubt she is well aware of it, but I will take that to her today and see if any further supports can be provided.