Transfering Care from EU country

Joe Exotic

Hi all

My brother has just been diagnosed with multi organ cancer, he lives and work in Germany and hasn't worked in ireland for years.

Anyway the prognosis isnt good to say the least but we are trying to stay positive.

Chemo has been scheduled starting in the next few weeks and its been decided to at least carry out the first stage of treament there.

As the case is so serious and as my brother is pretty much unsupported over there (covid etc.) the family would like him to come home

the concern is that he might not get treatment here as he hasnt lived or paid taxes here in years (i know this is unlikley) while he has health insurance in Germany.

In addition we are worried that if he transfers here he would be in a long waiting list for treatment.

Has anyone any experience of the above and transfering treatment home ?

If someone could even point me in the right direction id appreciate it, the HSE site only covers treament abroad not treament comming home.

cnocbui

I wouldn't even begin to contemplate moving him from a first world health system to Irelands third world system.

My brother had to be medivacced from the northern territory of Australia down to Perth, after he broke his pelvis and shoulder on a final bucket-list trip because his skeleton was almost entirely rotted away with cancer due to advanced melanoma. He'd had emergency surgery to pin everything before stabilising and getting to a state where he could be moved. The cost without tavel insurance would likely have been north of €20 K.

I have experienced spending 18 months on an Irish waiting list. It would have been longer except I managed to snag an upgrade due to a cancellation likely due to COVID fear by someone else - madness.

The family should go to the brother, not the other way around. Rent a house or something.

coffeepls

I would suggest ringing the Irish cancer society. Your brother doesn’t need a diagnosis, he has had that. This is regarding the continuation of treatment, and who will pay for that. Both are EU countries, so that may be something.

From my experience, the waiting lists re cancer is very much re diagnosis. But give the Irish cancer society a ring and hopefully they can help answer your worries.

Joe Exotic

https://www.boards.ie/discussion/comment/117845040#Comment_117845040

Thanks Will do i appreciate the feedback

sea2summit

Hi OP,

Just came across your thread and I hope it's not too late for the below information. We were in the exact same predicament and situation as yourselves last year. My father unfortunately passed away this week but hopefully the information below will help and guide you in some way.

My father received a terminal lung cancer diagnosis whilst living in Belgium. He underwent his first batch of chemotherapy while in Belgium, and in May of this year, returned home to Ireland to be closer to family and friends.

While in Belgium, he received scans every 10 weeks to monitor any changes. He had a scan in Feb & again at the end of April just before he moved home.

I'll be honest - the transfer wasn't straight forward, and at the same time as we were transferring, the HSE scam occurred. It delayed the care my Dad received in Ireland and unfortunately coinciding with that, my fathers cancer progressed.

As an Irish Citizen having worked in the EU over the last number of years, my father was entitled to claim social welfare - Illness Benefit or Disability Allowance or Invalidity Pension (due to never returning to employment), he also had to fill in a Habitual Residence Form. Please note, that the social welfare are a paper based organisation and each form requires the same proof of documentation over & over again - it drove us absolutely demented, so please make sure to have multiple photocopies of IDs etc because it will save you a lot of hassle.

He was also entitled to a Medical Card automatically due to his diagnosis. You will need to fill in a medical card application form, and follow up religiously every week until you get it. We had awful trouble getting ours - again, this is due to the way the organisation operates. It took us 3 months from application to submission to physically receiving the card. Everything is means tested.

With regards to his care in Ireland, I honestly believe the HSE failed on several occasions.

The HSE did not make it easy for us to transition his care from Belgium to Ireland. First of all, my Dad had to be physically living in Ireland in order for the ball to get rolling.

Step 1 - Find a GP - we found one before he moved home but they wouldn't look at him or actually take him on until he was in the country.

Step 2 - GP to assess my father despite the medical report & consultation notes provided from his Belgian oncologist

Step 3 - Referral to Oncologist - this took weeks to initiate

• My father arrived in Ireland in May 2021, he had his 1st oncologist appointment at the beginning of July, approx. 9 weeks after he arrived. This was an intro appointment " who are you, who am I, how we can help blah blah blah" (waste of time!) The oncologist then ordered the nurse to schedule some scans etc - these scans didn't happen for another 4 weeks, results were 2 weeks later. To compare, in Belgium he would have his scans 2 days after any appointment, and the results within 2-3 days maximum, and if there was any treatment to be carried out, in would happen within a couple days also instead of weeks in Ireland.
• The oncologist requested ALL scans & reports that were conducted since my fathers diagnosis. This was a headache to arrange. Belgium, similar to Germany I imagine, digitialize their scans and they are on a platform called PacsOnWeb - however, the HSE is paper based. It took me weeks to get all this information to the oncologist in Ireland, and it was me who was responsible to gather the information, not the oncologist in Ireland.
• I also asked a GP in Ireland, prior to my father moving home to Ireland, what documentation or medical details we would need, and I was told a one page overview would be sufficient. This is completely incorrect. You need EVERYTHING.
• My fathers oncologist in Beaumont, also wanted the physical slides (tissue samples) that were taken from a lung biopsy in Belgium. Again, I had to call the laboratory in Belgium and have them sent by UPS.

The wait times in Ireland were acceptable, but much longer than in Belgium. The system is fundamentally flawed. My father had about 20 different people calling him every week asking the same questions - they don't talk to one another, and things get missed regularly.

The nurses, doctors etc are extremely professional, diligent and caring but the HSE and how it operates fails them. Appointments don't happen as quickly as you would like them to, and then of course, despite having appointments made for you and specific times given to you, they never happen on time which adds extra frustration. We regularly have sat in waiting rooms for 1 or 2 hours before being seen to. It's horrific.

One other thing to note is that the community / public / palliative care teams are not always available despite them saying "call us anytime". I have frequently spent hours upon hours calling them, to not have someone answer or call me back until many hours later. Again, this is extremely frustrating especially when you're dealing with a symptomatic cancer patient who needs urgent attention.

We have no regrets in transferring my Dads care to Ireland, but the HSE is not a smooth operation and it lacks in comparison to the care he received in Belgium.

I wish you and your brother all the best of luck with transferring his care. Should you have any specific questions, feel free to reach out.

Joe Exotic

https://www.boards.ie/discussion/comment/118001307#Comment_118001307

Thanks so much for the response, My sympathies for the death of your Father. This must a really difficult time for you.

We have recieved the same advice you did but from the above i can see it wont be as easy as they make out. Thaks very much very taking the time to give me this advice ill definatley use it and hopefully this will speed up the process