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'They'd rather see a patient have their leg amputated than pay for a machine to save it'

TD Michael Fitzmaurice says a patient can’t get the device he needs to save his leg from being amputated.

The HSE would rather see a patient have their leg amputated than pay for a machine to save it.

— ROSCOMMON-GALWAY TD Michael Fitzmaurice has slammed the HSE for what he claims is an “inhumane stance” on provision of funding for a medical device one of his constituents’ needs.

The patient faces losing a leg unless he can get hold of the device, Fitzmaurice has claimed.

The man in question, according to the independent deputy, was told by his consultant that he needs to use an arterial assist pump (ArtAssist pump) for at least three months or he will lose his leg.

Device recommended by his doctor 

The constituent – a pensioner - was told by the hospital that they would try and make a machine available to him, but it later emerged this wasn’t possible. He ended up hiring a machine from a private medical equipment company, resulting in a bill of over €2,000.

The ArtAssist pump increases arterial blood flow for those who suffer from severe vascular conditions in their legs.

4/4/2016 Talks on Forming a New Government TD Michael Fitzmaurice Source: RollingNews.ie

Criticism 

Fitzmaurice said:

This man has already paid over €2,000 out of his own pocket for this machine. He has now been told by his consultant that he needs it for 3 more months or he will risk losing his leg.
Yet, the HSE, who funded up to 2012, are saying they will not fund the machine. However, if this man has to have his leg amputated, they will cover the cost of the amputation.

The use of the pumps in the Galway and Roscommon was discontinued pending the outcome of a review of their efficiency, requested by the HSE in 2013.

Fitzmaurice claims the HSE circulated a memo to doctors in 2012 explaining that the apparatus would not be funded under the Medical Card Scheme, and that if doctors wanted to prescribe it, their clients would have to pay for it.

Funding amputations 

Fitzmaurice said:

It is absolutely scandalous that the HSE will fund the amputation of a patient’s leg but will not fund the machine that might enable them to keep their leg. The excuse that they are reviewing the ‘benefits’ of this machine does not fly, because as far as I am concerned the primary physician for the patient, and not some bureaucrat, is the person who should be making any such decisions.
It is inhumane as far as I am concerned. The fact a pensioner must decide between the basics of food, light and heat or paying for a machine which can help him keep his leg is absolutely criminal.

The Roscommon-Galway TD said he had been in correspondence with the HSE for the last two weeks, but there had been no movement on the issue.

Who pays for the pumps?

TDs were briefed on this issue by respected Galway-based vascular surgeon, Sherif Sultan, back in 2013.

At the time, Fianna Fáil’s Dara Calleary said there was a disagreement between different units of the HSE as to who pays for the ArtAssist pumps. During that period, over 550 patients needed a pump in Ireland.

There were 127 patients on a waiting list for a machine. Calleary made the same point as Fitzmaurice – that buying a machine would cost a lot less than the cost of an operation to amputate someone’s leg.

The former Minister of State at the Department of Health, Alex White, said this type of expenditure would be made at local level under “local schemes”.

15/6/2010. Fine Gael Leadership Crisis Roscommon-Galway TD Denis Naughten Source: Eamonn Farrell/Photocall Ireland

He said the ArtAssist pump would fall into this category. Roscommon-Galway TD Denis Naughten – who is now the Minister for Communications, Climate Change and Natural Resources – called the situation “bizarre” in 2013.

The local review, by the Galway-Roscommon NCCP office of the HSE, into the efficacy of this pump was questionable, Naughten insisted.

He said Sultan had published peer review studies on this equipment and conducted an analysis of the 127 patients on the waiting list that showed it was five-and-a-half times cheaper to use the ArtAssist pump than to treat people conventionally.

Of those treated with this equipment, 94% will save their legs… I find it bizarre the HSE wants to carry out its own review.

In response to a query on the matter by TheJournal.ie the HSE stated:

In June 2013, HIQA found that “from the limited data that is available, intermittent pneumatic compression appears to be a potentially beneficial treatment … but more research is needed to confirm this.Until such evidence is generated… this treatment remains unproven”. Based on the recommendations from the HIQA report, we are unable to provide funding for the supply of Art Assist Compression devices for home use at this time.

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