Pádraig Schaler remains in a coma nearly 10 months after being struck by a van on Cape Cod last summer. His family says Ireland’s healthcare system has failed him.

In 2013, Schaler, who had just finished his Irish and History degree at Dublin’s Trinity College, traveled to the United States on a J1 visa to work in Cape Cod for the summer.

According to the police report, the 23-year-old was riding his bike near the Bramble Inn at 10 a.m. on June 27, 2013, when he turned in front of a van driven by Mark Couto, 52, of Brewster. Both driver and cyclist were headed east on Route 6A when Schaler turned left in front of the vehicle without warning as Couto was trying to pass him. The report stated that Schaler was not wearing a helmet.

The accident left Schaler in a coma. His parents, Reinhart Schaler and Pat O’Byrne, flew to Cape Cod to be by their only son’s bedside in the hospital. He was moved back home to Beaumont Hospital in Ireland, but his family was informed that he needed intensive neurological rehabilitation. Unhappy with the options open to them in Ireland, his parents decided to move him to Germany in November, at a cost of €12,000 ($16,400) for the air ambulance transport.

Because he was half German and half Irish, Padraig was able to get into a German hospital.

Pádraig was immediately started on intensive neurological care in Germany. In Ireland, he would have had to wait a year for treatment and would have only been entitled to three months of rehab.

“There’s three beds in the National Rehabilitation Hospital in Dublin and usually patients get in there for three months,” his father told TheJournal.ie. “In the meantime they stay while they are waiting in an acute hospital.”

“They say its a matter of money, and funds. It’s not – it’s a matter of priorities,” said Reinhart.

Padraig’s parents have made contact with four other families in similar situations.

“A lot of them don’t speak up because they are in Ireland – people are a little bit fearful to give out [as it] might have repercussions,” said Reinhart.

While the German hospital is better equipped and the health system there is better than in Ireland, his parents say the choice to move Padraig to Germany was not an easy one.

“Pádraig has a real love of the Irish language,” said his father. “One of the things that we thought would be really difficult was he was going to be removed from his friends.”

Padraig’s mother described it as “agony” to see what happens to “somebody who was so vivacious and perfect.”

And being unable to communicate with him “just makes it so much more difficult than a physical ailment”, said Pat. “The progress is incredibly slow.”

Padraig’s parents still hold jobs in Ireland and rent an apartment in Germany. Their two daughters remain in Ireland.

“At moment, with fundraising we’re not in debt but we are coping,” said Reinhart. “Thanks to all the support from all our families.”

Angered at his son’s situation and the response of the Irish health care system, Reinhart wrote an open letter to Ireland’s prime minister Enda Kenny.

“As the parents of a child in a coma, or to be more precise a minimally conscious state, we can tell you that “this broken health system” has not just failed our son but has also torn apart our family. It forced Pádraig out of the country he loves more than any other, away from his friends, and the language and culture he so deeply cherishes.

“I don’t know how stupid they think people are,” Reinhart says of the people running Ireland’s health system. “I don’t understand how they can sleep at night when they know that is happening to people.”

“We thought that if anything happened to any of us the State would look after us, the health system would be there to help us. It’s not the case at all. It’s really, really horrific. It’s something that I really don’t understand how they can keep telling us… Reilly is saying that they’re cutting out of the budget and health care is going to get better. It’s beyond a joke, to me it’s criminal.

“What they basically do is they forget about you.”

Meanwhile, Padraig’s progress has been slow, but tiny triumphs are huge milestones.

“We ask him to squeeze his hand – he can do that now. We ask him to move his foot, he can move his foot. He is not just moving but doing that when we ask him to do it. He can understand what we are saying. He is out of this locked in deep coma that he was in when we left.”

Reinhard writes about his experiences in a blog, and the family keep regular updates on their son’s condition on the site CaringforPadraig, where the family has compiled three simple steps of action they believe would improve Ireland’s health system.