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Health Services

Dáil Éireann Debate, Thursday - 17 June 2021

Thursday, 17 June 2021

Questions (101)

Michael Collins

Question:

101. Deputy Michael Collins asked the Minister for Public Expenditure and Reform when the continuance of the Northern Ireland planned healthcare scheme, formerly the cross-border directive, will be placed in law here (details supplied); and if funding has been allocated to the long-term continuation of the scheme in addition to that of the cross-border directive, which forces patients to travel to mainland Europe for treatment. [32820/21]

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Oral answers (6 contributions)

Will the Minister confirm that the continuation of the Northern Ireland planned healthcare scheme, formerly the cross-border directive, will be placed into law in the State? This is crucial to thousands of our citizens on waiting lists across the country and it is a serious recruitment and retention issue for armed forces who rely on the scheme for treatment in hospitals in Northern Ireland through the Permanent Defence Force Other Ranks Representative Association.

I ask the Minister to confirm the funding has been allocated for the long-term continuance of the scheme in addition to that of the cross-border directive which forces patients to go to mainland Europe.

I thank the Deputy for raising this issue, which I know is of particular interest to him. I acknowledge the work that he and others have done in assisting patients in his constituency to avail of the services of the cross-border directive. While the policy matter is one for the Minister for Health, I am happy to answer the question as best I can.

Since the start of this year, the provisions of the EU cross-border directive no longer apply to the UK. On 28 December 2020, the Government approved the implementation of a new Northern Ireland planned healthcare scheme. The new scheme, operational from 1 January 2021, enables persons resident in the State to access the same treatments previously provided for under the EU cross-border directive and be reimbursed for such private healthcare in Northern Ireland by the HSE, provided such healthcare is publicly available within Ireland. It is intended that the scheme will operate for 12 months on an administrative basis initially, with a view to developing a general scheme to provide a statutory basis for the scheme. The Minister for Health is progressing plans in that regard.

The scheme is demand led. The cross-border directive costs have been increasing year on year and in 2020 were €15.4 million. The bigger picture here is that we need to get away from people needing to travel to Northern Ireland. That is the bottom line. We are investing €22 billion this year in our public health service. We should be able to provide the service for cataract treatment, for example. In that regard many of the constituents that the Deputy is assisting to bring to Northern Ireland will be able to benefit from the additional investment which is now being provided in ophthalmology services.

As the Deputy is aware, a reconfiguration is under way in Cork, involving the existing services amalgamated from two sites at Cork University Hospital and the South Infirmary Victoria University Hospital to now be based on the South Infirmary campus. It includes a new outpatient building, which is nearing completion. Following its completion, services will transfer to the South Infirmary in quarter 4 of this year. A new theatre complex is also being built in the South Infirmary which will create two new theatres, one of which is expected to be completed in quarter 1 or quarter 2 of next year. We need to get away from the situation where people need to travel to Northern Ireland and provide the services locally. For the Deputy's constituents in Cork, we should be providing that service in Cork and that is what I am determined to achieve with the Minister.

I thank the Minister for his reply. Next week bus 67 heads to the North from both Cork and Kerry. Deputy Danny Healy-Rae and I have been organising those buses, as the Minister has acknowledged. He says that we should get away from people needing to go to the North and I fully support him in that. It is not just the cataracts; it is the hips and the knees, and getting a simple thing like an MRI scan. Someone cannot get an MRI scan done without waiting for weeks here. We are light years away from resolving these issues here and until that is the case, I am asking the Minister to give more detail on the continuation of the Northern Ireland scheme that was introduced for this year.

When I raised this issue last year, we were led to believe that it was resolved. A Fine Gael Senator from west Cork said that it had been resolved for the long term and advised us to stop scaremongering. However, the Minister is telling me today that he is looking into it. I ask him to give me more details on what he is looking into. Will the Government fund it? Will it continue? I would appreciate an answer to those questions.

The Minister for Health is developing the general scheme of legislation to provide for the continuation of a scheme that is tantamount or equivalent to the cross-border directive in order that the services can continue to be availed of.

I want to finish the point on the cataracts and I acknowledge that it is not the only issue. In addition to the enhanced facilities at the South Infirmary, a new medical ophthalmology service funded by the South/South West Hospital Group is due to commence in August and will be based in St. Mary's health campus in Gurranabraher. The service will be provided following the recent appointment of two new additional medical ophthalmologist consultants and support staff. It will enable the streamlining of medical and surgical cases providing improved patient access. It will be clinically tasked with reviewing 3,000 patient referrals on current outpatient waiting lists. That is a very important reform.

I have looked at the breakdown of the services that people need in Northern Ireland when they have travelled there. When it came to day-case specialties, ophthalmology was by far the largest with over 1,300. The number for orthopaedics was 125 and for general surgery it was 53. The Deputy is right to say that when it comes to outpatient specialties in surgery and so on, orthopaedics also represents a very significant number. We need to fix that issue so that those services are provided here.

Any new services to be provided in Cork are to be greatly welcomed and I appreciate the Minister sharing that information with us. The problem is that the pandemic has led to enormous waiting lists throughout Cork and the rest of the country. People from Dublin, Waterford, Limerick and elsewhere have contacted me looking for services such as hip, carpal tunnel, knee and obviously mainly cataract surgery. The Minister has said that work is being done on the long-term development of the scheme that is there at present. However, I do not want to find myself in the situation I was in last year, being criticised by those on the Government side saying I was scaremongering and claiming that a long-term scheme was in place.

We still do not have that long-term scheme. The Minister has said it is being worked on. When will funding become available to continue that scheme in the long term? Will that be announced next week or will it go right up to 28 December as it did last year or will it be 1 January next year before we get confirmation? That is not fair for people who are suffering in pain and people who are going blind. They need to know today whether they can go somewhere to have this treatment within two months. Some people have told me they have been waiting for five years, which is incredible.

I assure the Deputy that funding is not the constraint. The cost of the scheme in 2020 was €15.4 million. In the context of a healthcare budget of €22 billion, funding is not the issue. The scheme is demand led and the costs depend on how many people avail of the services under the cross-border directive or the Northern Ireland planned healthcare scheme. It is important to reassure people that that scheme continues to be in place. I acknowledge that in its current format it is temporary, but it is the intention of the Government to put that on a firm footing in order that people in the Republic can continue to access services in Northern Ireland in a manner equivalent to the cross-border directive that we had up to the end of last year. The funding is in place. We have an existing scheme. The expectation is that a new scheme to be permanent should be underpinned by legislation. It should be a statutory scheme and it falls to the Minister for Health to introduce that. I will raise it again with him, further to the question having been raised by Deputy Collins this morning.

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