Dáil Éireann Debate, Tuesday - 2 May 2017
787. Deputy Mattie McGrath asked the Minister for Health the amount charged in 2016 to the NHS for Britons being treated here by the HSE; the number of persons this charge applied to; the cost to the HSE for Irish persons being treated by the NHS; and if he will make a statement on the matter. [19177/17]
Amharc ar fhreagraRegulation (EC) 883/2004 and Implementing Regulation 987/2009 provide for the coordination of social security systems, including healthcare, within the EU/EEA and Switzerland. Under these provisions, persons who are insured with (covered by) the healthcare service of one EU member state are entitled to receive healthcare in the public system of another member state in certain circumstances, at the cost of the member state in which they are insured. Such persons may include:
- visitors to one member state from another;
- pensioners of one member state who reside in another and their dependants;
- dependent families of persons who are employed in another member state; and
- persons referred for treatment in another member state.
Ireland and the United Kingdom operate a bilateral healthcare reimbursement arrangement, in respect of health services provided under the Regulations, covering temporary visitors between the two countries, pensioners of one country and their dependants residing in the other country, and the dependant families of persons employed in the other country. Under the arrangement net liability between the two countries is calculated on a lump sum basis rather than an individual basis.
The amount payable in any one year is based on an estimate of the numbers of persons within the categories eligible for reimbursement and for whom each country is liable and an estimate of the average cost of providing healthcare treatment. The amount payable is agreed following compilation of the necessary data and discussions between the two administrations. An initial payment on account is made for the relevant year and is subject to final settlement once all necessary statistical and financial information is complete. The finalisation of accounts is normally some years in arrears to facilitate collation of relevant statistics and for the approval of the average cost prepared by each country for the year concerned at EU level. Total payments in any one year can as a consequence relate to both final settlements in respect of previous years' liabilities and the payment on account in respect of the current and/or previous years.
The net payment received by Ireland from the United Kingdom in 2016 was €277.6m, of which an amount of €97m related to the settlement of final accounts for previous years, and an amount of €180.6m related to the payment on account for 2016. The relative values of this amount attributable to each country are as follows:
|
€ |
|
|
Payable by the UK to Ireland |
€193.1m |
|
Temporary Visitors (based on an estimate of 15,725,000 visitor days) |
€ 12.6m |
|
Pensioners and their dependants (based on an estimate of almost 35,000 persons) |
€180.5m |
|
Payable by Ireland to the UK |
€ 12.5m |
|
Temporary Visitors (based on an estimate of 13,272,000 visitor days) |
€ 8.1m |
|
Pensioners and their dependants (based on an estimate of 1,260 persons) |
€ 4.4m |
|
Net paid by UK to Ireland |
€180.6m |
Entirely separate arrangements apply to patient referrals for scheduled treatment in the other country whereby the costs arising are reimbursed on an actual costs basis. These arrangements are administered by the Health Service Executive. In 2016 the HSE issued 867 forms to approved patients who availed of healthcare in the United Kingdom at a cost of €9,169,452. In relation to UK patients who received healthcare in Ireland, data for 2016 is not yet available, however in 2015 the HSE submitted claims totalling €1,857,764 in respect of 14 approved UK patients who received healthcare in Ireland.
