Growing numbers of public patients are escaping long waiting list queues and taking matters in to their own hands by travelling to Northern Ireland or an EU country for treatment while the HSE picks up the bill.
ew figures reveal more than €4.9m was paid out by the HSE to patients going to approved hospitals in Northern Ireland up to the end of June.
More than €2m was also reimbursed by the HSE to over 500 patients for more than 1,018 episodes of care, mostly in EU countries, in the first half of the year.
The patients are availing of the scheme for a range of specialist appointments, treatments and surgeries including hip and knee operations, cataracts, ear, nose and throat procedures, cardiology care and plastic surgery.
Under the EU Cross Border Directive scheme – or the post-Brexit equivalent covering Northern Ireland – patients who are referred by their doctor and approved by the HSE can have their treatment carried out in hospitals in the North or in the EU.
The patient agrees to pay for the care upfront – with a hip operation at around €13,500 – and apply to the HSE for reimbursement towards the cost with the money coming through in about two months.
A breakdown of patients using the scheme in Northern Ireland up to the end of June shows the biggest number come from Donegal, but the second highest are in Cork, followed by Dublin, Monaghan, Louth, Kerry, Cavan, Wexford and Tipperary.
Some people are going to their credit union to get a loan, knowing the sum the HSE will reimburse will come through in around eight weeks.
Dave McAuley, chief executive of the Donore credit union in south inner city Dublin, said his credit union has facilitated a few people – including a number who became members to avail of the loan.
“We don’t know the medical condition of the person but we want to support them getting treatment.”
He said the HSE arranges to pay the reimbursed sum directly to the credit union.
“We have guaranteed payments from the HSE,” he said. There is no financial benefit for the credit union but it is a social service, he added.
He called on the Department of Health to provide some fee or other financial supports to credit unions – similar to that given to post offices for social welfare payments – in order to allow more to facilitate members.
“There are imaginative ways. We have to make sure we are not putting our small resources at risk for the good of members.”
Linda Ward, a nurse from Castlecomer, Kilkenny, was one of those who took the journey north to Kingsbridge Hospital in Belfast in November last year to have a hip replacement.
Before the operation, she would wake up in the middle of the night with pain and have to take medication.
“I was blaming the pain in my hip on my feet. A neighbour in town remarked I was limping and said it was similar to her husband before he went to Kingsbridge Hospital to have his hip done.”
She told how this prompted her to have an X-ray which found severe arthritis and that the hip needed replacement.
“The doctor said he would refer me to University Hospital Waterford but it could take years to have the surgery.”
Instead she contacted Kingsbridge Hospital and received an outpatient appointment to see an orthopaedic surgeon within days. “He said I should qualify for the HSE scheme and it would take eight weeks: five to get approval and three before the surgery.”
She initially inquired about a loan at her credit union but her family were able to come up with the €13,500, with the HSE reimbursing €11,000.
“The surgery just took half an hour. Twelve weeks later I was able to drive myself to Belfast for a check-up.”
Ms Ward, a nurse in St Patrick’s Centre in Kilkenny was back to work shortly afterwards.
“I would encourage anyone to check out the scheme.”
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