Neil Michael joined the passengers on the 50th ‘cataract express’ bus as they travelled to the North to undergo the routine I procedure that public patients are forced to wait years to have performed by the HSE
It wasn’t quite how anybody involved expected the 50th ‘cataract express’ bus trip to end when it arrived back at a stop just outside Cork city on Sunday.
But, shortly after getting to the service station to meet relatives, passengers were joined by members of an armed support unit.
They had come on board to help one of the passengers, who had fallen ill.
Although an ambulance had been called, the elite gardaí parked up at the service station were called on to assist until the paramedics arrived.
The passengers had all travelled up to Belfast the day before and were relaxing after their operations on Sunday morning.
Mostly pensioners, they all remained in good spirits despite what for most of them was a fairly gruelling round trip of more than 1,000km.
They had taken the well-worn path travelled by around 1,500 others since the first cataract express just over two years ago.
The Killarney-based Jimmy O’Callaghan bus that the latest group went up on is the brainchild of Independent TDs Michael Collins and Danny Healy Rae.
But while they can be credited with launching the service, the inspiration for it in the first place is John Patrick Harrington.
He is a 92-year-old who had to endure the 1,000km round trip from Bantry to Belfast in 2017 because he faced a four-year wait despite going blind.
Following advice from Mr Collins on how the Cross Border Directive (CBD) on Healthcare Scheme worked, Mr Harrington headed up to Belfast to get his eyes done.
To qualify for the scheme, all you need is a referral from your GP and the treatment you need is treatment you would normally be able to get on the HSE.
And once you have receipts for the cost of the procedure — which you pay for upfront — you use these to then claim the money back from the HSE.
Many who heard about the scheme and Mr Harrington, whose son Jerry has now thrown his time behind helping other pensioners get up to Belfast, felt that if someone so old could do it, so could they.
The latest passengers include grandmother Mona Kirby, 79, from Ballyroe, who went up last weekend with her husband, retired haulier Biddy, 89.
She had her right eye done in June, and he had his left done at the same time.
“So at least we had a good right eye and a good left eye between us,” Mona joked.
Biddy had his second eye done last week, and although Mona went with him, she was too unwell on the day to have the operation. This time round, she was going up to try again.
The couple, who used to run Kirby’s Corner pub in Ballinhassig before they handed it over to their son Billy, first started on the waiting list three years ago.
All they had heard since is a letter asking if they still wanted to remain on the waiting list and have cataracts.
“I suppose they were just seeing if we are still alive,” mused mother of five Mona, who has 13 grandchildren.
“It’s a crying shame that we have to do this to get our eyes done. But we had no choice because we could be another two years waiting.”
Mary Whelton, who works in SuperValu in Clonakilty, West Cork, went up to get her right eye operated on.
The 56-year-old, who was with painter and decorator husband Denis, 64, said she was told in July the soonest she could be seen by a consultant to talk about her cataracts was September 2022.
“I can’t drive at night anymore because of the state of my eyes,” said the mother of three, who has had to take out a credit union loan to pay for her treatment.
“I stopped at the beginning of December.
“I can’t wait any longer than I know I will have to under the HSE and I have no choice but to go to Belfast. It’s just ridiculous.
“And only for this service, people like me would be in dire straights.”
Eileen Lane, from Macroom, found out last Wednesday that she is cataract-blind in one eye.
The sight is restorable, but the longer Eileen leaves it, the less likely she is of having her sight fully restored.
Despite her deteriorating eyesight, the 58-year-old was told in June that she would have to wait at least 18 months before she could get her right eye operated on.
And when she double checked two weeks ago how long she would have to wait, she was told the same again.
“Despite being told six months ago that I would have to wait at least 18 months to be seen, I was told the other week I would still have to wait at least 18 months,” said the mother of three, who travelled with husband Peter.
“I think it is crazy I can’t have such a simple procedure done in my own country and that I have to go all the way to Belfast.
“I am delighted to get the opportunity to get my eye done, because I can’t drive at night anymore.”
If last weekend’s bus trip has proven anything, it is that the CBD scheme is as popular as ever.
And people remain as grateful to TDs Healy-Rae and Collins for ensuring there is a bus service especially for people who want to go up to Belfast.
In 2015, the first full year of operation of the CBD scheme, 150 reimbursements were made by the HSE at a cost of €585,863.
And by 2017, the year the cataract express started, reimbursements had shot up to €4.4m.
In 2018, some 3,886 reimbursement claims were processed, at a value in excess of €12m.
This year’s final figure is expected to be past €15m as reimbursements for this year were €11.3m to the beginning of November for a total of 4,365 reimbursements.
But while the figures for the CBD are high and rising, so too are those for claims made under the Treatment Abroad Scheme (TAS).
Unlike the CBD scheme, this one covers the cost of treatment either not available in Ireland or not available within the time normally necessary to get here.
You also have to be referred by a public hospital consultant to qualify for TAS, unlike with CBD, where your GP can refer you for treatment.
In 2018, treatment costs came to €11.8m, but up to around November this year, they stood at just over €13m.
TAS costs were €11.3m in 2017, up 23% on the €8.7m spent in 2016 and up 54% since 2012.
In a Dáil debate on the cross border healthcare scheme on November 26, Health Minister Simon Harris admitted “significant further growth is expected in 2019”.
This will be good news to Kingsbridge Private Hospital in Belfast, where the cataract express passengers go.
As reported yesterday, CEO Mark Regan is planning to more than double the number of cataract operations it carries out for people in the south.
He expects capacity to increase early next year to 200 a month.
Mr Regan is due to meet HSE officials at the start of next month to talk about offering “a more standardised service”.
To match this increased demand, the agency has set aside in next year’s HSE Service Plan €37m to cover claims.
The increase in popularity in CBD has, however, led to delays in the amount of time it takes people to get their money back.
Last month, Mr Harris told the Dáil the delay is now at around two months but he conceded he is “open to correction on that”.
He said the HSE has arranged for the provision of overtime for existing staff and deployed additional staff in the cross-border office.
And he said the HSE “is now in the process of recruiting further additional staff”.
He said the agency is also “sourcing alternative accommodation to house the expanded complement of staff for the cross-border directive office”.
Whatever about the amount of money treatment abroad schemes cost taxpayers for as long as waiting lists remain too high, an increasing number of studies are pointing to other costs that could be avoided.
Studies over the past 20 years have already shown cataract operations in the elderly lead to anywhere between 3% and 10% less falls and fractures.
However, one recent study went further.
In October last year, the Journal of the American Geriatrics Society published a study which showed that a diagnosis of cataracts was associated with a 16% increase in hip fractures.
This was the results of a survey of more than 100,000 people over six years.
It also concluded that of the 57,972 cataract patients used in the study, those who underwent surgery had a 42% lower risk of developing osteoporosis or suffering from a fracture from a fall.
Tralee-based grandfather Patrick Casey was warned by his GP that he stood a greater chance of injuring himself from falls if he didn’t get his eyes sorted.
The retired lorry driver, who was on the first cataracts express, started going blind while into his seventh year waiting for the HSE to treat him, The 74-year-old father of six, who borrowed the money he needed to be treated in Belfast from his local credit union, could barely see through both of his eyes because they were riddled with cataracts.
Astonishingly, despite waiting so long to be seen and despite being an urgent case, he even faced a further wait.
As an added irony, his own grandfather had had both his cataracts taken out 50 years previously in Tralee, in 1968, and had had only had to wait a few weeks for the appointment.
“My eyesight is now absolutely brilliant,” he recalled. “I spoke to Jerry at the start and found out about a new bus service that was being planned and I jumped at the chance to get treated.
“I had had a terrible time trying to get seen through the normal channels, and I had just got nowhere.”
He is not surprised the cataract express is still in operation.
“The waiting lists are still crazy, so I am not surprised,” he said.
Until last Sunday morning, great grandmother Mary Glavin had cataracts in both eyes.
The 73-year-old, from Skibbereen, Co Cork had been told she would have to wait at least two years before she could get them operated on.
She suffered a haemorrhage behind her left eye in 2017 and had already undergone laser surgery.
Mary says she was told to get a new pair of glasses by staff at Cork University Hospital while she waited for cataract treatment on the HSE.
Her own optician, however, didn’t think she needed a new prescription and instead believed what she actually needs is to get her cataracts operated on.
“I have had a range of problems with my eyes,” said the mother of four, who also has five great-grandchildren.
“I’ve had large black spots in one eye, and flashing lights. It’s been really unpleasant.
“So I feel great getting my eyes done — I got the left eye done at the weekend and I will have the right eye done in the new year. It’s just one less thing to have to worry about.”
Despite being a jovial character with a ready quip for most things, she says she is unhappy about the fact that she can’t get treated in Cork.
“For a start, it would save all the hassle of having to travel all the way up to Belfast,” she said.
“Even at the end of the two years I was told it would take before my cataracts get operated on, I could probably have to wait another two years on top of that.”
“It’s easier now as an elderly person in Ireland to feel utterly useless and unwanted.
“You get to a stage in life where you realise this is no country for old men and women.
“I think the people in Government have lost all respect for the elderly. We’ve served our purpose, we paid our taxes, and were parents to more taxpayers. We’ve played our role, thanks a bunch and now it’s goodbye.
“But at a time in our lives where we should be entitled to basic services — many of us are just left to our own devices and to fend for ourselves.
And that is just not on.