HSE delays cuts in reimbursement rate for patients going north for cataracts treatment

Passengers travelling on the Cataracts Express service, also known as the Belfast or Blind bus service, in April as it marks its 150th trip. The service has helped more than 4,000 people get treated. Picture: David Creedon

Changes in the rate of reimbursement for patients who travel to Northern Ireland for cataracts treatment have been postponed until September 1.

The HSE has confirmed that plans to change the rate of reimbursement, first revealed by the Irish Examiner, have been postponed. They were initially due to kick in from July 1.

When the changes kick in, it will mean patients who travel for standard eye treatments will be reimbursed around €860, while those who go for more complex treatments will get between €1,100 and €1,900, depending on the extent of their treatment.

Those rates are currently between €1,900 and €4,200, depending on the nature of treatment. The HSE has confirmed the reductions were initially due to come in several years ago following a review, but this was delayed. 

"The HSE had not updated the pricing of procedures for the last few years," a spokesperson said. "This was due to the interruption of covid coupled with the reclassification of certain cataract procedures following the international coding system (Australian AR-DRG Classification System), in which some prices have increased and some have decreased.

"HPO prices for cataracts were due to change effective from 1 July 2024. In order to ensure no one is disadvantaged and communicate fully with service users, treating consultants and providers the HSE is deferring these cost changes until 1st September 2024."

Cork TD Michael Collins has criticised the move to reduce the rate of repayment as "scandalous". Mr Collins raised the matter in the Dáil in recent weeks when he had heard about the changes. 

He has been involved in helping constituents travel to Belfast for cataract operations in recent years. However, despite the postponement, he said he will not accept the reduced rate of repayment for patients who rely on the scheme.

"This fight is far from over," he told the Irish Examiner. “We have to make sure the cuts don’t come in because so many people depend on going to the North to save their eyesight.

The decision, which was due to come into effect at the start of July, had already led to a number of people cancelling planned surgery because they could not afford it under the new rate.

People on the Cataracts Express service, also known as the Belfast or Blind bus service, are mostly those who have been waiting years to get treatment or are starting to go blind. 

The service, which has helped more than 4,000 people get treated, was set up by Mr Collins and Kerry TD Danny Healy-Rae in December 2017. Mr Collins had earlier warned the decision could lead to “many of our citizens suffering unnecessarily and going blind”.

Treatment for cataracts and other operations on, for example, hips or knees, was initially reimbursed via the Cross Border Directive (CBD) on Healthcare. This was replaced by another reimbursement scheme, the Northern Ireland Planned Healthcare Scheme, after Brexit.

Under either scheme, the HSE is obliged to refund whichever is the lower of the two costs — the cost of care in the North, or cost of care on the HSE. People cannot claim for travel costs, accommodation or any prescription medicine costs.