Over 700,000 waiting for treatment while HSE sees drop to inquiries for cross border directive

Over the five years to 2023, the number of Irish patients receiving reimbursements for medical procedures under the scheme was down 55%.

More than 700,000 people are waiting for hospital treatments including surgery, orthopaedics, and gynaecology.

At the same time, HSE figures show there has been an 80% drop in the number of patients on waiting lists inquiring about the option of availing of treatment abroad under the Cross Border Healthcare Directive since 2018 — with just 662 people making enquiries last year.

Ireland South MEP Cynthia Ní Mhurchú, to whom the figures were released, said she believes this is due to the fact that many people on waiting lists are unaware of the directive.

Over the five years to 2023, the number of Irish patients receiving reimbursements for medical procedures under the scheme was down 55%.

In 2023, the HSE spent €9m reimbursing people who were on waiting lists but chose to undergo treatment in another EU country — down from over €15m in 2020.

Under the scheme, patients who travel to another EU country for the medical procedure they are waiting for will be reimbursed for the treatment — but not the travel and accommodation costs. The treatments covered are ones that are publicly funded and available in Ireland.

The healthcare must be planned, you need a valid referral, and you must qualify for the healthcare you want as a public patient in Ireland.

It is separate from the Treatment Abroad Scheme, which covers treatments that are not available in Ireland.

Option to travel abroad

Ms Ní Mhurchú suggested the HSE should write to those currently on waiting lists to advise them of their right to have their procedure carried out in another EU country, with the HSE covering the cost of the treatment itself.

This would have the dual benefit of reducing the number of people on our hospital waiting lists and give patients the option to travel abroad and receive their treatment earlier.

The Fianna Fáil MEP called on the HSE to launch a nationwide publicity campaign, saying that many patients would avail of the chance to have that treatment paid for in another EU country.

The Cross Border Healthcare office in Kilkenny has sought to take a proactive approach to rolling out the directive, and Ms Ní Mhurchú has called for more resources be made available to help further publicise the benefits of the scheme for Irish people.

Fianna Fáil MEP Cynthia Ní Mhurchú suggested the HSE should write to those currently on waiting lists to advise them of their right to have their procedure carried out in another EU country

She said there was a concern that healthcare professionals themselves are also unaware that patients have a right to seek cross-border healthcare paid for by the HSE. 

One issue that may be impacting the number of people applying is that the upfront cost of the treatment must be paid by the patient, with reimbursement typically taking 14 weeks upon receipt of application.

It is noted that the credit union launched a specific Cross Border Healthcare loan, which covers the cost of the treatment until the HSE reimburse it.

"Travelling to another country with a substantial outlay of costs may not be an option for all patients, but for others it could mean a life changing procedure without the wait," Ms Ní Mhurchú said.

The directive began operating in Ireland in June 2014 and, that year, there were just seven reimbursements  to the tune of €29,000.

As of 2021, the Cross Border Healthcare Directive no longer covered travel to Britain or Northern Ireland following Brexit.