Cross-border confusion

Will Northern Ireland stay within the EU cross-border healthcare rules, even if the rest of the UK does not?

Northern Ireland is part of the UK even though it is physically detached from it. It has its own parliament, laws and NHS.

Depending on negotiations between the UK and European Union, it will be in the unusual situation of being half in and half out of the EU with a border somewhere in the sea.

There is and will be, unless negotiations take a different turn, no border between Northern Ireland and the Republic of Ireland.

There are various political and healthcare deals between the two that are not dependent on the European Union. However, the future of cross-border healthcare under UK/Ireland and EU deals is of great concern on both sides of the border.

Much publicity is given to the thousands that go for treatment from the Republic of Ireland to the UK – but how many go to Northern Ireland compared to the rest of the UK is not known.

Even less well known is the number of people travelling from Northern Ireland to the Republic of Ireland – as figures are lost in UK numbers.

Cross-border healthcare and surgery, in particular, is extremely popular, especially in border communities and it allows people to get treatment faster rather than sitting in long waiting lists. The EU Cross-border Healthcare Directive enables a patient to travel to the Republic of Ireland, or to anywhere in the EU, for treatment.

In figures released by the Minister for Health, 3,300 people applied to be on the scheme since 2015 with 1,345 in 2019 alone. In the same period £8 million was paid out to those who had surgery in the Republic of Ireland.

How to continue in the future will partly be determined by the Northern Ireland Executive in their dealings with both the UK and EU on post Brexit arrangements. There are long local health waiting lists in Northern Ireland, so with no alternative within a reasonable timeframe, people feel comforted by the current arrangement.

How much influence the Northern Ireland Executive now has with the UK government is uncertain. Some fear that the cross-border healthcare arrangement will be sacrificed in UK/EU deals.

Currently the 7,000 people in Northern Ireland who need a replacement hip or knee can expect to wait from between 56 weeks in the Belfast and Southern Trusts, and 93 weeks in the Western Trust for a hip replacement. The delay facing people needing a knee replacement is even longer, ranging from 65 weeks in the South Eastern Trust to 114 weeks in the Western Trust – but through the cross-border scheme these operations could be done almost immediately in the Republic of Ireland or European continent.