The number of Irish patients approved to have their operations performed abroad and reimbursed by the Health Service Executive (HSE) is increasing significantly.
When the scheme started during 2014, there were just seven cases approved, but in 2019 the figure rose to almost 5,000 patients at a cost of €13 million (US14.9m). Already, so far in 2020, 3,130 claims have been reimbursed at a cost of over €10 million (US$11.5m) and an average cost per patient of €3,195 (US$3,675).
The main inpatient care accessed abroad is for orthopaedics, ear, nose and throat (ENT), gynaecology and neurology treatment. For outpatients, the main treatments are in ophthalmology, orthodontics, ENT and neurology. Surgery and outpatient consultations are covered.
The treatment is provided under the EU Cross Border Healthcare Directive, which allows patients to have healthcare they are entitled to in Ireland, in another country in the EU, or the European Economic Area. Patients can access this care in the public or private sector.
With 780,000 Irish patients on hospital waiting lists, patients are using the system to avoid long waits in Ireland.
According to the HSE Cross Border Directive Unit, the use of the scheme is growing every year. While applications slowed in March due to COVID-19, there was a significant backlog to work through and some of that is reflected in the latest figures.
Patients do not have to be on a waiting list to access the treatment abroad. They must be a public patient, and the treatment a person wants to access must be one that the patient would have been eligible for in their own country, and the patient must have an appropriate referral, usually from a GP.
The patient pays up front for the treatment and then supplies the HSE with the invoices and receipts for reimbursement. The HSE reimburses the cost of the treatment in Ireland, or the cost of the treatment abroad, whichever is the lower amount.