Backlog of 1,500 patients awaiting payment for treatment abroad, report says

Understaffing has been blamed for a 2½-month backlog in processing applications from patients seeking treatment abroad.

About 1,500 patients, many of them awaiting reimbursement for urgent procedures, are caught up in the backlog.

Health Service Executive officials running the cross-border directive (CBD) scheme say the waiting list is a “cause for concern in relation to delivering a quality patient service”.

In 2020, 22 whole-time equivalent staff were approved to operate the scheme, they point out, but only seven have actually been recruited and taken up their posts. As a result, the office handling applications under a number of cross-border treatment schemes suffers high churn rates and relies on agency staff.

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A massive fall in the number of patients travelling to Northern Ireland and Britain under the CBD scheme is revealed in the 2022 annual report on overseas treatment schemes. The most popular destinations with Irish patients seeking treatment abroad are now Spain and Poland.

Since 2014, the CBD has allowed public patients in the Republic to access healthcare in another European Union state, the cost of which is reimbursed upon their return to Ireland.

In 2020, 90 per cent of 8,744 cases that were reimbursed were in respect of treatments in the UK, and 98 per cent of these treatments were accessed in Northern Ireland. Almost three-quarters of the outpatient and day-case work carried out in the North were ophthalmology and orthopaedic treatments.

In 2021, the proportion of reimbursements relating to the UK had dropped to 73 per cent and last year this figure fell further to just 18 per cent. Virtually all of this work was carried out in Northern Ireland.

The number of reimbursements has also slumped as fewer patients travelled to the UK; down to just 2,936 in 2022.

This decline is reflected in a fall in the sums paid over in the scheme, from a peak of €12.3 million in 2018 to €4.3 million last year.

Most of those outpatients who still travel to the UK under the scheme do so for orthodontic treatment, while most inpatients travel for orthopaedic work.

Last year, patients were reimbursed for treatment carried out in 19 different EU states under the scheme, led by Poland (927 payments), Spain (855) and Lithuania (352).

Almost 3,000 reimbursements were also made under the Northern Ireland Planned Healthcare Scheme, to a total value of €11.3 million. The largest number (890) came from Co Donegal.

A third scheme, the Treatment Abroad Scheme, for treatments not available in the Republic, continues to send most applicants to the UK (84 per cent in the last quarter of 2022).

Last year, applications increased 26 per cent as hospital activity increased after the Covid-19 pandemic.

Among the treatments provided under the scheme were four children’s heart transplants and nine other children’s transplants.