Donnelly overrode concerns about cross-Border scheme

Secret tapes recorded in the Department of Health show how Stephen Donnelly overrode official concerns about how to extend a scheme that allows for the reimbursement of cross-Border medical care, which had been impacted by Brexit.

The tapes outline how there were “a lot of concerns” about an approach favoured by Mr Donnelly to continuing the refunding of cross-Border care, which had been carried out under an EU directive which was due to lapse after Brexit took effect.

This directive has enabled many thousands of operations to be carried out after so-called “cataract bus” runs carried people north of the Border, who could then reclaim the cost of operations under EU rules.

Officials discussed how Mr Donnelly favoured an interim scheme on an administrative basis, not underpinned by legislation, to enable it to continue. “The Minister has taken a slightly different approach to the one that was recommended by our officials in that area and they’re proposing to put some kind of an interim scheme in place on an administrative rather than legislative basis”. The official said there would be “a lot of concerns about that” and it was an “emerging situation” and “one to keep an eye on”.

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They worried there would be impacts on the private health insurance market, and that the action could leave the State open to legal cases from private hospitals, as well as charges of inequity as it would allow those who could forward fund their surgeries quicker access to care than those who would have to wait for public care in Ireland.

Just such a programme, the Northern Ireland Planned Healthcare Scheme, which operates on an administrative basis, came into being on January 1st, 2021. Mr Donnelly has said the Government intends to put it on a statutory basis.

The tapes show officials believe the Attorney General “whose job it is to have an independent view on these things” could challenge the scheme when it came to Cabinet, despite the existence of “political cover”.

A spokeswoman for the department said people faced losing access to a range of care options after Brexit, and the Minister made decisions after consulting a range of factors, including officials. “The Minister greatly values the advice he gets from officials… but he doesn’t follow it on every occasion.”

“Without a scheme to apply from January 1st, 2021, people would lose access to a range of care options available under the EU directive from private providers in Northern Ireland. Continuing, but also better access to timely care is a key pillar in the delivery of Sláintecare.”

The spokeswoman said Northern Ireland had implemented a cross-Border directive as well, indicating that Stormont's Minister for Health, Robin Swann, "clearly came to the same conclusion about the necessity to have a scheme in place".

The department has said the recording and publication of tapes made in the department limits constructive debate and dialogue in the Civil Service and is damaging to the public interest.

A series of disclosures based on internal conversations in the department have been made to an Oireachtas committee by Shane Corr, a civil servant in the department.