Your Money: How to beat Irish waiting lists and get treatment abroad paid for by the HSE

The news about never-­ending waiting lists for hospital procedures has become everyday.

There’s no shock any more when you hear of hundreds or thousands of people waiting for an appointment with a consultant, for a scan or treatment for everything from cataracts to hip replacements.

If only there was a way of getting surgery quickly, easily and free of charge.

And there is.

It baffles me why more people don’t avail of it, especially when those who do – who are entitled to it – are so happy with the results.

The answer lies in EU Directive 2011/24/EU. Or, as it is better known, the Cross-Border Healthcare Directive (CBHD).

This entitles people languishing on a public waiting list for a necessary, but possibly elective, procedure to have it paid for in another EU member state (which for this purpose also includes Northern Ireland, where it is called the NIPHS scheme), and have the costs reimbursed by the HSE.

In the last five years, €81m has been spent on patients under the dual schemes, but it should be multiples of that. And it’s your right, as a European citizen.

All the procedures covered abroad are available in Ireland, but if you’ve been waiting for it too long, then a letter from your GP can shunt you onto a surgery list elsewhere.

The NIPHS (Northern Ireland Planned Healthcare Scheme) is particularly popular, because there’s no aeroplane journey involved, and you get treatment in a private hospital or clinic a couple of hours away.

In 2022, €15.5m was reimbursed to patients for this.

Separately, hundreds of patients have travelled to Spanish, Polish and German hospitals, among others, for lots of procedures, where they were seen quickly and effectively, with many offering superior accommodation and post-operative rehab to what may be available in a public hospital in Ireland.

Kerry people will be familiar with the “cataract bus” regularly organised by TDs such as Michael Healy-Rae, with over 2,000 locals getting eye surgery in the North over the last few years.

The Cathedral Eye Clinic in Belfast is just one which has seen “thousands” of Irish patients come through its doors under NIPHS and even has a ­dedicated in-house facilitation team, which, it says, particularly helps elderly Irish people not used to navigating the process.

“These individuals, faced with extensive waiting lists of years for cataract surgery, come to our clinic for timely treatment, usually within four to six weeks of referral,” chief operating officer Joyce Shaw says.

“Cataract surgery through the NIPHS is most prevalent. From scheduling appointments to co-ordinating reimbursement, with the HSE, patients find the process efficient and well-managed.

“Patients can travel to our clinic for their consultation one day, followed by surgery the following morning and be back home in time for dinner.

“The Ramada Hotel is a two-minute walk from the clinic, ensuring our patients have a comfortable, convenient hotel to stay in should they wish to do so”.

Who is eligible?

Irish residents who are entitled to ­public healthcare and are on a public waiting list, or have a GP referral can apply for either NIPHS or an EU hospital under the CBHD rules.

What’s covered?

There’s no precise list of all the procedures available, but pretty much anything that isn’t being privately accessed is included.

Day case, inpatient and outpatient care in acute hospital services would be the most common (this includes the popular cataract surgery).

It also includes joint replacement, psychiatric services, fertility treatments and physiotherapy.

The waiting lists for dental and orthodontic services for children are even worse than some medical lists, so those under 16 who require such treatments are also included up to €2,200.

What’s not?

Any chronic or long-term healthcare condition or treatment (for example, organ transplants, dialysis etc).

Healthcare that isn’t normally available in a public hospital in Ireland, or nursing home care.

You cannot use private health insurance for referral. A hospital consultant proving the letter for you must be seeing you as a public patient.

Only the procedure itself is covered, and only up to the limit of what it would cost here to perform, or whatever the foreign clinic charges for it, whichever is lower.

The HSE does not refund travel costs, accommodation for yourself or a companion or any prescription medicines you require.

The Drug Payment Scheme limits any spend on medications to €80 per month if you don’t have a medical card.

What’s the catch?

The main stumbling block is cost. While the HSE will refund treatment under the directive, the patient must pay for it up front. This often means a loan, but credit unions offer them at good rates.

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