Patients flock overseas for treatment as waiting lists soar

Use of EU cross-border health scheme is doubling every year, HSE figures show

Thousands of frustrated patients are heading overseas for medical treatment as waiting lists in Irish hospitals continue to soar, new figures show.

The use of the EU Cross Border Healthcare Directive by Irish patients to access health services abroad is doubling each year, according to the data supplied by the Health Service Executive.

The directive allows patients to access healthcare services including operations, specialised inpatient care and outpatient appointments, in another European country once they have a referral letter from a GP or hospital doctor.

Patients pay upfront for their treatment and the cost is later reimbursed by the HSE.


The HSE has reimbursed 4,615 procedures/appointments at a cost of €9.247 million since the directive came into force in October 2014, figures supplied to The Irish Times show.

While usage of the Directive was slow initially, with just 150 claims at a cost of just over half a million euro in 2015, the HSE reimbursed 1,025 claims under the directive in 2016 at a cost of €1.447 million.

In 2017 HSE costs under the directive rose to €4.4 million for 2,011 reimbursements.

Activity for the first four months this year is already at 41 per cent of the total activity for last year - with 1,422 reimbursements at a cost of €2.79 million to date in 2018.

Kerry Independent TD Michael Healy Rae told The Irish Times he advises patients on long waiting lists in his constituency about using the directive to access care "every day".

The plan envisages the number of patients waiting longer than nine months to fall by 10,000

He said he has referred hundreds for reimbursable treatment in a private hospital in Northern Ireland, with cataracts, tonsils and joint replacements among the most frequent categories. "It is crazy the HSE can't perform the operation here but can pay for it to be done in a different district abroad."

The HSE said it has published extensive information on how to use the directive on its website, which patients should read so that they know and understand how it works. A spokeswoman advised patients to contact the HSE’s National Contact Point with any questions they have, as on occasion some have been given “incorrect or inaccurate information” by healthcare providers abroad.

The latest National Treatment Purchase Fund (NTPF) hospital waiting list figures show that 507, 507 people were awaiting an outpatient appointment while 79,414 were awaiting an inpatient/day case procedure at the end of April.

Minister for Health Simon Harris last month published a new action plan to reduce the number of patients waiting for hospital operations or procedures.

The plan envisages the number of patients waiting longer than nine months to fall by 10,000. The NTPF says it will offer treatment to all patients waiting more than nine months in a number of high volume specialities - including cataract, hip and knee replacement, and tonsils.