Thousands go abroad as Irish waiting lists grow


Thousands of Irish patients are going overseas for medical treatment as waiting lists in Irish hospitals continue to rocket.

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

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. Many go to Northern Ireland.

Beginning with 150 claims at a cost of €0.5m 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 of 2018 is already at 41% of the total activity for 2017 - with 1,422 reimbursements at a cost of €2.79 million.

Claims are for many different types of procedures and treatment including joint replacements and tonsil removals, with cataract surgery proving particularly popular this year. For the first four months of 2018, the HSE has reimbursed 415 outpatient appointments and day case procedures for cataract surgery abroad, at a cost of €314,811. This compares to a total of 162 such reimbursements, at a cost of €130,620, under the directive for the whole of 2017. 

The latest National Treatment Purchase Fund waiting list figures show that 79,414 were awaiting an inpatient/day case procedure, at the end of April. The Association of Optometrists Ireland says that waiting times for cataract surgery are up to five years in some parts of Ireland.

The National Association of GPs encourages its members to refer patients waiting a long time for care to use the directive. The HSE has extensive information on how to use the directive on its website.

The Private Hospitals Association has called for a change in HSE policy to allow any patient seeking approval for treatment abroad to be first offered treatment within the Irish private hospital system in one of 19 private hospitals.

View the IMTJ country report on Ireland for analysis on outbound medical tourism.



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