Dr. Sheelah Connolly:

The first question was on cross-Border initiatives. It is correct that a number of them are up and running and appear to work very well. Included in these are the paediatric and cardiac services. Prior to Brexit, there was an EU directive that allowed people from the South to access healthcare in other European countries, including in the UK. Many went to Northern Ireland. At the same time, people from Northern Ireland were coming to Ireland to access services, often in private hospitals. We do not know what is going to happen in this regard. A temporary scheme was put in place after Brexit. It was to be available for a year. Whether it will proceed into the longer term, we do not know. We did not examine whether there is a specific impact on the waiting lists because we do not have the information where people are based, but it is probably marginal in terms of the big increase in waiting lists over time.

Senator Martin said eligibility criteria are becoming more similar and questioned what is happening with the systems in and of themselves. We did not consider that in the research but there is potentially a lesson for Ireland. Although we hear a lot about shortages of GPs in Ireland, most people here could access a general practitioner within a couple of days, at least before Covid. That is not the case in Northern Ireland, where people often have to wait two weeks for a GP appointment. There is a lesson in that regard. It is good to give people cheaper GP care if we can, but, if we do not have the required capacity, it can lead to very long waiting times, which is not very useful.

Senator Black asked about medical staff leaving. We did not examine that in the research; however, across the UK there is probably increasing interest in the issue of people who have been trained there leaving for other countries. Therefore, it is potentially an issue in the UK also.

Senator Clonan asked about disability. We had intended to include that in the research but unfortunately could not get comparable data across the jurisdictions to quantify what he referred to in respect of there being better service provision in the North relative to the South. The Senator is probably hitting on a wider issue, concerning a right to health, which exists in other European countries. It includes healthcare and disability services. This does not really exist in Ireland. We fund the services for those who cannot afford them, but in some other countries it is an entitlement. It is probably feeding into that.