Louise O'Reilly (Dublin Fingal, Sinn Fein) | Oireachtas source

The Sinn Féin motion is very clear on the need for the Government to defend our national interest and to negotiate for the North to be designated with a special status within the EU. We make the case that we need a whole-of-Ireland approach, not least because of the catastrophic effect that Brexit will have for the Border regions and the island more generally, but because it is not a black and white or them versus us situation in respect of the North and the South. We have a symbiotic relationship. People, goods and services flow naturally across a man-made partition. We also co-operate, integrate and work together.

Nowhere is this more prevalent than in health care. Brexit will hit health in terms of free movement, right to health services and regulatory issues. What will happen when we can no longer act as a critical mass for services such as the congenital heart network? What will happen when patients are no longer able to cross the Border to access services under the cross-Border directive? What will happen when emergency ambulatory transfers from across the Border are impinged? Services will be restricted and lives could be lost. In recent weeks, the Irish people were shocked and horrified but were also seeing familiar scenes in terms of chronic waiting lists. What will happen with the discontinuation of the entitlement to source treatment in the North and Britain in certain circumstances in which there are delays in having the treatment concerned offered in Ireland where the cost is met by the HSE? Currently, there are soundings being made about the possibility of the entitlement being replaced by a bilateral agreement that would offer a similar level of entitlement.

Reference has also been made to the option of what is known as the S2 route, but that assumes that Britain will become a member of the European Economic Area. Ultimately, entitlements using the S2 route are more restrictive and less favourable than those covered by the cross-Border health care directive. In response to parliamentary questions I submitted last year, the HSE revealed that in the 18 months to 30 June 2016, it reimbursed €659,245.09 - just to be accurate - for treatments and services in the North under the cross-Border health care directive. This represented 277 people travelling for vital health care. Brexit poses an enormous threat and a further inconvenience to those patients accessing services for which long waiting lists exist - orthopaedics and orthodontics being the most common. If the cross-Border directive is no longer applicable to the North post-Brexit, it will create an even greater vacuum in the delivery of health services and put even more pressure on our over-burdened health service.

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