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

There is unanimity across the House and among the majority of people in the North of this island that Brexit will be bad for Ireland. Not only is it a threat socially and economically, but it also threatens the health of people, north and south of the Border. It threatens the health of Irish people because a hard border will damage access to health care and health facilities, as well as damaging the health co-operation that exists.

The past decade has seen major developments in health co-operation, with a number of joint departmental projects being developed across the island. These include: work on shared radiotherapy and paediatric cardiac services; health promotion focusing on alcohol, tobacco and obesity; cancer research; mental health; and suicide prevention. In particular, I would highlight the areas of suicide prevention and shared radiotherapy services. A huge amount of work has been put in by the individuals concerned and those projects are really starting to show dividends. People in Donegal can now access radiotherapy services in Altnagelvin and it is extremely important for those people that we maintain that service.

There is already a shared understanding between the Governments, North and South, that health is an area of opportunity for shared provision. However, Brexit could derail this co-operation in a number of areas. In the 18 months to 30 June 2016, the HSE reimbursed over €650,000 for treatments and services in the North under the cross-border health care directive, which represented 277 people. I have spoken to people in my own constituency of Dublin Fingal who have availed of this and who have travelled across the Border to avail of services that we have not been able to offer them in this State.

Illness, disease and health know no borders and these figures demonstrate that people are willing to travel for vital services and treatment when they are needed. The evidence of this is in the every area and constituency; people will travel if they can get the health care they need.

It is of major concern that this scheme could cease North and South as a consequence of Brexit. Further entwining of the health services and co-operation can be found through the all-island congenital heart disease clinical network board. Only a few years ago the board was tasked to build a world class congenital heart disease service for all of the children and young people on the island who suffer with congenital heart conditions. As a result, an announcement was made in 2016 that capacity would be expanded for catheterisation procedures in the newly opened, state of the art hybrid cardiac catheterisation laboratory at Our Lady’s Hospital for Sick Children in Crumlin. This service is very much anticipated and needed. This will create an all-island catheterisation waiting list, to the benefit of children across the island. This will be the first all-island waiting list of its kind but a hard border will threaten this. To be clear, in order for this service to be effective it needs a critical mass of a minimum of 6 million people, which is the population of the whole island.

Brexit also threatens clinical trials for medicines and treatments which are carried out on an all-island basis. Cancer Trials Ireland, CTI, is the leading cancer research trials organisation in Ireland. A major goal of CTI is to strengthen the capacity for cancer centres across Ireland, North and South. While the vast majority of these trials are carried out in Cancer Trials research units in the south, a number of trials have participation from research units in the north. The withdrawal of Britain from the EU will, no doubt, have a significant impact on this.

A hard border threatens services that are already stretched and struggling in the Border region. Currently there is a memorandum of understanding between the ambulance services North and South. Ambulance personnel and paramedics from the North and the South routinely attend to people and accidents on either side of the Border. We should be looking at strengthening this understanding as opposed to having to deal with a situation where ambulances cannot operate in this manner any longer.

To date there is a record number of shared health services operating on a North-South basis. Those operating these services and those using them know that sickness and disease do not respect arbitrary borders and they are keenly aware that between the North and the South we have some of the best hospitals, doctors, nurses and health care professionals in the world. Such work could all be undone if the Government and all Members do not fight to ensure that there is no hard border.

What is being done to protect these services? I welcome the all-island health dialogue. It was a good innovation but it is not enough. We need to know that these arrangements will be Brexit-proofed. We need to know that people who live in the Border region will be able to rely on the systems that have developed through North-South co-operation. We need to know that these issues are taking priority in Government buildings and at negotiations between the EU and Britain.

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