Robbie Gallagher (Fianna Fail)
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The Minister of State is very welcome to the Chamber. The cross-border healthcare directive, as it was once known, was introduced in 2014. It has proved to be a major success. Interestingly, only seven people availed of the scheme in 2014, but up-to-date figures indicate almost 15,000 people have availed of healthcare across the Border.

For many people who are languishing on waiting lists, whether it is for a cataract operation or some other eye procedure, or perhaps a hip or knee replacement, the cross-border health scheme was a complete game changer. It changed their lives completely and improved their quality of life no end. Back then, people could go to any EU state to avail of healthcare but, unfortunately, Brexit came along and there were worries that that would be the end of the scheme. Thankfully, that has proven not to be the case. The Government moved swiftly last year to introduce an interim scheme, the Northern Ireland planned healthcare scheme, which allowed people in the Republic to avail of healthcare in Northern Ireland, or elsewhere in the EU, including operations and procedures that were available in the South. The scheme has continued and it has proved to be very successful

As I said, the figures speak for themselves. From 2018 to 2021, cataract procedures proved to be the most popular. Some 4,131 people availed of those procedures, while 1,413 people had hip replacements and more than 600 people has knee replacements. On 28 December 2020, the Government moved to sign the Northern Ireland planned healthcare scheme into law for a 12-month period. There is now concern because that 12-month period is about to expire. People are asking what the future of the scheme will be, whether there will be one and who will be entitled to it. There is uncertainty that needs to be put aside. We hope that the Minister of State will confirm for us, and the Irish people, that the Northern Ireland healthcare scheme will continue so that people who, unfortunately, have been waiting for procedures for many years will be able to avail of this scheme in future.

It is also worth noting that PDFORRA has an arrangement in place with Kingsbridge Private Hospital in Belfast under this scheme. It is also concerned about what the future of this scheme holds for its members. I hope the Minister of State will have good news for everyone in the Chamber and will bring clarity to this issue for many of those people who suffer for years as they wait for healthcare procedures, so that they will know that they will be able to continue to avail of healthcare in the North, if that is what they wish to do.

Mary Butler (Waterford, Fianna Fail)
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I thank the Senator for raising this important issue. I apologise on behalf of the Minister for Health, Deputy Stephen Donnelly, who is in a Cabinet meeting.

I understand Department officials recently discussed this issue with the Senator and colleagues at the Seanad Special Committee on the Withdrawal of the United Kingdom from the European Union. As a result of Brexit, the EU cross-border directive ceased to apply in Northern Ireland. To mitigate this loss, this Government made the important decision to introduce the Northern Ireland planned healthcare scheme which has been in effective operation since 1 January of this year. Under this scheme persons resident in the State can access and be reimbursed for private healthcare in Northern Ireland by the HSE, provided such healthcare is publicly available within Ireland. Therefore, despite the various consequences and challenges which have arisen as a result of Brexit, this scheme continues to ensure that patients have access to healthcare in Northern Ireland.

The Northern Ireland planned healthcare scheme is currently operating on an interim administrative basis pending the drafting of a general scheme to place it on a statutory footing. In that regard, Department officials have undertaken a comprehensive analysis to inform the design of the statutory scheme, including detailed consideration of the operation of the current administrative scheme, stakeholder feedback and, helpfully, the recommendations of the Seanad Brexit committee's interim report and feedback from Senators at the most recent committee meeting with officials.

Furthermore, officials have been engaged with our Northern Ireland counterparts, who have introduced an administrative Republic of Ireland reimbursement scheme to enable patients to access care in this State. We are examining the parameters of that scheme. This extensive analysis is continuing at pace and while it will continue into 2022, I assure the Senator that this remains a priority and, importantly, the administrative scheme, which is operating successfully, will remain until a statutory scheme is in place.

I am confident this assurance will provide certainty for patients that they will continue to access care under the administrative scheme beyond the end of this year. Further information regarding how to access the Northern Ireland planned healthcare scheme and be reimbursed for private healthcare in Northern Ireland is on the HSE website.

It would be helpful to provide the latest data from the HSE. Those data indicate that almost 4,000 reimbursements have been made so far this year for persons who have continued to access healthcare in Northern Ireland under either the cross-border directive transitional arrangements or the new Northern Ireland planned healthcare scheme. This equates to a reimbursement cost in excess of €7 million. These schemes are primarily servicing a demand for private healthcare in Northern Ireland across the primary specialties of orthopaedics, ophthalmology, ear, nose and throat, and gynaecology. As with cataract, hip and knee procedures, for which the Senator provided figures, these are the areas where we are most challenged in relation to waiting lists. Many people who travel, especially for a cataract operation, can return home on the same day. That is important.

I reiterate what the Minister said. The administrative scheme, which is operating successfully, will remain until a statutory scheme is in place.

Robbie Gallagher (Fianna Fail)
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I thank the Minister of State for her comprehensive response and for the clarity she has brought to the issue for many people who may have been concerned that the scheme would terminate at the end of this year. For individuals who find themselves languishing on waiting lists, many for long periods where their quality of life is severely affected, this is good news.

Mary Butler (Waterford, Fianna Fail)
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Regarding utilisation of the EU cross-border directive, I understand the Senator asked officials at a recent meeting of the Seanad Special Committee on the Withdrawal of the UK from the EU which EU member state patients had accessed treatment in under that scheme. HSE data indicate that the top three EU member states where treatment was accessed so far this year under the directive are Spain, Poland and Germany.

I hope the Senator has found this update helpful and assure Senators that the placing of the Northern Ireland planned healthcare scheme on a statutory footing remains a priority. Importantly, the administrative scheme will remain until a statutory scheme is in place.