Jim O'Keeffe (Cork South West, Fine Gael)
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Question 212: To ask the Minister for Health and Children the payments received and made for each of the past four years and estimated for 2008 in respect of medical treatment accorded to residents from the UK and other EU countries treated in hospitals here and Irish residents treated in the UK and other EU countries; the recent changes in such payment arrangements; and if she will make a statement on the matter. [44783/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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Regulation (EC) 1408/71 coordinates health and social security arrangements among EU member states (it also applies in the remaining EEA member states and Switzerland). Under these provisions, persons who are insured with (covered by) the healthcare system of one EU member state are entitled to receive healthcare in the public system of another member state in certain circumstances, at the cost of the member state in which they are insured. Such persons may include

people who are employed in one member state and resident in another and their dependants,

pensioners of one member state who reside in another and their dependants,

visitors to one member state from another, and

persons referred for treatment to another member state.

Ireland has waiver agreements with a number of member states (Belgium, Denmark, Germany, Luxembourg, France, Austria, Sweden, and until 2007 Netherlands) which comprehends temporary visitors between the two countries and accordingly charges do not normally arise.

Ireland operates a bilateral healthcare reimbursement agreement with the United Kingdom comprehending such persons as temporary visitors between the two countries; pensioners of one country and their dependants residing in the other country; and the dependant families of persons employed in the other country. Under the terms of the agreement net liability between the two countries is calculated on a lump sum basis rather than an individual basis. The payment made in any one year is determined based upon an estimate of the number of persons falling within categories eligible for reimbursement and for whom each country is liable and an estimate of the average cost of providing healthcare treatment. Total payments in any one year can relate to both final settlements in respect of previous years' liabilities and advance payments in respect of the current year. The net payment received from the UK over the last four years is as follows: 2005 — €448.6 million, 2006 — €396.7 million; 2007 — €450 million; 2008 — €100 million estimated. These amounts represent the actual payments made in cash in these years and do not correspond to the full liability for that particular year. As explained below, only a small portion of these payments relates to UK visitors to Ireland and Irish visitors to the UK. By far the largest part of the payment received from the UK authorities on an annual basis relates to the provision of healthcare to UK pensioners and their dependants residing in Ireland.

The amount payable in any one year attributable to temporary visitors between Ireland and the UK is determined by the estimated number of visitor days and an estimate of the average cost of providing healthcare treatment. The finalisation of accounts is normally some years in arrears to facilitate collation of relevant statistics and for the approval of the average cost prepared by each country for the year concerned at EU level. The last accounts finalised were in respect of the year 2002 in respect of which Ireland's liability to the United Kingdom was calculated at Stg£6,487,402 (€9,455,000 approximately) for 21,084,000 visitor days (Ireland to UK) and the United Kingdom's liability to Ireland was €12,288,014 for 19,602,700 visitor days (UK to Ireland). Accounts for subsequent years have not yet been finalised. However visitor days for the years 2005, 2006 and 2007 have been estimated respectively as follows:

The HSE may approve applications from Irish people for treatment in another EU member state, where certain criteria are fulfilled. The HSE is responsible for payments to these member states for the costs of such treatment. The HSE is also operationally responsible for all other payments made to member states other than those governed by the Ireland/United Kingdom bilateral healthcare reimbursement agreement. My Department has requested the Parliamentary Affairs Division of the Executive to arrange to have details of such payments compiled and issued directly to the Deputy.