Mary Upton (Dublin South Central, Labour)
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Question 95: To ask the Minister for Health and Children the situation regarding the overpayment to her Department by the UK Government, as reported recently; and if she will make a statement on the matter. [17127/09]

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, people who are insured with (covered by) the health care system of one EU member state are entitled to receive health care in the public system of another member state in certain circumstances, at the cost of the member state in which they are insured.

Ireland operates a bilateral health care reimbursement agreement with the United Kingdom, arising from the application of Regulation (EC) 1408/71. The agreement comprehends such persons as temporary visitors between the two countries; pensioners of one country residing in the other country and their dependants; and the dependants residing in one country of people who are employed in the other country. The amount due is the net difference between the costs to the Irish health services of providing care to those with UK entitlements and the cost to the UK health services of providing services to those with Irish entitlements. Allowance is also made for those with dual entitlements in both jurisdictions. 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 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 health care treatment. Payments are made in advance with final settlements made once all necessary information is complete. 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 three years was: 2006 - €397m; 2007 - €450m; 2008 - €100m. These amounts represent the actual payments made in cash in these years and do not correspond to the full liability for that particular year. In line with established practice, advances are subject to final settlement once all necessary information is complete, including the approval of average costs figures for both countries at EU level.

Due to the nature of the claims process and the fact that bilateral discussions are continuing, it is not possible to establish whether any previous payments the UK has made represent overpayments in advance of the finalisation of accounts for these years. By far the largest part of the payment received from the UK authorities on an annual basis relates to the provision of health care to UK pensioners and their dependants residing in Ireland. The estimated number of pensioners for whom each country is liable is based on a survey by both administrations undertaken every three years. Such a survey was completed in 2008 and, in line with the agreement, will be applied to determine the liabilities for that year and retrospectively 2007. Discussions between my Department and the UK on the application of the survey and other aspects of the implementation of the agreement are continuing. The 2008 survey does indicate a reduction over previous surveys in the number of pensioners for which the UK is liable. This is in line with trends in demography and patterns of migration between the two countries.

While discussion of the detailed application of the survey is continuing, the reduction indicated in the survey will lead to an offsetting reduction in respect of the UK's estimated liability for 2007. The likelihood of such a reduced liability in respect of 2007 and subsequent years was considered in agreeing the 2008 payment of €100m set out above. The emerging reduction in ongoing liability of the UK also informed the estimation of the potential income from the UK authorities this year of €250m which is incorporated in the Revised Estimates Volume. As indicated, in line with established practice, the UK's final liability for 2007 will be determined once all necessary information is complete, including the approval of average costs figures for both countries at EU level.