Liam Twomey (Wexford, Fine Gael)
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438. To ask the Minister for Health the way the funding received from the National Health Service is accounted for; and the way the Health Service Executive or his Department bills the NHS for looking after NHS patients here; and if he will make a statement on the matter. [47905/14]

Leo Varadkar (Dublin West, Fine Gael)
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Regulation (EC) 883/2004, and Implementing Regulation 987/2009, provide for the co-ordination of social security systems, including healthcare, within the EU/EEA and Switzerland. Under its provisions, persons residing in Ireland who are attached to the social security system of another member state are entitled to receive health care services in Ireland at the cost of that member state, provided they are not subject to Irish social security legislation.

Since 1973 Ireland has operated a bilateral healthcare reimbursement agreement with the United Kingdom, in respect of health services provided under EU Regulations, covering 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 agreement does not provide for reimbursement to, or in respect of, a particular individual. The payment made in respect of any one year is based on 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. The amount payable is agreed following compilation of the necessary data and discussions between the two administrations. Payments are made in advance and are subject to final settlement once all necessary statistical and financial information is complete.

The payments are received by the Health Service Executive as Appropriations-in-Aid and are offset against the gross funding requirements of the Executive at national level thus reducing the net liability to the Exchequer.