Seán Fleming (Laois-Offaly, Fianna Fail)
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401. To ask the Minister for Health the payment received to date for 2014 under the agreement Ireland has operated in relation to the bilateral health care reimbursement agreement with the United Kingdom in respect of health services provided under EU regulations; the payment received in 2013 and the reason the amount received in 2014 is different in view of the fact that payments are meant to be based on the most recent sample survey which was conducted in 2008 and that both Administrations have agreed in principle to work towards a form of pensioner registration and while this has not yet been completed the reason there has been a change in the level of payments; and if he will make a statement on the matter. [49078/14]

Leo Varadkar (Dublin West, Fine Gael)
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Ireland operates a bilateral healthcare reimbursement agreement with the United Kingdom in respect of health services provided under EU Regulations. This agreement covers such persons as temporary visitors between the two countries, pensioners of one country and their dependants residing in the other country, and dependant families of persons employed in the other country.

The United Kingdom made payments totalling €220 million in 2013 and €171.98 million in 2014. These amounts represent the actual payments made in cash in these years and do not correspond to the full liability for that particular year. The amount payable 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. Payments are made in advance with final settlements made once all necessary information is complete. The final settlement 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. Total payments in any one year can as a consequence relate to both final settlements in respect of previous years' liabilities and advance payments in respect of the current and/or previous years.

The payment of €220 million in 2013 comprised a sum of €16 million in advance payment for 2012 and a sum of €204 million in advance payment for 2013. The payment of €171.98 million in 2014 comprised a final settlement payment of €71.98 million in respect of years 2007 and 2008 and a sum of €100 million in advance payment for 2014. A further advance payment for 2014 of €94.5 million is to be made in the first quarter 2015. The data used in the advance payment calculations in recent years reflects both the yearly reduction in pensioner liability as agreed between the two administrations as well as a reducing estimated average cost of providing healthcare treatment. Discussions between both administrations on introducing a system of pensioner registration are ongoing.