When Michael Carroll’s two-year-old granddaughter took his hand to guide him to her own home in Cork, he realized his failing eyesight was affecting everyone in the family.
Realizing this and not wanting to wait on a list for years, he traveled to a Spanish hospital near Alicante where he underwent cataract surgery a few days ago, reassured that the HSE would cover charges under the EU Cross-Border Directive.
Since 2014, the directive allows all EU citizens to seek treatment abroad and have the costs reimbursed by their own country. It is ideal for anyone stuck on a waiting list, with Irish patients free to approach the HSE Cross-Border Healthcare Directive department. , Kilkenny, once they have a medical referral.
More generally, however, it is difficult for governments to decide whether they want a functioning and accessible public healthcare system, or whether they want to continue to entrust patients to private companies. It is also an opportunity for private hospitals, knowing that they are paid as a guarantee by the State.
Mr Carroll is one of more than 300 Irish patients who have traveled to Spain for treatment this year alone. Addressing thein Denia, he recalls his granddaughter telling him to “be careful”, as she guided him around his toys.
At just 65 years old, cataracts had clouded his sight so much that he was no longer steady on his feet and had stopped driving.
“It was very blurry. The glasses made me a bit better, and it really pushed me to get cataracts fixed. Like a lot of people, he knew about the ‘cataract buses’ taking people to Northern Ireland. North for operations.
After Brexit, these buses continue under a new scheme called Northern Ireland Planned Healthcare Scheme with criteria similar to the EU directive. He considered using it, but decided against it after researching online and finding an Irish agency that connects patients with hospitals in Spain.
It was then that he realized that “cross-border” was not just about the Irish border, a common misunderstanding.
There are a number of such agencies in Ireland, which operate on commission from private hospitals. They help with the loan paperwork, with the initial cost for a hip replacement amounting to €10,000.
First South Credit Union in Cork is one of the credit unions now offering a new, streamlined lending process open to new members and built around running costs. After successfully navigating, Mr Carroll had his cataract removed last week.
He was one of the first patients in a new hospital, specially designed for traveling patients. He and his wife Geraldine said their stress was gone.
“Through the HSE they were saying there would be a new cataract center in the south infirmary, but that could take two years,” he said. “I could walk in the walls by then.
Géraldine explained: “We stayed in Benidorm, and we were taken back and forth to the hospital. There was no pressure on us. »
Last year, 571 patients traveled to Spain, but this year it reached 326 in June, according to Catherine Donohue, general manager of the HSE business unit, acute hospital services. Poland is also becoming more popular with 390 this year, up from 376 in 2021.
Ms Donohue attended the opening of this hospital, but stressed that the HSE does not approve hospitals only for individual operations on request. She said the directive had created “a huge market” for private healthcare.
“In an ideal world, we wouldn’t have patients waiting, but there are patients waiting,” she said. GPs frequently refer patients directly to the Kilkenny office, where patients seek treatment under the cross-border directive. There is no obligation to use an agency, but HSE approval is mandatory.
Ms Donohue recommended that any patient choosing an agency do their homework first.
“The HSE are going to ask for your PPS number, your GP number, your home address, your phone, everything. This is very sensitive information, you need to be sure if a third-party provider is helping you, that they have appropriate data protection systems in place,” she said.
One of the agencies, Healthcare Abroad, which Mr. Carroll went with, recently entered the market. His team includes Chris Goodey, former chief executive of the National Association of General Practitioners, and the group’s 2019 financial collapse is under investigation.
Chief Operating Officer Paul Byrne said of their partnership with HCB Denia Hospital in Spain: “We are trying to make Irish patients more comfortable. They will have Irish radio stations, TV stations, we are trying to find Irish newspapers. »
This hospital hopes to perform up to 1,500 operations a year for Irish patients. Almost all of the procedures available in the Public Health Service in Ireland are performed in the Spanish Hospital. Hospital director Ana Vasbinder said: “For our Irish patients, this will truly be a home away from home.”
Another Trasna agency, established in 2018, has taken on 100 patients this year, with 400 in planning, said chief marketing officer Bronagh Twomey. “We don’t decide where the patient goes, it’s the patient’s choice,” she said.
Hips, knees and cataracts are the most frequent requests from partner hospitals in Germany, Northern Ireland and elsewhere. Reports in English are sent to general practitioners.
“There is wonderful healthcare in Ireland, but it’s about accessibility,” said Ms Twomey. “We try to keep it simple, there is massive capacity across Europe.”
Another agency, MPTM, has been focusing on Polish hospitals since 2019. They have helped 300 patients travel from Ireland, again with patients choosing the hospital. “Almost all of my customers are Polish,” said Mariusz Pleśniar of MPTM.
Orthopedic operations are the most requested, followed by neurosurgical, physiotherapy or pain management procedures.
“Apart from these procedures, ENT (ear, nose, throat) services, including pediatric ENT, gynecology and general surgery services remain popular, along with various specialist diagnostic procedures,” he said.
In Northern Ireland, the ROI Reimbursement Scheme, put in place after Brexit, was extended this week until June 2023. By the end of February, 540 people had traveled from North to South for treatment under this scheme. .
The managing director of the private Mater network in Cork and Dublin, David Slevin, said: “Demands have increased and continue to increase with the long waiting lists in Northern Ireland. People shouldn’t have to wait unnecessarily with chronic pain.
It is clear that this directive provides greater choice for patients, although it must be demoralizing for Irish surgeons to see their patients having to travel overseas. Many have instead called for a real fight against Irish waiting lists, but from the patient’s point of view, this faster option wins out.
Stephen McMahon of the Irish Patients Association called for an information campaign.
“Administrators, including consultants and GPs, should, as part of their duty of care, inform patients of their rights and how to exercise those rights,” he said.
Many people will be reluctant to travel, perhaps too ill to join the thousands of public patients criss-crossing the continent. Only serious investment in public health across Europe can provide them with realistic home care options.