Danny Healy-Rae demands bilateral deal to protect cross-border care

Ceann Comhairle, thanks for this opportunity to raise this very important matter. As has been said, we've been taking up people, myself and Kerry and Deputy Collins in Westcorp to Belfast to get their sight restored, to get their hips and knees replaced and shoulders and other ailments, tonsils for youngsters and I have to say at this stage I took a child of 80 years old with his two eyes and got the two cataracts removed so he could go back to school and a man as old as 95 years of age. Now, I'm asking you, Minister, is it Minister Coveney's answer is, or, yeah, oh yeah, Minister Coveney promised us in the last government that he would put legislation in place to allow a bilateral arrangement between the UK and the south of Ireland so that this service could be continued. I'm asking this government now, will he put this bilateral arrangement in place because Tarnas de Bradcour has said that given assurance that patients from the north will be reimbursed if they have to be treated in the south of Ireland, so why can't the people here in the south of Ireland get similar reimbursement if they have to be treated in the north? Thank you, Ken Curla. I'd like to thank Deputy McGrath, Collins and Healy Ray for raising this topic. The Directive on Patients' Rights in Cross-Border Healthcare, commonly called the Cross-Border Directive, provides rules for the reimbursement to patients of the cost of receiving treatment abroad, where the patient would be entitled to such treatment in their home member state. The Directive seeks to ensure a clear and transparent framework for the provision of cross-border healthcare within the EU for those occasions where the care patients seek is provided in another member state rather than in their home country. The EU Cross-Border Directive, which has been implemented in Ireland since 2014, has enabled many Irish patients to access health services in many other EU member states. Of course, our geography, proximity to Northern Ireland and the UK, means that the vast majority of Irish patients tend to access care in that jurisdiction. That is why the impact of our neighbours, the UK's decision to leave the EU has a very real impact for our citizens. As the Cross-Border Directive is underpinned by EU legislation from 1 January 2021, the revisions of this scheme will no longer apply to Northern Ireland and the UK generally. This is an unfortunate and undesirable consequence of Brexit that is outside the Government's control, but Minister O'Donnelly is acutely aware that patients and deputies are concerned about the loss of access to services in Northern Ireland particularly, which are accessed under the Directive. As part of Department officials' Brexit planning, there has been extensive examination of this matter, which has raised a number of key policy and legal issues. Noting the importance the Department places on ensuring the Irish patients will continue to access this capacity, Minister O'Donnelly has tasked Department officials with examining the feasibility of implementing a unilateral cross-border directive type arrangement to provide that Irish residents can continue to access services provided by private health service providers in the UK post the end of the transition period. That work, which is detailed and complex, is still currently ongoing. We would like to reassure deputies that it is Minister O'Donnelly's intention that Irish patients should be able to benefit from accessing these services in the future. I think it is also important to restate that patients will still have recourse to access health services under the EU cross-border directive scheme in 30 other countries from 1 January 2021. Thank you, Minister. Deputy Collins. Deputy Healey Ray. Deputy Healey Ray. Very good. Thank you very much, Minister. But I suppose your reply is a bit confusing in that I am not so sure that the bilateral arrangement will be secured. And as to what that will cover, or what that will cover. You are also saying that there is an option to go to Europe, to the mainland Europe. And I don't think that that's a fair option to say to someone in their 80s or 90s to get on a plane and travel abroad to get their cataract removed. Indeed, their hips is not an option at all for hips or knees. And for the young child of 8 years of age that has cataract, that is not a real option. I am asking, Minister, to pull out all the stops and ensure that we get a bilateral arrangement which will ensure that people will be reimbursed. I fully understand the reasons why the deputies have raised this issue here today. A decision of our neighbour to leave the EU will have unfortunate negative implications for Ireland that are outside our control. With the loss of access to healthcare services currently provided by the cross-border directive representing a substantive and real loss of access to healthcare services for Irish people. However, as I said, Department of Health officials are continuing to examine this matter with a view to ensuring that access to services in Northern Ireland and the UK might be retained in 2021. Separately, I think it is useful to note that we have a memorandum of understanding with the UK that will be signed shortly which will ensure continued access for Irish residents to essential healthcare in the UK post the end of the transition period. This is a very positive outcome in terms of Irish and British government's commitment to maintaining, in so far as possible, the current healthcare arrangements under the common travel area. In addition, on behalf of Minister Donnelly, I want to assure deputies that both the Irish and UK governments are fully committed to continuing existing cross-border health services, like the cardiology and cancer treatment services in Aldenagelvan, Derry, and paediatric cardiology and related maternity services in Dublin, and to ongoing health service cooperation into the future. Finally, Minister Donnelly will keep deputies updated on progress in relation to department officials' examination of the feasibility of implementing a unilateral CBD type arrangement. people will be used in the network in about 8¢you сожалng with the intervention internment.