A new reduced rate of reimbursement for people who travel to Northern Ireland to get cataract surgery comes into effect from Saturday.
The Health Service Executive (HSE) announced the reduced rates earlier this year but postponed its introduction until September 1st. Since the scheme was introduced thousands of people have travelled north to get the procedure and then recouped their healthcare costs from the State.
In the South a regular bus service brings mostly elderly people to the North so they can avail of services there and seek to have their healthcare costs recouped.
“In the South it is a particular problem,” said Killarney GP Gary Stack. “We have no ophthalmology surgery service in Tralee, so Cork University Hospital is where you are talking about.”
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However the vast majority of his patients find they are not able to get the service locally and avail of the cross-Border subsidy scheme. “I would say 20 to 30 to one.”
The changes being introduced mean the amount available for the most common procedure is to drop from €1,456 to €1,171, with the HSE saying this reflects changes in prices since they were last reviewed. The amounts available for other procedures are being increased. The scheme recoups healthcare costs at a rate based on whichever are the lower – healthcare costs in the North or healthcare costs in the Republic.
Dr Stack said the people who are going to the North for the procedure are paying “two and a half to three grand” for the whole package, and that the increase in the amount they have to pay themselves may put some people off. “It may be an issue for some people, especially if you are living on a fixed pension.”
He said the people who are in need of the procedure tend to be aged 65 or older. “There are two issues I would see. One is the quality of life issue, reading, driving, watching the TV, using the computer. But as time moves on [people in need of cataract procedures] are more prone to falls, and the problem is that if you fall it is quite likely you will fracture your hip. There is a 5 per cent mortality in the first month. And 25 per cent mortality in the first year.”
He said the cost of the procedure in Northern Ireland is not out of kilter with the cost being charged by local private services. “Why do we export out procedures? Why can’t they be done locally?” he said.
He was not sure how often the bus service that brings people from Cork to the North for the service leaves but each one carries about 50 people.
Independent TD Danny Healy-Rae said the “165th cataract bus” left Killarney at 6am on Friday to go to a hospital in Northern Ireland, picking up people in Cork on the way. It was, he said, one of 10 such buses arranged by him and Independent TD Michael Collins in the last three weeks ahead of the HSE’s lowering of the reimbursement levels.
“The Government is boasting that the Exchequer was never in a better place financially and at the same time they are hitting the most vulnerable people who want to save their eyesight,” he said. “The HSE have reduced the three centres in Cork to one centre since July 1st, and they haven’t yet appointed a director to run the new centre in the South Infirmary.”
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