Gary Rutherford is sitting on the terrace of the cafe at the newly opened Vithas Valencia Turia hospital, sun hat and sunglasses on, enjoying the 30-degree heat and the sea air blowing in from the Mediterranean nearby.
The only suggestion that he’s not here in Spain on holiday is a small bandage on his right knee, the legacy of surgery he underwent two days earlier.
A passionate dancer, last August Rutherford (59), from Balbriggan in north Dublin, damaged the meniscus in his knee while swing dancing with his wife, Gráinne. Suddenly his favourite hobby was off limits, while everyday tasks, such as putting on shoes or driving, were painful.
“It’s the loss of quality of life, not being able to go hill walking or dancing with Gráinne,” he says. “As you get older, you want to keep moving and feel like you can do these things together.”
Cortisone injections provided temporary relief. But, with no medical insurance and facing a long waiting list, the outlook was bleak for Rutherford, a father of seven.
That was until a surgeon alerted him to a European Union healthcare directive that allows citizens from within the bloc to receive planned medical treatment in private hospitals in other countries. For Irish patients this offers the chance of avoiding lengthy waiting lists, with the medical care itself paid for by the HSE.
Within weeks of hearing about the scheme, Rutherford had signed up for treatment in Valencia and was on a flight to the city. Arriving on a Sunday night, he and his wife stayed in a nearby hotel before a pre-op check-up and meeting the anaesthetist on the Monday. The next day he was operated on, spending a night in the hospital before being discharged on the Wednesday.
“I couldn’t be more pleased, because the outcome is as good as it could be. They repaired the [knee] on both sides,” says Rutherford, smiling broadly.
He has since undergone several days of post-op physiotherapy, visiting the hospital from his hotel, before returning to Ireland.
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“It’s a wonderful thing being in the European Union,” he says.
The cross-border scheme means patients have to finance only their flights and hotel accommodation. Although they pay for the treatment upfront, the HSE reimburses them (100 per cent in almost all cases) within four months.
“The whole idea of it for the European Union was to reduce waiting lists in all member states,” says Paul Byrne, chief operations officer of Healthcare Abroad, a company that helps Irish patients access treatment in other countries under the cross-border directive.
The scheme, he says, is saying: “Look out your front window; there are all the hospitals you have available to yourself in Ireland. And if you look out your back window, in your back garden, that’s all the hospitals that are available now to you in Europe.”
After a GP or consultant has identified the necessary treatment, Healthcare Abroad determines their eligibility for the scheme and then schedules appointments and manages paperwork, as well as handling the reimbursement process. Representatives of the company collect patients from the airport and take them to their accommodation and are on hand throughout their stay.
The company works with hospitals across Europe but mainly in Spain, which has become by far the primary destination for Irish cross-border patients. This is partly because of the prowess of its healthcare facilities, but also due to the many flight links between the two countries. In addition, there is the relatively low cost of living in Spain, meaning that a patient in Valencia, for example, can easily find a hotel near the hospital for €120 per night.
Relatively low costs for many treatments are a further incentive to visit Spain, says Byrne, who estimates that a hip operation there could be €3,000-€4,000 cheaper than in central Europe.
“It’s not just us [that has] an issue with the public waiting lists, it’s all European member states,” he says, pointing out that certain medical conditions will have much longer waiting lists in a given country over others, while the inverse may be true for other conditions.
Byrne says Ireland has only recently started making use of the cross-border mechanism, whereas many northern Europeans have been taking advantage of it since its creation in 2014.
“If you were an American and you’re in Texas and you hurt your knee or your back and you knew that there was a really good orthopaedic surgeon in Florida, you would have no issue getting on the plane and going to Florida to see that surgeon and getting it fixed,” he says.
“The Europeans on mainland Europe do this an awful lot better than we do in Ireland. I think as Irish people […] we’re a bit blinkered and don’t realise there’s so much that Europe has to offer the person in the street.”
That is now changing as word of the cross-border initiative gets around. Healthcare Abroad says it has helped more than 2,000 Irish patients receive treatment in Spain.
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Sergio López, a physiotherapist, worked for three years previously in a Vithas hospital in Dénia, along the Mediterranean coast, before taking up a post with the company in Valencia. In both hospitals he has been treating almost exclusively Irish patients.
“[The Irish] are closer to the Spanish personality than any other European country,” he says, as he massages the leg of a male Irish patient who is recovering from knee surgery. “The way they interact with us is closer to the Spanish. They are kind, they really appreciate the services; they are actually really easy patients.”
Alice McSorley (81), from Co Sligo, flew out to Valencia for a hip operation after the waiting list in Ireland, which was several months long, threatened to disrupt her summer plans. “She was in constant pain,” says her daughter, Róisín Healy. Once they heard about the cross-border scheme and decided to use it, the process was incredibly quick, she adds.
“We contacted [the company] and two weeks later we were here,” she says, sitting by her mother’s bed in the hospital where she is recovering.
“I know you have to travel, but when you’re finished, you’re finished and you’re not in constant pain,” says McSorley.
For many, the ease of this still relatively unknown European healthcare mechanism is such that they assume there must be a catch of some kind. For the HSE and companies facilitating treatment, the challenge now is to get the word out and encourage more Irish to take advantage of it.
Gary Rutherford has been passing the time since the operation by practising his Irish. His wife Gráinne, meanwhile, has found that long-distance medical treatment can be good for the social life, going for drinks and meals with a group of other Irish women from her hotel who had also accompanied their partners to Valencia for treatment.
“That’s the wonderful thing that we’ve come across here,” says Rutherford. “Some people here we’ve met are from Dublin, some from the country. People just want to get their pain dealt with as quickly as possible and move on with their lives.”
