There is often a conflict between natural geographic areas and division of healthcare as determined by political boundaries. The most obvious example of this is the Inishowen peninsula in north Donegal.
Although part of the North-Western Health Board area, it forms a natural geographic unit with the northern part of the Western Health and Social Services area. Patients in Inishowen should be able to use hospital services in Derry in the same way as they can use those in the Republic.
Paul (51) is a resident of Muff in north Donegal who has had direct experience of cross-Border healthcare barriers. Last July he was diagnosed with a cyst in the brain. His GP referred him to the neurology services in Altnagelvin Hospital in Derry.
The neurologist decided Paul needed neurosurgery. However, because he lives in the Republic, he was referred to a neurosurgeon in Dublin. Paul was born in and has worked for most of his life in Derry. Although in the Republic, Muff is to all intents and purposes a suburb of Derry. Paul holds an NHS medical card. Notwithstanding, his GP was told he could not be treated in the North because he was "permanently resident outside the UK". Paul is now waiting for a neurosurgery appointment in Beaumont Hospital in Dublin.