Questions over cross-border health waiting list scheme - as rising prices in Republic limit applications
A DUP MLA has questioned a cross-border health scheme for people stuck on hospital waiting lists for hip and knee operations, after officials revealed that half of the money allocated to it was returned.
While welcoming the fact that it has helped some patients, Diane Dodds says there is “a clear inequality” in the process, as it isn’t financially viable for many people who need it.
The waiting list reimbursement scheme was introduced, in part, as a replacement for a pre-Brexit EU scheme, and allows patients to seek private treatment in the Republic of Ireland and claim back the costs.
At the health committee last week, Department of Health (DoH) officials revealed that the scheme did not have the same demand as its predecessor. This was attributed to the rising cost of treatments in the Republic. 80% of applications were for orthopaedic surgeries, such as hip and knee replacements.
Mrs Dodds says the cross-border healthcare scheme has helped some, but “major shortcomings” must now be tackled.
The DUP health spokesperson told the News Letter: “Evidence to the Health Committee makes clear that while some patients have benefited from the cross-border scheme, many more have not, and we need to understand why.
“A key obstacle is the tariff charged in the Republic of Ireland, which has created a funding deficit and limited the scheme’s reach. That raises serious questions around planning and value for money.
“There is also a clear inequality at the heart of how this scheme has operated. For those who could afford to pay upfront or top up the difference, access was opened up. For households already under financial pressure, that simply was not an option. Healthcare access should be based on clinical need, not the size of someone’s bank balance”.
The Upper Bann MLA said cross-border provision “can only ever be a partial, temporary solution” and the long-term answer lies in “building a health service here in NI that is capable of meeting the needs of our own population”.
Officials said last week a decision was taken at an early stage to reallocate funds back into the health service.
A Department of Health spokesperson said the Waiting List Reimbursement Scheme is one of a number of measures being taken forward under the Elective Care Framework to increase capacity, improve access to treatment and support those patients who have been waiting the longest.
“The scheme provides eligible patients ordinarily resident in Northern Ireland, who have been on an HSC hospital treatment waiting list for one year or more, with the option to obtain treatment privately outside Northern Ireland and receive reimbursement up to the equivalent average HSC cost for that procedure. While initially focused on the Republic of Ireland, access has since been expanded to include EU providers, broadening the options available to patients.
“Since its launch in June 2025, the Department has taken steps to widen eligibility, reducing the waiting time threshold from two years to one year, and has put in place a dedicated helpline, online guidance, and application support to help eligible patients access the scheme. By the end of March 2026, 727 applications had been received, with 523 approved, representing an estimated financial commitment of £4.93 million.
“The Department recognises that affordability can present challenges for some patients and will continue to keep the operation of the scheme, including communications and patient support arrangements, under review to ensure eligible patients are aware of and can avail of this pathway where appropriate.
“More broadly, while the reimbursement scheme is making an important contribution, it is only one element of a wider programme of work to address waiting lists. Sustainable progress will require multi-year investment to support long-term planning and delivery of elective care capacity here in Northern Ireland”, a spokesperson said.