Health Insurance Surgery outside the state

roker

Registered User
Messages
1,816
I have had a cataract done via the Health Board zero cost. Rather than wait another 18 months for my other eye, I have gone private with the same Consultant.
What puzzles me that I could go to Belfast and fill a form and refund the money off the Health Board, same as Healy Ray is doing with his bus from Cork. Why does this not apply in Eire?
 

Rosjohn

Registered User
Messages
56
@Rosjohn Sorry to offend, what do I call the republic as apposed to the North/Ulster
Not offended at all.
People usually say the South or the Republic or "down here".
The Constitution says the " name of the State shall be Éire, or in the Englih language Ireland"
 

arbitron

Registered User
Messages
234
I have had a cataract done via the Health Board zero cost. Rather than wait another 18 months for my other eye, I have gone private with the same Consultant.
What puzzles me that I could go to Belfast and fill a form and refund the money off the Health Board, same as Healy Ray is doing with his bus from Cork. Why does this not apply in Eire?
It doesn't apply here because the HSE uses the NTPF for outsourcing within the state. There are several public policy/clinical governance/political/fiscal reasons that they don't allow it.
 

roker

Registered User
Messages
1,816
It doesn't make sense because the HSE still pay for out of state procedures
 

arbitron

Registered User
Messages
234
The economics of it are crazy. Years ago I had a free half day in my schedule and offered to do an extra public clinic to help clear the waiting lists. It would have cost the hospital maybe €300 per clinic in wages for me, seeing 16-20 patients at a time. They said no budget. A couple of weeks later they asked me to do it privately where they were offering me €100-250 (depending on the case) per patient! That would be 10-15 times the cost of me doing it publicly. I declined and wrote to the relevant bosses, never got a reply. I'm sure their hands were tied by different funding streams and finance rules but it was an outrageous waste in my view and a failure for patients waiting years for appointments.

From the government's perspective there are big political landmines around funding NTPF/private outsourcing in Ireland. Imagine the opposition's glee talking about the Beacon or the Blackrock Clinic being paid millions of euro to do the work of the HSE. For some reason there isn't the same reaction to the money being spent in a private hospital abroad, which is very strange as private hospitals here pay taxes and employ tens of thousands of staff. The government get nothing back from the hospitals abroad.

There are also concerns around consultants who work in both public and private. Back in the heyday of outsourcing some of them were referring large numbers of patients to NTPF because their public lists were so long. They then ended up being sent some of these patients in their private clinics, so it looked like they were doing it to make money. Maybe a small number of them were, but most of my colleagues hated it. They started getting grief from the media and even accusations/complaints from patients. Many stopped doing NTPF as a result and would be hesitant to get involved again.

Another issue with outsourcing to private is that a procedure may not go as planned and follow-up may be required. That can mean multiple clinic visits, maybe extra procedures, an inpatient stay... those costs quickly add up. I worked on a public service where we were seeing about 3 NTPF patients a week who had an operation done privately and needed follow-up in the public hospital for complications. This is to be expected as any procedure will have complications, even in the most experienced hands. But we had these patients appearing who had to be added in on top of our already full workload, we had no info on them, and it caused big headaches for everyone, not least the patients. That sort of fragmentation of care creates significant risk, delays, and ultimately costs everyone.

This money would be far better spent in the Irish health system, funding a comprehensive public health service. We should be deeply embarrassed as a nation that we have to ship patients abroad for basic care.
 

Protocol

Registered User
Messages
3,505
This money would be far better spent in the Irish health system, funding a comprehensive public health service. We should be deeply embarrassed as a nation that we have to ship patients abroad for basic care.

Yes, when I see the people from Kerry going to NI for cataract surgery in a bus organised by the Healy-Raes, I often wonder are the local ophthalmologists not embarrassed?
 
Top