Patients on waiting lists face losing access to healthcare scheme in North
Patients in the Republic who are languishing on hospital waiting lists will lose out after Brexit as a vital cross-border treatment scheme becomes more difficult to access.
The scheme allows eligible patients in any EU country to avail of treatment outside the jurisdiction. They pay upfront, but get the costs reimbursed by their national health service.
Patients in the Republic currently enjoy the convenience of going to Northern Ireland or the UK for a range of treatments, including hip and knee surgery or cataract operations.
But post-Brexit, while they will still be entitled to avail of the scheme, they will be confined to hospitals in mainland Europe, requiring more expensive travel costs with potential problems with language barriers.
The cross-border directive is now becoming an increasing safety valve for patients on waiting lists here.
Figures obtained by the Irish Independent show the HSE has paid out €7.5m this year in reimbursements to 2,234 patients. This compares to €2.4m for the whole of 2016 when less was known about the scheme.
Most are going to Northern Ireland, Wales, England and Poland.
Mark Regan, chief executive of Kingsbridge Hospital in Belfast, which has seen a big influx of these patients in recent years, said the scheme is now "mainstream".
He said: "The numbers are going up every month.
"Patients have so little to travel, and pensioners can avail of free train travel."
A recent policy paper led by Queen's University and the University of Ulster on the potential impact of Brexit also said it may make it more difficult to continue with all-island health services.
Services at the Altnagelvin Hospital in Derry, which treats cancer patients from Donegal, may be affected if there are restrictions on the mobility of staff and patients across the Border. The radiotherapy service itself is funded by the two governments.
Meanwhile, one of the current major areas of activity to ensure alternative systems are in place post-Brexit involves plans to avoid a shortage of medicines in the Republic.
Over 60pc of medicinal products on the Irish market either transit, or come from the UK. In addition, up to 60pc of marketed medicinal products share labels and leaflets with the UK marketplace.
It means that Ireland has a critical reliance on the UK for medicines. The medicines' watchdog, the Health Products Regulatory Authority (HPRA), has said it is preparing for a worst-case scenario.
A spokeswoman for the HPRA said it is involved in contingency planning as it seeks to ensure ongoing availability of medicines. It is exploring opportunities for dual-labelled packaging with other European countries. It is also working with UK regulators to help maintain, where possible, dual labelling for products that are on both the UK and Irish markets.
The risk to supply also affects veterinary medicines.