To ask the Minister of Health (i) whether NHS patients from Northern Ireland are still able to access surgery and other medical procedures, with the cost covered by the Health and Social Care Board, in (a) other jurisdictions of the UK; (b) the Republic of Ireland; (c) the EU; and (d) private clinics; and (ii) what impact Brexit has had on these arrangements.

(i) There are a number of different ways in which patients can access healthcare outside of Northern Ireland with the cost covered by the Health and Social Care Board.

Transfer as part of a waiting list initiative

This can occur where, as part of a drive to reduce waiting times, a provider from outside Northern Ireland is chosen to deliver additional capacity for patients waiting for HSC assessment or treatment. Such providers are normally based in the rest of the UK or in the Republic of Ireland.

Contractual arrangements/service level agreements/MoUs

A number of service level agreements are in place between Health and Social Care Trusts in Northern Ireland and providers outside Northern Ireland to secure dedicated capacity for referrals for highly specialist services which are not suitable to be provided in Northern Ireland and for which there is a sufficient, predictable annual volume of activity

There are also a number of MoUs which facilitate cross border and all Ireland healthcare such as between ambulance services and the radiotherapy unit at Altnagelvin Hospital.

Extra Contractual Referrals

The Health and Social Care Board in Northern Ireland may authorise patient travel for specialist treatment which it does not routinely commission.

This may be either because the treatment needed is of a specialist nature which is not available in Northern Ireland or because there is a clinical reason why the local service is not appropriate. The provider is chosen by the local consultant using his clinical judgement. The Health and Social Care Board expects these requests to be to NHS providers in the UK but will consider requests to EU countries including the Republic of Ireland where there is clear clinical rationale for doing so.

Private clinics

Management of waiting lists is one of the mechanisms by which the health service upholds the principle of equity of access to health and social care services free at the point of care. Where a patient chooses to pay for private treatment at the time of their choosing, doing so takes them outside the Northern Ireland HSC system’s arrangements and its principles. It would be inequitable for the Health and Social Care Board to fund individuals for private treatment so that they could access care in advance of others on the waiting list who may have greater clinical need. Accordingly, the Health and Social care Board would not cover the costs incurred.

(ii) The UK’s exit from the EU has no impact on these arrangements.