Debate contribution: Cross-border Healthcare

Debate contribution by Mr Colin McGrath on 18 June 2024.

MLA

Mr Colin McGrath

Party at the time

Social Democratic and Labour Party

Date

18 June 2024

Type

Debate contribution

Business

Opposition Business

Heading

Cross-border Healthcare

Assembly identifier

Official Report component 4497005

Read the official Assembly record

Text

I beg to move

I welcome the opportunity to open the debate on cross-border healthcare. The SDLP tabled the motion with the public firmly in our minds. We are very much an ageing population, and I certainly feel that myself as the years go by. That being the case, our reliance on our health system will only increase over time, whether that be for one-off visits or for people who require more sustained and repeated care. At the heart of today's debate are two words that sum up what our approach to healthcare on an all-island basis should be: "efficient" and "compassionate". At the outset, I want Members to know that, in approaching the debate, whilst we are discussing people's ability to avail themselves of healthcare in the South, that in no way diminishes anyone's sense of national identity. Receiving healthcare in Dublin will not make those here who are British any less so. There is nothing new about cross-border healthcare. The provision of such healthcare has been a key element of the European Union for many years. As a result of our exit from the EU, many here who had been able to avail themselves of care in the South through cross-border healthcare were worried about what the future of that provision might be. As one that does not support Brexit, our party was committed to ensuring that we minimised the adverse impact that Brexit threatened. Therefore, we were concerned about the loss of the cross-border healthcare directive in 2020. To set it in context, between 2019 and its closure, there were well in excess of 3,000 reimbursement claims for the cross-border healthcare directive at a cost of just over £15 million. The former Minister of Health, Robin Swann, then introduced —

I do not disagree with what the Member said, but, of course, the greatest inequity is that people are not getting their healthcare and are being forced to use their savings to pay for it up front. I want to see a system whereby people do not have to claim money back and, instead, treatment can be approved so that they can get it without having to make any payment. That would remove that inequity from the system. The bottom line, however, is that, if that system were not in place, none of them would get any treatment or relief from the symptoms of illnesses that some have been living with for a long time. I will mention again the number of people whose pain has been alleviated. There was also the Republic of Ireland reimbursement scheme, which was introduced by Minister Swann. Between its introduction and closure, there were over 3,500 reimbursement claims at a cost of just over £21 million. If people did not have that system to invest in, they might end up going privately. If they do so, they will get nothing back. At least this way means that those who have the money can pay for the service, get treatment and claim it back. That takes pressure off the system, which will help others to avail themselves of services. It is an imperfect system, because it addresses a problem that should be resolved in a different way. Think of the 6,500 people whose lives have been supported and improved through our capacity and willingness to work with our colleagues in the South, whether they needed a new hip, cataract removal, scans or cardiac surgery. The schemes covered a range of interventions. All those conditions, however, could be addressed through our willingness to work together through a scheme that costs a fraction of our healthcare budget. It is an efficient use of our healthcare funding. You cannot put a price on the impact of those operations. If people did not have them, the impact on their quality of life would be enormous. It should also be noted that the second scheme that I referenced was delivered by a unionist Health Minister. It is an important point to make, as it recognises our ability to reach beyond ourselves and deliver positive outcomes for all members of the public, regardless of our own views or constitutional aspirations. That must surely be the sort of vision that we need to look for in our Government working together. Imagine if we had been without Ministers at the time of making those decisions. I am not so sure that the schemes would have been introduced. There would have just been more uncertainty. That underscores the importance of having this institution up and running so that Ministers can take the decisions that are required to provide services for the community. If we could see delivery of such a short-term scheme, which would deliver positive outcomes for the public, each of us could then consider our capacity for further joint health working with colleagues in the South. Members of the Health Committee and those beyond it know the full range of problems in our health sector. Many segments of the health service are clogged up by long waiting lists, meaning that people are not getting the outcomes that they need. The services could provide care to women and families in some of the most emotionally charged and heartbreaking situations. I refer specifically to the perinatal and paediatric post-mortem services that we do not provide here. The absence of a paediatric post-mortem service and the fact that we still cannot access the service in the South result in many women and families having to access the service in England. While it must be said that the service puts care and compassion at its heart, I cannot help but think that it is worth exploring whether we would be able to provide the service on this island. We must give credence to the need for cross-border working, given the increasing reach of Sláintecare in the South. That reform of services delivers positive health outcomes in the South, but it is also quickly becoming an attraction for healthcare staff from the North. I will set it in context: a primary care doctor in the North could earn around £75,000; in the South, they could earn an average of €130,000, which equates to over £100,000. Think of what could be achieved in some areas if we were to commence cross-border working to help deliver some elements of primary care as well. Meanwhile, again for context, in the past five years, we have spent well in excess of £11 million on GP locum cover alone. As we commence the debate, I look forward to hearing Members' contributions and hope that they demonstrate a willingness to do some imaginative thinking in order to deliver positive health outcomes for all members of the public. I hope that Members across the House will support our motion, remembering that efficiency and, most importantly, compassion are at its core.

1,139 words. Text as published by the Northern Ireland Assembly.

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