Jill Kerby

WITH RECORD HSE QUEUES YOU NEED YOUR OWN TREATMENT PLAN

If you are over age 75, and have need for the services of a public hospital Emergency Department you may very well be worried.

And if you are one of the 687,000 patients still waiting for treatment in a public hospital anywhere in the country – up nearly 10,000 on July - or know someone who is in the 50% waiting over six months, you might want to do something more than just worry about the length of that delay.

The latest news about HSE waiting lists is only getting worse, and the Minister for Health is now on the verge of appointing a new ‘health Czar’, to try and bring some control to the €15 billion mess that is the public health service here.

Good luck to him. 

Until that stubborn nut is cracked, anyone who doesn’t already have private health insurance or a large bank balance needs to ‘hope for the best and plan for the worst’. And that means coming up with a practical, personal, affordable health plan of your own to ensure that you (or someone you love) doesn’t end up on that ‘patient-in-waiting’, or better still, is able to get off that list by receiving appropriate treatment.

Find a Private Consultant

According to the latest National Treatment Purchase Fund survey, the majority of the 687,000 patients– 493,780 - are waiting to see a consultant.

Since the public consultants’ supply problem will not be sorted out easily or quickly, you need to get your GP to recommend one. Expect to pay the consultant a fee of c€200, which is tax deductible. Use income or savings. If you have neither, sell something on eBay, DoneDeal.ie, Gumtree.ie , at a car boot sale or local market. If that isn’t possible, try borrowing the money from family or friends or the Credit Union. Check out the CU’s ‘It Makes Sense’ microloan scheme for people in receipt of a social welfare payment.

Try to avoid borrowing the money from a moneylender, but frankly, a €250 loan for an important medical consultation is just as worthy as a loan for expensive Christmas toys or elaborate First Communion clothes. On-line begging for expensive private medical treatment/hospitalisation is also perfectly respectable:  it’s called ‘crowd-funding’.

Private Treatment

Once you have a diagnosis from the consultant you can start investigating how to arrange and pay for your treatment.

The reactivation of the National Treatment Purchase Fund in 2017 means that public patients on hospital waiting lists, or on the recommendation of a consultant  are being sent to private hospitals in the EU/EEA under the EU Cross Border Treatment Directive or under the HSE Treatment Abroad Scheme if treatment is not available in Ireland (or is taking longer than it should to occur.) The cost to you, the patient is refunded by the HSE up to the cost of the same treatment in a public hospital in Ireland. (Ironically, the only private hospital treatments the HSE will not refund are those incurred in the 19 private hospitals located here in Ireland.)

The single longest outpatient waiting list -18,660 - is for a gastrointestinal check. The longest in-patient treatment list is for ophthalmology cases, followed by orthopaedic and urology cases.

Shop Around

If you need a hip replacement, for example, and are low on the Irish public hospital waiting list or the Cross Border or Treatment Abroad Scheme you can look for an approach a treatment centre in the EU and EEA and get prior approval from the HSE. See National Contact Points, Cross Border Health Directive on www.citizensinformation.ie

If for some reason HSE approval is not forthcoming, but your doctor still recommends treatment and you can afford to pay for it yourself, either from a private Irish or foreign hospital, you will at least be entitled to claim standard tax relief on your medical costs and expenses, according to Sandra Gannon of the tax consultants TAB Tax Services. (A hip replacement here will cost up to c€16,000 but just c€3,500 in Lithuania.)

Buy Health Insurance

The best way to avoid getting caught up in all the HSE’s legendary waiting lists, is to have a good private health insurance policy with comprehensive outpatient and hospital based cover (c€1,300 plus per annum.)  The greatest benefit of having such insurance is not the better accommodation or food in the private hospitals (however welcome) it is your ability to jump a queue that is now 86,111 long for inpatient or day care treatment in a public hospital.

It won’t do much good to someone with a pre-existing condition (like a dodgy hip) that caused you to join those horrific queues in the first place, says Dermot Goode of www.totalhealthcover.ie but you will be covered sooner for new, unrelated medical events.

Finally, even a good health cash plan (one premium can cover the entire family) from www.hsf.ie  for about €950 a year will pay tax-free benefits for a range of outpatient and in-patient events, including consultants fees and private hospital expenses.

Please send your queries to Jill c/o this paper or by email: jill@jillkerby.ie

 (The new TAB Guide to Money Pensions & Tax 2017 is now out. €9.99 in good bookshops. See www.tab.ie for ebook edition.)