Tommie Gorman: How the Irish army has found a way past the Republic’s health waiting lists by crossing the border

And it cost soldiers just €78 a year

Any deployment to Northern Ireland of Irish Army troops would "carry with it the near certainty of fatal casualties", the Republic's defence minister warned in 1985. Picture by Cathal McNaughton, Press Association
Members of the Irish Army have a beneficial cross border health arrangement. Picture by Cathal McNaughton, Press Association

Members of PDFORRA, the representative organisation of Ireland’s defence forces, have found an ingenious formula to bypass the waiting lists for operations in the country’s under-pressure public health service.

For an annual cost of €78, the soldiers, sailors and air crew are able to travel over the border to access services at the two private Kingsbridge hospitals in south Belfast and Ballykelly Co Derry.

As a result, Óglaigh na hEireann, and indirectly the Irish government, have become one of the Kingsbridge organisation’s best customers. To date it has catered for 650 ‘episodes of care’ at its two centres in Northern Ireland. While some have involved just patient meetings with Kingsbridge consultants, 439 procedures have been carried out. The surgeries include hip, knee and shoulder replacements, cataract work, vein removal, vasectomies and tonsillectomies.

Many of the patients required the care to deal with a health issue that occurred in the course of their work and was threatening their ability to remain in full-time work. One PDFORRA member has benefitted from four procedures at Kingsbridge.

While approximately 50% of the population in the Republic of Ireland have private health insurance, PDFORRA say the annual subscription costs would be a struggle for most of its member. Instead, for the outlay involved - €1.50 a week – they have the option of access to Northern Ireland’s small but growing private health care sector, via what’s called PMAS, PDFORRA’s Medical Assistance Scheme.

Derry-born, Damien Quigley, is one of the key architects of the initiative. He joined the Irish Army Defence Forces in 1988. He became national support officer with its representative organisation, PDFORRA, in 2007. He was one of a group who spotted how under the EU’s Cross Border Directive, citizens were entitled to access treatment in the public or private sector of another EU member state.

Kingsbridge private hospital in south Belfast
Kingsbridge private hospital in south Belfast

It was through the Cross Border Directive facility that Munster TD’s, the Healy-Raes in Kerry and Michael Collins in Cork began using to direct busloads of constituents to the Kingsbridge clinic in South Belfast for procedures including cataract operations and knee surgery.

Damien Quigley and his PDFORRA colleagues spotted an opportunity for their members and formed PMAS, a not-for-profit company, limited by guarantee.

They feared that with the UK, Northern Ireland included, leaving the EU after Brexit, the EU Cross Border Directive scheme would cease to exist. But such was the scheme’s popularity, and its usefulness in helping to curtail rising waiting lists, the Irish government introduced measures that amount to an identical replacement scheme.

Damien Quigley retired from the Defence Forces two years ago. With another former colleague, Michael Murphy, he now worked full-time running the PMAS service, from a small office in Bridgend, Co Donegal.

The scheme’s long-term future depends on it remaining effective and viable, based on members’ subscriptions. PDFORRA says it has 6,500 members and according to Damien Quigley, 70% of them subscribe to the voluntary medical assurance scheme.

The HSE undertakes to pay, at most, the Irish going rate, when a patient using the Cross-Border Directive, or the Northern Ireland version, accesses treatment abroad. If the service costs less than the Irish rate, the lower amount is paid. If it costs more, the individual must make up the balance.

One requirement is the patient must pay the upfront costs and then seek reimbursement from the Irish health service. PDFORRA has a facility with its own Credit Union, ANSAC (Army, Naval Service, Air Corps), to cater for this stipulation.

Because of the volume of business he brings to Kingsbridge, Damien Quigley, says he is able to negotiate “bulk-purchase prices” for procedures. These two advantages – the credit union facility and deals struck with Kingsbridge – are vital for the PDFORRA scheme.

Founded six years ago, PDFORRA’s medical assurance project is now is expansion mode. At its annual gathering in the Slieve Russell Hotel, Ballyconnell this week, PDFORRA will announce plans to extend the scheme to 1300 former members who were subscribers until they retired.

Is there a better successful and highly unusual All-Island story?

*Tommie Gorman is a former RTE Northern Editor