They have fulfilled their NHS contractual obligations â€“ Kingsbridge offers a second source of income. Some carry out CBD patient consultations on week days but the actual CBD surgical procedures at places like Kingsbridge usually take place at weekends, or in some cases, on Fridays.
This growing phenomenon of Cross Border Directive patient work, carried out in a private setting, may have some bearing on the capacity of Northern Ireland’s NHS system to deal with its core patient group. Statistics produced last week confirmed that for many services, Northern Ireland has the UK’s waiting lists.
The NHS lists problem is increasing while Northern Ireland’s private practice component, still tiny compared to the Republic of Ireland, is growing.
Kingsbridge has actually explored the possibility of doing a double on the Cross-Border directive. As well as its Belfast private hospital, the company also owns a facility in Sligo, the old Garden Hill hospital, bought from the Mount Carmel group during the recession.Â
Its CEO Mark Towey, in association with Mark Regan in Belfast examined the possibility of wooing Northern Ireland patients to Sligo and using the Cross Border Directive provisions – in this instance UK money – to fund procedures.
But the plan has hit the buffers, mainly for two reasons. In the Republic a referral from a GP is enough to get a patient up and running in seeking access to a consultant in another member state and to the HSE unit overseeing the scheme.
But in Northern Ireland to have engagement with the NHS-supervised Cross Border Directive, a person must have a consultant’s/clinician’s support. As outlined in relation to the CBD on the NHS website:
“…the letter provided by the EEA clinician must clearly state why the treatment is needed in your circumstances, and what the clinician considers to be a medically justifiable time period within which you should be treated. The clinician should support his statement by giving objective reasons.”
Sometimes the waiting time to see a consultant/clinician in Northern Ireland can be two years or more. Sometimes, perfectly within their rights, those same consultants, in their private time are carrying out procedures on Republic of Ireland (RoI) CBD patients at places like Belfast’s Kingsbridge Private Hospital.
The other undermining factor for a potential Northern Ireland run CBD scheme is the going-rate, the budget for a procedure allowed to patients, seeking treatment across the border or elsewhere.
Because the NI going rate is often significantly less than that of the RoI, the patient would have to make up a considerable shortfall. (Private hospitals in Dublin, Cork and Galway, where the key staff are sometimes consultants who also work in the public sector, charge approx â‚¬12,000 for a hip replacement â€“ some thousands more than the NHS going rate and the budget of any Northern Ireland citizen, seeking to use the Cross Border Directive to travel south.)
These two factors explain why Kingsbridge has struggled to replicate the runaway CBD success of its Belfast model at its site in Sligo.