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Cross-border surgery reimbursement to tackle waiting lists

Aileen Moynagh
BBC News NI health reporter
PA Media Nesbitt is looking at the camera and is speaking. He is wearing thin black framed glasses and wearing a black suit and tie. He has short grey hair. PA Media
Mike Nesbitt said initially £10m will be invested in a reimbursement scheme

The Health Minister Mike Nesbitt has been spelling out how he plans to use £215m earmarked for tackling what he's described as Northern Ireland's "appalling waiting lists".

The money will be targeted at those stuck for years on lists for operations and also re-introduce the cross-border reimbursement scheme.

It will provide compensation to someone who has been on a list for more than two years and opt to pay for a procedure carried out in the Republic of Ireland. It comes into effect next month and will be extended to include all European Union (EU) states.

The Department of Health said patients would require prior approval before accessing the scheme.

Mike Nesbitt said initially £10m will be invested in the waiting list reimbursement scheme, which will begin in June 2025.

These planned investments reflect the executive's ringfencing of funding in this year's health budget for waiting list activities – in line with the finalised programme for government.

However, Nesbitt warned these initiatives will have "unavoidable consequences for wider health and social care provision".

He said this was because the initiatives were "in large part being funded by monies diverted from my core budget for day-to-day services".

Getty Images A stock image of a doctor, wearing a white jacket with a stethoscope around their next and holding a pen and piece of paper. They are sitting at a desk, across from a patient, who is out of shot. Getty Images
The reimbursement scheme, which will begin in June 2025

Other initiatives for the year ahead involve:

  • Targeting long waits – four years or more – including hip, knee, and other orthopaedic treatments; tonsillectomies; hernia treatment; gallbladder removal (lap choles) and colonoscopy.
  • Significantly reducing waiting lists for children requiring specialist procedures such as peg tubes, scopes, and scoliosis surgery, as well as waiting times for women waiting on gynaecology mesh removal procedures.
  • Partnership arrangements with independent sector providers to clear outpatient waits of longer than four years in Ophthalmology; Orthopaedics; General Surgery; Gynaecology; ENT; and other specialties.
  • £10m in funding for mega clinics for an estimated 20,000 additional patients. Mega clinics provide groups of patients with a "one-stop shop" which can involve, for example, surgical review and anaesthetic preoperative assessment in a single appointment.
  • Expansion of red flag and time-critical capacity across a range of specialities, including: Endoscopy; Diagnostic Imaging (eg MRI and CT); Urology, Breast Surgery; Dermatology; Systemic Anti-Cancer Therapy and Cardiac Surgery.
  • Expansion of Primary Care Elective Service capacity in dermatology, minor surgery, and gynaecology. It is estimated that £2.9m would allow the service to see and treat about 16,500 patients in 2025/26.
  • Partnership working with the voluntary sector to deliver a £500k per year Waiting Well programme to help and support those waiting for treatment and a £1m per year Cancer Charities programme to deliver cancer work in the community and reduce pressures on statutory services.

In March 2025, the Health Minister Mike Nesbitt said there would be a "cocktail of delivery" to begin tackling Northern Ireland's hospital waiting lists.

He said £80 million was needed to make sure waiting lists did not expand any further plus £135 million on top of that to tackle the backlog.

Nesbitt said today's announcement reflects "the Executive's ringfencing of up to £215m in this year's health budget for waiting list activities – in line with the finalised Programme for Government".

"This breaks down into £85m for red flag and time critical care; £80m for building up capacity to address the long-standing mismatch with demand; and up to £50m to start tackling the backlog in care," he said.

"Investment at this level will need to be sustained for at least five years to bring hospital waiting times down to acceptable levels."

Nesbitt added: "I will provide more details on the different initiatives later this month with publication of an implementation plan for my Department's Elective Care Framework."

The minister continued: "Only £50m of the ringfenced £215m total has involved additional monies for my Department."

The Department of Health is expected to publish "detailed plans and assessments on the financial pressures this year and the measures that will be needed in both the short and medium terms" in the coming weeks.