The number of patients approved to have their operations performed abroad and reimbursed by the Health Service Executive is increasing significantly, according to new figures provided to RTÉ News.
When the scheme started during 2014, there were just seven cases approved but last year the figure rose to almost 5,000 patients.
Already so far this year, 3,130 claims have been reimbursed at a cost of over €10 million.
Last year the scheme cost over €13 million.
The main inpatient care availed of abroad is for orthopaedics, ear, nose and throat, gynaecology and neurology treatment.
For outpatients, the main treatments are in ophthalmology, orthodontics, ENT and neurology.
Surgery and outpatient consultations are covered.
The treatments are provided under the EU Cross Border Healthcare Directive, which allows patients to have healthcare they are entitled to here, in another country in the EU, or the European Economic Area.
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Patients can access this care in the public or private sector in another EU country.
With 780,000 patients here on some form of hospital waiting list, patients are using the system to avoid long waits in Ireland.
According to Catherine Donohoe, HSE General Manager Acute Hospitals & head of the Cross Border Directive Unit, the use of the scheme is growing every year.
While applications slowed in March due to Covid-19, there was a significant backlog of claims to work through and some of that is reflected in the latest figures.
Patients do not have to be on a waiting list to access the treatment abroad.
However, they must be a public patient here, the treatment a person wants to access must be one that the patient would have been eligible for here and the patient must have an appropriate referral, usually from a GP.
Patients cannot access any part of the healthcare they are seeking in Ireland.
The patient pays up front for the treatment and then supplies the HSE with the invoices and receipts for reimbursement.
The HSE reimburses the cost of the treatment in Ireland, or the cost of the treatment abroad, whichever is the lesser.
The reimbursement rates are published on the HSE website.
'I don't want to go skydiving, just go for my daily walk'
Esther Farrell from Portlaoise is travelling to Spain this weekend for a hip replacement operation on her left hip.
Her treatment is being provided under the Cross Border Healthcare Directive in a hospital near Alicante.
She has been on the waiting list in Ireland for nearly three years and is on a lot of medication.
Mrs Farrell said that her hip problem is affecting her quality of life and she can only drive a small distance.
"It has affected my life in every aspect. Going to bed and getting out of bed. I can drive to the shop which is about 500 yards away and that is about it", she said. "It's been this way for about the last few months. It's got progressively worse now."
This week she was tested for Covid-19 to make sure she did not have the virus and can travel for the procedure this weekend.
She will depart from Dublin on Sunday, be collected from her hotel on Monday, have the operation on Tuesday and return to Ireland the following weekend.
She will then self-isolate back at home for 14 days.
"My home has been my pod with the hip problem so cocooning for 14 days will not be strange because this is where I am most comfortable and I spend most of my day here," she said.
Mrs Farrell said she has no worries about travelling abroad for the procedure, due to the coronavirus.
She said she feels she could just as easily contract the virus here, going about her daily life and said the hospital in Spain has reported no cases of the virus.
She said that the airline has all the procedures in place, for example she will be brought to the plane in a wheelchair and collected by wheelchair in the airport in Alicante.
Esther is one of six people travelling out at the weekend, with the arrangements made by surgerynow.ie, which is one of a number of companies that assist people accessing the scheme.
"I have done a lot of research and been in contact with people who have made this trip. I know my life is going to change for the better. I want to do simple things. I don't want to go skydiving, just go for my daily walk. I'm very positive," she said.
