Brexit is a huge worry on the minds of many people in the Republic as the deadline is looming ever so near, with no agreement in place as we speak. There is no doubt that Brexit will impact on many businesses. While much preparation has been made for that impact, not knowing is the hardest pill to swallow right now. Agriculture will be hard hit. A recent Central Bank report stated that beef and sheep farmers will be the most economically vulnerable. It states that up to one third of farms could be forced out of business because of Brexit. The fishing industry will be most affected. The biggest shock of all is to see Michel Barnier negotiating with senior British officials and offering 18% of fish or more in a Brexit deal with the UK. I have asked the Minister for Agriculture, Food and the Marine, the Tánaiste and the Taoiseach in the past two weeks whose fish Michel Barnier is offering but I have not received an answer. We all know it is Irish fish that are on offer, but there is no Irish Minister negotiating on our behalf in these talks with Michel Barnier as more and more rights in terms of Irish fish and waters are being thrown away, like successive governments have done for decades.

My question relates to Brexit and all those in this country who are suffering from pain or the nightmare of going blind. In October, I asked the Taoiseach about the cross-border directive. I have asked the Minister of State, Deputy Feighan, and the Minister for Health, Deputy Donnelly, about it in the past two weeks. I asked the Tánaiste about it last Thursday. All of them stated that an agreement is in place for taking cancer patients from Donegal to Derry and an agreement for taking cardiology procedures from the North to the South will be in place, which is great news. In reply to me last Thursday, the Tánaiste and leader of Fine Gael stated, "I cannot give as clear a reply as I would like [to the question on the continuation of the cross-border scheme] because some of these issues are still being worked out." He continued, "we are trying to put alternative arrangements in place to maintain the status quo when it comes to cross-border healthcare", but this has not been worked out yet.

More than 5,000 people availed of the cross-border directive last year for cataract, hip and knee procedures among others. I or any other politician would totally agree with the statement of the Taoiseach that these procedures should be carried out here in the Republic, but that is not happening. Belfast or Blind bus No. 64, organised by me, Deputy Danny Healy-Rae, Councillor Ben Dalton O'Sullivan and Councillor Danny Collins, will leave Cork on Sunday. It will be full of people desperately trying to get to the North before 31 December because no one knows whether any type of cross-border scheme will be in place by 1 January.

Will people in this country, be they from west Cork or Donegal, who are in dreadful pain because they are in need of a hip or knee operation or who are going blind and in need of a cataract operation and cannot wait for three to five years for surgery, be able to contact a private hospital in Belfast from 1 January to have their procedure carried out and then be reimbursed by the HSE? In other words, are all the necessary arrangements in place or is the Government still negotiating a new cross-border deal?

I admire the Deputy's ingenuity. He is aware these questions are supposed to be about just one topic but he managed to get fish and the cross-border directive into the question. I do not know whether it is blind fish that are being caught off the coast. Can the Taoiseach deal with this matter?

First, on Brexit, we have been working very hard to avoid a no-deal Brexit. The Deputy is correct in stating that the western regions and the Border counties in particular would suffer very severely from a no-deal Brexit, and farming would be very negatively impacted in terms of dairy, beef, sheep and all agricultural products. The impact would be very severe. As for fish, it would potentially be disastrous if there was a no-deal Brexit, because it would mean an immediate hit. Therefore, Michel Barnier is negotiating on behalf of 27 member states. I am sure the Deputy knows that. There are not 27 member state ministers on the negotiating team. He knows that. I do not know why he says what he says in the way he says it in terms of ministers. We have all fed into that process, of course, and the negotiating team know the Irish bottom line in relation to fisheries and what we are trying to achieve here. We are endeavouring to avoid a no-deal Brexit. Doing so is in the best interests of Ireland, the United Kingdom, and the other member states of the European Union. It is the common-sense and logical thing to do to avoid a no-deal Brexit. I would appreciate if the Deputy would confirm that it is his view also that we should avoid a no-deal Brexit.

On the issue of the cross-border directive, it was a European Union directive. I would like the Deputy to acknowledge that the reason it is coming to an end as a cross-border directive under EU legislation is because the United Kingdom has decided to leave the European Union.

There is no appetite in the Northern Ireland public health system to continue the scheme. We have to develop a scheme unilaterally. Essentially, two private hospitals in Northern Ireland provide these services. Last year, there were 7,800 applicants. More than 7,300 accessed care there with almost 98% of these patients accessing care in Northern Ireland. The remainder accessed it in the UK. That is the overall position. Irish patients predominantly travel to Northern Ireland to access healthcare under that directive.

The total value of the reimbursement was €16.6 million. That was the taxpayers' outlay in this regard, which is why I and the Minister for Health, Deputy Stephen Donnelly, have approved funding for developing our capacity in the Republic to deliver more orthopaedic and cataract operations, in particular. We are protecting a range of cross-border healthcare measures even as the UK leaves the European Union, such as the treatment abroad scheme and the European health insurance card, for example, where there will be equivalence for Northern Ireland resident citizens. The cross-border treatment directive is different from those schemes. We are working on the issue and it will be continued administratively in the early months of next year.

I thank the Taoiseach for his reply.

I thank the Taoiseach and the Minister, Deputy Stephen Donnelly - I always believe in calling a spade a spade - for sorting out the medicinal cannabis access for Vera Twomey's daughter, Ava, and for so many sufferers who desperately need access to this medicine. However, people are suffering from the worry of losing their eyesight. They are contacting me and other politicians to find out if they can access cross-border care of a different type from 1 January next. There is no point saying they may for a month or two or that it might or might not be in place. It is quite simple. The Taoiseach says there will be extra resources to have these procedures carried out in the South, which is 100% commendable, but it might not happen in places such as Cork. It might be a year or two before these surgical areas are resolved.

In the past week a Fine Gael Senator in south-west Cork said that this is resolved and that people can go to the North. How is it that he has information? He told the Southern Star newspaper I was scaremongering, that this is resolved and he asked what was wrong with me now. His leader has not said it is resolved. The Taoiseach has not said it is resolved, but that the Government and the Minister, Deputy Stephen Donnelly, are working on it. Will there be a cross-border scheme next year? A seamless transition is what we are seeking. I am not suffering from any of these illnesses, but I am asking for the people who are in need of these surgeries. Will there be a seamless transition from the current scheme? I acknowledge the UK is leaving the EU, and I am keeping my fingers crossed that an agreement can be achieved, but this is the concern we have this year. I would appreciate if this could be resolved in the coming days for the 7,000 people who will require surgeries next year, or is it resolved?

As I said, the intention is to continue this on an administrative basis first and then to see if we can introduce legislation to underpin it. Essentially, officials in the Department of Health are giving detailed consideration to the implementation of a unilateral cross-border directive type of arrangement. It cannot be the same because the UK is no longer in the European Union and it does not have to reciprocate. The cross-border directive gave entitlements to citizens to go into other European countries, get treatments and for those to be reimbursed afterwards, if the public health system here could not provide them. That falls when the UK leaves.

I acknowledge that approximately 7,700 have availed of the scheme. We do not want people shut off, particularly those in the Border counties where it is used to a greater degree. There will be a unilateral type of scheme or arrangement which will provide that Irish residents can continue to access services provided by private health service providers in the UK post the end of the transition period. We will continue on an administrative basis and then underpin it with legislation.