496. Deputy Cian O'Callaghan asked the Minister for Health to provide the number of completed Cross-Border Directive reimbursement applications currently awaiting payment; the date of receipt of the oldest outstanding completed application; the current average and median processing time; and the number of applications outstanding for more than 30, 60, 90, 120 and 180 working days respectively. [67794/26]

498. Deputy Sinéad Gibney asked the Minister for Health the case-specific information available to an applicant seeking an update on an outstanding Cross-Border Directive reimbursement application; whether applicants can be informed of the stage their application has reached; whether it has been assessed as complete; whether further information or review is required; the indicative timeframe for reimbursement; and whether consideration will be given to providing meaningful individual updates rather than general information regarding current backlogs. [67996/26]

502. Deputy Sinéad Gibney asked the Minister for Health to confirm whether Cross-Border Directive reimbursement applications continue to be processed in the order in which they are received; whether there are circumstances in which a completed application received at a later date may be processed and reimbursed before an earlier completed application; and, if so, to outline those circumstances and the reason completed applications submitted in 2025 may remain outstanding while some applications submitted in January and February 2026 have subsequently been reimbursed. [67994/26]

503. Deputy Cian O'Callaghan asked the Minister for Health to confirm whether Cross-Border Directive reimbursement applications continue to be processed in the order in which they are received; whether there are circumstances in which a completed application received at a later date may be processed and reimbursed before an earlier completed application; if so, to outline those circumstances and explain how completed applications submitted in 2025 may remain outstanding while some applications submitted in January and February 2026 have subsequently been reimbursed. [67788/26]

504. Deputy Cian O'Callaghan asked the Minister for Health the case-specific information that is available to an applicant seeking an update on an outstanding Cross-Border Directive reimbursement application; whether applicants can be informed of the stage their application has reached, whether it has been assessed as complete; whether further information or review is required, and an indicative timeframe for reimbursement; and whether consideration will be given to providing meaningful individual updates rather than general information regarding current backlogs. [67787/26]

505. Deputy Sinéad Gibney asked the Minister for Health to provide the number of completed Cross-Border Directive reimbursement applications currently awaiting payment; the date of receipt of the oldest outstanding completed application; the current average and median processing time; and the number of applications outstanding for more than 30, 60, 90, 120 and 180 working days respectively, in tabular form. [67992/26]

507. Deputy Cian O'Callaghan asked the Minister for Health the assessment that has been made of the financial and healthcare impact of prolonged Cross-Border Directive reimbursement delays, including on patients servicing loans used to fund treatment and patients whose subsequent treatment has been postponed or cancelled while awaiting reimbursement; the additional staffing or resources that have been allocated to address the current backlog; the measures being taken to reduce processing times; and whether a target date has been established for returning processing times to the HSE's stated aim of reimbursement within 30 working days. [67786/26]

I propose to take Questions Nos. 496, 498, 502, 503, 504, 505 and 507 together.

The Cross Border Directive allows public patients to access necessary healthcare, which they would have been entitled to access in the public healthcare service in Ireland, in another EU or EEA country. The patient pays upfront for the treatment and is reimbursed upon return to Ireland.

The HSE is responsible for the operation of the cross-border directive and has a dedicated office for that purpose.

The continued growth in use of the scheme has placed additional demands on the HSE CBD office and given rise to a build-up of applications. The increased activity is evidenced by the number of treatments reimbursed increasing by approx. 75% between 2020 and 2024.

It is important that this service operates in a responsive way and that reimbursement applications are processed within a reasonable timeframe. The HSE advises it usually aims to repay patients within 30 working days of receipt of all completed documents. The HSE advise the CBD office is currently (as of 2 September 2026) processing applications received at the end of February 2026. A 6-month delay for reimbursement is clearly unacceptable. To address this the HSE has advised my Department that additional resources are being assigned to manage this increase in demand with the aim of restoring processing times to expected levels. I have set the HSE a specific target of getting back to the 30-day target by the end of 2026.

Reimbursement is at the cost of that treatment in Ireland or the cost of it abroad. Whichever is the lesser.  Reimbursement is confined to the costs of the care itself. It does not include any additional costs incurred by the patient.

In relation to the specific question regarding financial implications of the delays in reimbursement under the Cross-Border Directive is governed by European and national legislation. Reimbursement is generally limited to the eligible healthcare costs that would have been met by the public health service in Ireland. There is no provision within the scheme for the reimbursement of interest charges, borrowing costs or other consequential financial costs arising from the manner in which treatment is financed.

Furthermore, there should be no need for such a provision because reimbursement should be predictable and timely. Our priority is to ensure that the HSE’s processing of applications improves and meets with normal operations by the end of 2026. I can assure the Deputy that my department will continue to engage with the HSE to ensure that the measures identified by the HSE are being implemented to facilitate the efficient ongoing operation of the scheme.

As this is a service matter, I have also asked the Health Service Executive to respond to the Deputy directly, as soon as possible.