Concern in Altnagelvin over Donegal abuse of free care system

Altnagelvin Hospital, Derry.

MORE than five hundred Donegal patients, who were not entitled to free care, attended Altnagelvin Hospital for treatment, new figures reveal.

Last month, a number of patients were diverted to Altnagelvin after Letterkenny General Hospital was hit by significant flood damage which affected 40 per cent of hospital services.


However, these patients are not included in these figures.
From April 2011 to April 2013, the Western Trust’s Altnagelvin Hospital had 503 patients from the Republic of Ireland attend for treatment who were not entitled to free care.

It follows an internal letter, issued by the Western Trust, to Directors of Services, which highlighted concerns about the number of patients from the Republic of Ireland attending Altnagelvin.

Cross-border workers

The letter, signed by Ms Lesley Mitchell, Director of Finance and Contracting, Western Trust, noted that while some of these patients were cross-border workers and would be entitled to free healthcare, a large proportion of patients were not entitled to free treatment.

“One of the problems identified is that, following A&E attendances and patients receiving emergency necessary treatment free of charge in Altnagelvin Hospital, patients are coming back to the outpatients department for follow up treatment instead of being referred back to Letterkenny Hospital.

“This is a cause of concern and one which I am highlighting to ensure that Consultants/staff are aware that the Trust has no obligation to continue to treat these patients free of charge unless there is an extreme clinical need.

“Once the patient is fit for transfer they should be referred back to Letterkenny Hospital, and if the patient chooses to come back to Altnagelvin Hospital, then they will be charged for any follow-up out-patient appointments,” the letter reads.


A spokesperson for the Western Health and Social Care Trust (Western Trust) said that they regularly send communications to staff to keep them informed as to the policy and procedures which exist.

Patients dispute invoices

“For April 2011-April 2013, the Western Trust’s Altnagelvin Hospital had 503 patients from the Republic of Ireland attend for treatment who were not entitled to free care.

“Within this number, some patients would dispute paying after receiving an invoice stating that they did not know they would be required to pay for the treatment they received, even though their entitlement had already been examined,” she said.

While the Trust will always give exemption to those who require emergency treatment if they take ill or have an accident whilst in Northern Ireland, this does not entitle Republic of Ireland residents to cross the border for the sole purpose of free NHS treatment.

“Of the 503 patients who attended Altnagelvin Hospital from April 2011 – April 2013, some may have met these criteria after further investigation and had their charge waived,” she added.
Will Altnagelvin, in time, bill the HSE in the Republic of Ireland for this care?

Paying the bill

“The Western Trust does not bill HSE for patients who access health care at Altnagelvin Hospital unless the patient has been referred specifically by the HSE to the Western Trust for treatment that cannot be provided in Republic of Ireland.

“Patients who access Western Trust services outside of this referral process will have to pay the bill themselves unless they have received care as a result of receiving emergency treatment or if they take ill or have an accident whilst in Northern Ireland,” she said.

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