Ongoing areas of cross-border health cooperation

The re-emergence of structured cross-border health cooperation on the island of Ireland has gained renewed momentum after new funding announcements and a series of successful meetings between the two health ministers, Jennifer Carroll MacNeill TD and Mike Nesbitt MLA.

Minister for Health Carroll MacNeill TD met with the northern Minister Nesbitt on 14 May 2025 to discuss cooperation in the health sector at the twenty-sixth North South Ministerial Council Health and Food Safety meeting, which was held in the NSMC Joint Secretariat Offices, Armagh.

This followed Nesbitt’s visit to Dublin on 27 February, during which Minister MacNeill welcomed Minister Nesbitt to the Department of Health to discuss North-South cooperation on health and social care, after which the two Ministers undertook a joint visit to the New Children’s Hospital.

After this, the North’s Department of Health introduced a £10 million initiative designed to ease persistent pressures on elective care services.
Funded through a broader £215 million package for waiting list reduction, the cross-border component marks a return to pragmatic interjurisdictional solutions, this time operating outside the previously relied-upon European Union legislative framework.

With access to EU healthcare directives no longer available to UK regions, the new mechanism operates through a reimbursement model for patients receiving procedures south of the border. While scaled modestly, the scheme is a notable indication of the ongoing strategic relevance of cross-border engagement in health both for service delivery and for longer-term systems innovation.

The Waiting List Reimbursement Scheme (WLRS) applies to individuals waiting over two years for treatment in the North’s Health and Social Care (HSC) system. Under the scheme, patients may independently access treatment in hospitals across the border, with reimbursement up to the value of the equivalent HSC tariff upon completion. The approach aligns with past EU directive-based models in structure, but is now administered entirely through the northern department.

The scheme between the Government and the Northern Ireland Executive is an individual-based reimbursement system with eligibility thresholds and tariff limits. Costs in excess of HSC rates must be borne privately, and travel or accommodation expenses are not included.

Nesbitt has described the cross-border component as “a targeted investment to utilise all available avenues to reduce elective waiting times”, noting that its design ensures alignment with existing HSC financial parameters.

The northern department has emphasised that this is a time-limited and non-recurrent allocation. As such, it forms part of a short-term intervention strategy rather than a shift in structural service delivery. Future decisions will be based on performance data and wider fiscal considerations.

Policy alignment

There are several agreements in place covering specific specialist cross-border initiatives that ensure that patients can receive a range of medical procedures/services as close to home as possible. This has helped reduce travel time, and increase ease of access, which has been hugely beneficial for patients, their families, and carers across the island.

There is also ongoing engagement between both jurisdictions at official level, and this includes work on the exploration of those areas of health cooperation that could be further expanded to benefit residents on the island of Ireland on a cross-border basis.

The Department of Health says that opportunities to avail of further Shared Island Initiative funding are also being explored by officials in both jurisdictions. Under this initiative, the charity Cancer Fund for Children (CFFC) was awarded a total of €7.5 million (€5 million from the Department of Health combined with €2.5 million from the Shared Island Fund) to expand services with construction of a second residential therapeutic centre in Cong, County Mayo. CFFC has run Daisy Lodge in Newcastle, County Down since 2014, and the second centre will offer the same support services in a new location. The new centre, the Department states, “will welcome families from both Ireland and Northern Ireland for free short breaks and will establish a vital service based in the west of Ireland for children with cancer and their families to be able to relax and enjoy time together with other children and their families who are going through a similar experience”.

A departmental spokesperson adds: “Additionally, stakeholders working in healthcare north and south of the border continue to collaborate on cross-border EU funding programmes. The PEACEPLUS programme, which builds upon the work of the previous PEACE and INTERREG programmes is a new cross-border funding programme supported by the EU, the UK Government, the Government of Ireland, and the Northern Ireland Executive. Aiming to ensure equal access to healthcare and fostering resilience in health services, this will be achieved through a range of collaborative, cross border health and social care initiatives.”

Furthermore, 10 projects have been selected to receive over €85 million in funding support under the main health and addiction calls of the PEACEPLUS Programme, aimed at primarily benefitting residents of the North, but also communities in the border counties in the South, namely Counties Cavan, Donegal, Leitrim, Louth, Monaghan and Sligo.

“Working collaboratively to address healthcare challenges in both jurisdictions is of the utmost importance and enhancing north-south cooperation will continue to be a priority for the Department of Health.”

In a statement to eolas Magazine, a Department of Health spokesperson said that the Department is “committed to continuing close and productive cooperation with the Northern Ireland Executive on health and social care issues”.

“The Department is deepening and broadening north-south cooperation in healthcare provision through direct links between officials and clinical staff in both jurisdictions, as well as cross-border engagements such as the North-South Ministerial Council (NSMC), the Shared Island Initiative, and the Cross Border EU Funding Initiative, PEACEPLUS.”