Cross Border Directive, a hope for those suffering due to long waiting lists

Surgery had been cancelled on several occasions

Knowing about the scheme earlier may have saved more than a year and a half of my life,” says a Headford woman, who last year travelled abroad for life-changing hip surgery.

Rachel O’Connor (45) underwent a hip replacement operation in Alicante, Spain in October 2025 under the Cross Border Directive (CBD) scheme.

For more than 40 years Rachel led an active life and enjoyed running, walking and general exercise, however, she suddenly started having pain during some activities.

“At first, I thought I was getting sciatica, so I reduced some physical activities. But the pain continued, and I had to visit my GP,” recalls Rachel.

She was given some anti-inflammatories and advised to go for physio. However, this did not help. A follow-up x-ray showed that her hip was “gone”.

“My GP told me that I needed to see a consultant as soon as possible, and that I would have to have surgery.”

She had a meeting with a consultant at a private hospital and discovered that she was born with hip dysplasia, but it was never diagnosed.

“Because I exercised a lot over the years, the muscles around my hip were so strong that the condition didn’t present itself until now.”

Rachel’s pain came on suddenly and got progressively worse in a very short time.

“No one warns you that it gets worse so quickly, to the point where you can’t even bend down.

“I had a shooting pain down my back, and the simple things in life, like getting up off the chair, getting out of bed, out of the car, or even going to the toilet and trying to get up from there, became difficult.”

Rachel was initially being treated privately but after her surgery got cancelled twice, she asked her GP to refer her to the public system. “She warned me that I could be waiting for almost four years,” recalled Rachel.

According to HSE West, there are currently 118 patients waiting for hip surgery at Galway University Hospital. Out of these, 42 patients have been waiting for three months, 60 patients have been waiting for almost a year, 13 have been waiting for around two years, while three have been waiting for almost four years.

“It's not just the public healthcare sector, even the private sector is overwhelmed with an increased number of patients on the waiting list,” Rachel told The Tuam Herald.

“At this stage, I was in ferocious pain which travelled from my hips to my legs and back up to my shoulder.

“I couldn’t lift a cup, and I was constantly on a crazy number of painkillers. I had no quality of life. I couldn't go anywhere or couldn’t exercise anymore. I was getting depressed.

“So, I didn't care if he cut my leg off, just to do something to relieve the pain.”

After facing four surgery cancellations and losing more than a year and a half of her life to excruciating pain, Rachel started looking for other options.

Her research brought her to the HSE Cross Border Directive (CBD) scheme. The EU scheme allows a patient to get planned healthcare in another EU/EEA country and claim a refund. A range of procedures and treatments are covered such as hip or knee replacements, opthalmic, like cataract surgery, dental care, mental health treatments, and fertility treatment etc.

“I knew Spain was among the top five healthcare providers in Europe, so I rang Healthcare Abroad (a cross-border healthcare facilitator), made my inquiries and in two days I had all my ducks in a row,” explained Rachel.

However, the process does involve a lot of paperwork and Rachel advises that a person would need help completing it if they are not very tech-savvy or good with forms etc.

To qualify, a person must be in the Irish public healthcare system, be referred by a GP or consultant and they also need to be able to pay the cost of the healthcare upfront and then claim the reimbursement. Private health insurance cannot be used to pay for treatment received under the CBD scheme.

During her time in Spain, Rachel realised that she wasn’t alone in her frustrations with the waiting times in Ireland. She says she met 20 other patients from Ireland who were also there to receive treatment or surgery.

“All the other people with me had been on the waiting list in Ireland for over two years. Some were there for knee surgery, while others had spinal fusions. We bonded over the trauma and now we call us the hipster club.”

Rachel found her experience of healthcare in Spain to be quick and productive. She returned home walking without any support and free of pain.

She received great support from the staff at HCB hospital, in Denia, Spain before and after surgery and her recovery process was made smoother as a result of intense physio sessions that were part of the package.

“From arriving there to having the surgery and going to and from the hotel for physio, everything was arranged well by Healthcare Abroad,” recalled Rachel.

“All my tests were done in a day. I had the surgery the next day and was discharged to the hotel after three days.

“Even the hotels were well equipped for surgical patients and every small day-to-day need was taken care of. Everything was so well managed that I didn’t have to worry about anything other than recovery.

“I didn’t realise how much pain I was in until it was gone,” she said.

The total cost of Rachel's surgery was around €15,000, excluding the hotel and travel expenses, which the patient has to bear themselves.

“For anyone who is waiting for any procedure I recommend not to live in pain and just get it done through the CBD scheme.

“If you cannot afford the cost, you could also get a loan since you know the money is going to come back.”

For more information on the scheme and your eligibility, visit: www.hse.ie.