Patients taken to court for eye care costs in Northern Ireland

A total of 24 cases have been taken to the Small Claims Court since 2018 as part of efforts to recover costs for false ophthalmic and dental treatment claims in Northern Ireland.

A Freedom of Information Act request by OT revealed that since 2018, 24,631 people were contacted by the Business Services Organisation’s patient exemptions team after they failed to pass initial checks regarding their exemption or remission from healthcare charges.

It is unclear how many of those contacted regarding eye care and dental charges were on Universal Credit (UC).

A spokesperson for the Department of Health told OT: “The patient exemptions team does not hold information with regard to the number of patients who are on UC at the time of treatment and are then subsequently contacted by the team.

“Regarding the small number of cases referred to the courts, we are only aware of one case where the patient has claimed to be on UC at the time of treatment.”

Of the cases taken to court, 14 related to costs for ophthalmic treatment, with the remaining 10 cases relating to costs for dental treatment. The average amount pursued by the Business Services Organisation in each case was £245.

Since 2017, a legal technicality has meant that UC recipients in Northern Ireland are required to submit an HC1 form in order to be eligible for free eye care and dental treatment.

When asked whether the Department of Health would consider forgiving debts incurred by UC recipients who received care without submitting an HC1 form, a spokesperson highlighted that patients were made aware of the “interim arrangements” for receiving assistance with dental and eye care costs.

In 2017, the Department of Health notified practitioners that patients who receive Universal Credit would need to make an application under the Health Service Low Income Scheme to be eligible for support with healthcare costs.

They would then need to declare that they were in receipt of a Health Service Low Income Scheme certificate when completing their treatment or claim form.

“The memorandum highlighted that the patient should be made aware of their responsibility to determine the accuracy of the declaration they make,” the spokesperson shared.

“Through this process it was anticipated that patients in receipt of Universal Credit should have been aware of the requirement to complete the HC1 form,” they highlighted.

Calls for change

The lack of automatic entitlement to free eye care and dental care in Northern Ireland affects more than 200,000 people.

AOP chief executive, Adam Sampson, has described the loss of entitlement as a “diabolical situation.”

“We’re talking about thousands upon thousands of people, some of the most vulnerable in society, being excluded from eye care and dental care,” he said.

In November, the College of Optometrists wrote to the permanent secretary of the Department of Health in Northern Ireland calling for a series of actions to be taken to address the shortfall in care.

Actions included an immediate transition arrangement, where all people on UC can access eye care without additional barriers, and instructing the counter-fraud team not to pursue those on UC attempting to access eye care during the transition period.