Leaving the EU: Reciprocal Healthcare Legislation

Stephen Hammond Excerpts

Wednesday 6th February 2019 Written Statements

[The Minister for Health (Stephen Hammond)]

Current European Union (EU) reciprocal healthcare arrangements enable UK nationals¹ to access healthcare when they live, study, work, or travel in the EU and vice versa for EU citizens² when in the UK. They give people retiring abroad more security; they support tourism and businesses and facilitate healthcare co-operation.

These arrangements ensure that UK nationals living and working in the EU, European Economic Area (EEA) and Switzerland can access healthcare in exchange for paying taxes and social security contributions. The UK also funds healthcare abroad for a number of current or former UK residents. This includes healthcare for UK state pensioners who spend their retirement in the EU and needs arising healthcare when UK residents visit the EU for holiday or study through the European healthcare insurance card (EHIC) scheme.

The Government’s priority is to secure a withdrawal agreement with the EU. However, as a responsible Government, we are preparing for all eventualities, including the possibility the UK leaves the EU without a deal. If necessary, the UK would like to make arrangements with individual EU member states to ensure that there are no immediate changes to people’s access to healthcare after exit day and that there is a strong basis for ongoing co-operation on health issues. The UK is therefore seeking to maintain reciprocal healthcare rights for pensioners, workers, students, tourists and other visitors in line with the current EU arrangements, including reimbursement of healthcare costs, for a transitional period lasting until 31 December 2020. This is only possible with agreement from other member states and we have commenced discussions on this issue.

The Healthcare (International Arrangements) Bill (the Bill) is being brought forward as a result of the UK’s exit from the EU; however, it is forward-facing and not intended to deal only with EU exit. The Bill is intended to support the implementation of comprehensive reciprocal healthcare arrangements with countries both within and outside the EU to enable possible future partnerships.

The Bill can be used to implement complex bilateral arrangements with a member state that may differ to current EU arrangements, or to make unilateral arrangements to assist UK nationals to access healthcare abroad in exceptional circumstances and in the interests of patient safety. The Bill also provides the legal basis to fund and process data relating to healthcare outside of the United Kingdom.

The European Union (Withdrawal) Act 2018 will convert EU law as it stands on exit day into UK domestic law and preserve the laws made in the UK to implement EU obligations. This means that EU regulations providing for EU reciprocal healthcare arrangements will become part of the UK’s statute book on exit day. Without further legislation, in a no-deal scenario the regulations would not be coherent or workable without reciprocity from member states. Therefore, on 7 February, the Government will bring forward two statutory instruments under section 8 of the European Union (Withdrawal) Act 2018, to prevent, remedy or mitigate deficiencies in retained EU law relating to reciprocal healthcare.

These instruments also afford the UK an additional mechanism for ensuring there is no interruption to healthcare arrangements for UK nationals³ after exit day in those member states who agree to maintain the current arrangements for a transitional period. Through these instruments, the UK can transitionally maintain current EU reciprocal healthcare arrangements for countries where we have established reciprocity during an interim period lasting until 31 December 2020 and no later. The arrangements would not apply to member states who do not agree to maintain the current reciprocal arrangements with us.

Together with the Bill, these instruments are focused on supporting a smooth transition as we exit the EU. Both of these legislative vehicles are necessary to ensure the UK Government are ready to deal with reciprocal and cross-border healthcare in any scenario. They afford the UK Government flexibility of action and ensure the UK is able to respond quickly to protect people’s healthcare.

The Bill and the forthcoming statutory instruments are intended to support further preparations the UK Government are making with regard to reciprocal healthcare arrangements. The Government have issued advice via the Government and NHS websites to UK nationals living in the EU, to UK residents travelling to the EU and to EU nationals living in the UK. This advice explains how the UK is working to maintain reciprocal healthcare arrangements, but that their continuation depends on decisions by member states. It sets out what options people might have to access healthcare under local laws in the member state they live in if we do not have bilateral arrangements in place, and what people can do to prepare. Our advice to people travelling abroad after exit day is to purchase travel insurance, as we already recommend now. These webpages will be updated as more information becomes available.

The Bill and the statutory instruments feed into a broader body of work by the Department of Health and Social Care and across the UK Government, to ensure health and social care systems are well prepared as we exit the EU.

¹ This is a short-hand term for persons who are the responsibility of the UK. They may or may not be UK nationals.

² This is a short-hand term for EU27/EEA/Swiss-insured individuals i.e. persons who are the responsibility of an EU or EEA member state or Switzerland.

³ Please see footnote 1.

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