The House of Lords EU Committee has today published its report Brexit: reciprocal healthcare. The Committee warns that in the absence of an agreement on reciprocal healthcare, the rights of UK citizens to hold an EHIC card for treatment in the EU will cease after Brexit.
Other rights, provided for by the S2 scheme and Patients’ Rights Directive, will likewise come to an end. Without EHIC or an equivalent arrangement it could become much more expensive for UK citizens with chronic conditions – such as dialysis patients and people living with rare diseases – to travel to the EU post-Brexit, for holidays, recuperation or treatment. These people might find it difficult to obtain travel insurance at all.
The Government wishes to maintain reciprocal healthcare arrangements including the EHIC scheme after Brexit, but the current arrangements are designed to support the freedom of movement of EU citizens. The Government intends to stop freedom of movement to the UK, and has not yet set out its objectives for the future UK-EU relationship. The Committee therefore urges the Government to confirm how it will seek to protect reciprocal rights to healthcare of all UK and EU citizens post-Brexit, as part of any agreement on future relations.
The report also argues that it is essential for EU citizens lawfully resident in the UK to have a continuing right to access long-term healthcare, as well as the practical means by which to exercise that right. The Committee therefore calls on the Government to use domestic legislation to clarify the means by which all EU citizens lawfully resident in the UK at the time of Brexit will be able to continue to access essential healthcare.
The Committee warns that a hard border with Ireland would be highly detrimental to healthcare for patients on both sides of the border, including children and other vulnerable patients. Ambulances are currently able to travel freely across the border, medical professionals from one country can work in the other, and patients can easily cross the border to access healthcare. These arrangements may not continue if an agreement is not reached.
Lord Jay of Ewelme, Chairman of the Lords EU Home Affairs Sub-Committee, said:
“One of the primary aims of the EU’s reciprocal healthcare arrangements is to support free movement by eliminating the financial or bureaucratic barriers that individuals would otherwise face in accessing healthcare.
“These arrangements have brought the greatest benefit to some of the most vulnerable members of our society. The Committee heard evidence on the vital role that reciprocal healthcare plays in improving the lives of people with disabilities, the elderly, and children.
“We do not wish to see this progress reversed in the future. While we applaud the spirit underlying the Government’s ambition to maintain reciprocal healthcare arrangements, including the EHIC, post-Brexit, it is difficult to square this with ending freedom of movement of people from the EU.
“We therefore urge the Government to clarify whether it will seek UK participation in the EHIC, S1 and S2 schemes as a non-EU Member State; set up a separate scheme with the EU27; or explore the possibility of reaching bilateral arrangements with individual EU Member States. Clarity from the Government will enable UK and EU citizens, the NHS, and insurance providers, to plan for the post-Brexit future.”
As most UK tourists know, an EHIC is NOT accepted in many countries across the EU. Holidaymakers are routinely told at hospitals and clinics to pay for their treatment and then claim it back on their travel insurance. We predict more expensive travel insurance for every EU tourist after 2021 – and proof of insurance by some member states – but let’s hope that EU visitors are also required to carry proof of travel and health insurance, rather than rely on free NHS care.
Unless a system can be devised where payment is transferred electronically to the EU clinic on the day of admission, we don’t see how any UK government scheme will alter that reality.
It’s unlikely that the UK government will put resources and staff into a new system, although the situation in Northern Ireland is different and unique in many ways, so will probably require a unique health card system for Ireland and NI with a great deal of goodwill on both sides underpinning free treatment to a certain level.