This briefing paper analyses the Healthcare (International Arrangements) Bill 2017-19. The Bill is one of a series of 'Brexit Bills' intended to adjust UK legislation in preparation for Brexit. The aim is to allow the UK to maintain reciprocal healthcare arrangements with the EU and its Member States post-Brexit.
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Why is the Bill necessary?
The Bill, introduced in the Commons on 26 October 2018, establishes the legal basis for the Secretary of State for Health and Social Care to fund and implement reciprocal healthcare schemes and share necessary data after the UK leaves the EU. It is intended to allow the UK to maintain reciprocal healthcare arrangements with the EU and its Member Sates after Brexit, in the event of either a Brexit deal or no deal scenario. However, the provisions are not limited to arrangements with the EU; the UK Government states that the Bill would also allow the UK to strengthen existing reciprocal healthcare agreements with countries outside the EU, or implement new ones.
The Bill seeks to safeguard healthcare for 190,000 UK expats living in the EU, and the 50 million UK nationals who travel abroad to EEA countries every year, through agreements with the EU or its Member States. For example, the Bill would establish the basis for a new arrangement allowing the European Health Insurance Card (EHIC) scheme to continue, subject to an agreement with the EU. The EHIC currently grants UK nationals access to free or reduced cost healthcare within the EEA, and pays for 250,000 medical treatments each year. For expat UK state pensioners who have chosen to live in the EU, and those intending to retire to the EU, the Bill seeks to safeguard their access to healthcare if there is no EU deal.
If a deal is reached it is expected that the powers to maintain reciprocal healthcare arrangements during an implementation period will stem from the proposed EU (Withdrawal Agreement) Bill. However, separate legislation will be required from the end of this period, expected in 2020 or thereafter, once the UK can no longer rely on EU reciprocal healthcare regulations. In the event of a no deal scenario, the UK Government may need to rely on the powers of the Healthcare (International Arrangements) Bill to implement new bilateral agreements with individual Member States from 29 March 2019.
Current legal basis for reciprocal healthcare arrangements
The UK Government’s ability to fund and arrange healthcare for UK citizens within the EU is currently enabled by EU Regulations (883/2004 and 987/2009), which set out detailed rules for who is eligible, and provide the legal authority for the Secretary of State to make overseas payments to reimburse the cost of healthcare. At present, the Secretary of State has only limited domestic powers to fund overseas healthcare, or implement complex reciprocal healthcare agreements with other states. When the UK leaves the EU, therefore, the Government states it will be necessary for domestic legislation to provide the Secretary of State with powers to fund and arrange for healthcare overseas.
Commenting on the introduction of the Bill, Health Minister Lord O’Shaughnessy said:
“Whether on holiday, working or retiring abroad, British people want to know they can access the same high quality healthcare that they enjoy in the NHS. This Bill will allow us to implement new healthcare arrangements with other countries – in the EU and elsewhere – so that UK citizens can travel with confidence.”