Health and Brexit

The United Kingdom left the European Union on 31 January 2020 after both sides concluded a Withdrawal Agreement to facilitate an orderly departure.

The Withdrawal Agreement provides for a transition period which ended on 31 December 2020.

On 24 December, 2020 the EU and UK negotiating teams reached agreement in principle on a Trade and Cooperation Agreement. The Agreement provides for tariff-free, quota-free trade and for sectoral cooperation in a number of important areas.

The European Commission has provided more information on the Agreement on its website.

Given the late stage at which the negotiations were finalised, the European Commission recommended that the Agreement be provisionally applied for a period from 1 January while the EU and UK procedures to conclude it are completed.

The departure of the UK from the EU will result in some changes, both here in Ireland and for our EU partners. The Department of Health, the HSE and relevant agencies have been working to prepare for the impact of Brexit on our health services.

It is important for you to be aware of what Brexit may mean for your daily life and the different ways the UK’s departure from the EU may impact you

Both the Irish and British Governments are committed to maintaining, in so far as possible, the current healthcare arrangements under the Common Travel Area (CTA). Under the CTA, Irish citizens and British citizens who live in, work in, or visit the other state have the right to access publicly funded health services there. Other North South cooperation arrangements will also continue on the island of Ireland.

The Trade and Cooperation Agreement between the EU and the UK provides a new framework for the continuation of access to healthcare for persons resident in Ireland who are working, visiting or residing in the UK from 1 January 2021. The scope of these arrangements includes planned treatment and necessary healthcare.

The sale and supply of medicines to and from the UK continues as normal. The manufacturers of medicines, wholesalers and pharmacists, are working closely with Government in this area and, as a result, there is no evidence to suggest that Ireland is likely to face general medicines supply issues, now or in the near future.

All stakeholders will continue to closely monitor supplies and will put any additional arrangements in place as necessary. This includes time- and temperature- sensitive medicines. Some of our medicines come from or through the UK to get to Ireland. However, medicines manufactured in the UK can continue to be supplied to the EU as long as they continue to meet EU standards.

For medicines coming through the UK, Ireland is well placed to maintain the general supply of medicines. This is because medicines are not normally subject to Free Trade Agreements or checks at borders. There are already additional stocks of medicines routinely built into the Irish medicine supply chain to address any initial delays at ports, should they occur.

You do not need to order extra quantities of medicines or extra prescriptions. . If you do, you could disrupt existing stock levels and hamper the supply of medicines for other patients. Anyone with an ongoing need for medicines should fill their prescription as normal.

The Trade and Cooperation Agreement between the EU and the UK provides a new framework for the continuation of access to healthcare for persons resident in Ireland who are working, visiting or residing in the UK from 1 January 2021. The scope of these arrangements includes planned treatment and necessary healthcare.

Cross border health services (like the cardiology and cancer treatments in Altnagelvin, Derry and paediatric cardiology and related maternity services in Dublin) are managed by service level agreements. Similar arrangements are in place between the National Ambulance Services and the Northern Irish Ambulance Service for the provision of cross-border ambulance services. In all scenarios, services like these can be expected to continue.

Following the end of the transition period, the UK is no longer bound by EU rules. Therefore, the EU Directive on the Recognition of Professional Qualifications, which allowed for Irish and UK citizens to have their professional qualifications (including many health qualifications) mutually recognised, no longer applies.

It is important to be aware that persons who had their UK professional qualifications recognised in Ireland before the end of the transition period are not affected by this change and vice versa (where persons had Irish professional qualifications recognised in the UK). This includes applications in the process of being recognised when the transition period ended.

From the beginning of January 2021, all applications for the recognition of UK health and social care qualifications in Ireland will be processed as ‘third country’ applications, similar to all applications from outside the EEA. This should have no discernible effect on the application process in the majority of cases. However, in a small number of cases, the process might take longer than was the case under the Directive.

Further information on individual health professions can be found on the relevant regulator’s website.

Medical prescriptions written by registered medical practitioners, registered dentists and registered nurse prescribers in the United Kingdom will continue to be recognised in Ireland. This is on the basis that practitioners in the UK equivalent to those in Ireland with prescriptive authority will continue to have their prescriptions recognised for dispensing in Ireland.

UK citizens can therefore continue to access prescription-only medicines when in Ireland, using a prescription issued by a UK registered medical practitioner, dentist and or nurse prescriber.

However, online prescriptions from UK prescribers, or prescriptions written by UK-based prescribers for the purposes of enabling mail order supply, issued to people living in Ireland will not be legally valid after the end of the transition period.

The UK have made similar arrangements, and this will allow Irish citizens to continue to access their prescription medicines in the UK, provided their prescription includes certain additional information about themselves, their doctor and the medicine prescribed. This is not a change to current practice and the information that must be included on the prescription is the same as what was previously required to allow prescriptions issued by Irish based practitioners to be dispensed in the UK prior to the end of the transition period.

For further information on Brexit please visit www.gov.ie/Brexit

The Trade and Cooperation Agreement between the EU and the UK provides for a continuation of healthcare rights when on a temporary stay in a State covered by the Agreement.

Under the Agreement, residents of Northern Ireland can continue to use their current UK European Health Insurance Card (EHIC) to access necessary care while on a temporary stay in another EU Member State (MS), until the card reaches its expiry date. At that point, residents of Northern Ireland may obtain a new ‘Global Health Insurance Card’ (GHIC), issued by the UK Government.

The Government continues to recognise the importance placed on continued access to EHIC rights for the people of Northern Ireland. We are pleased therefore, that healthcare rights will be maintained under the Agreement for persons resident in the UK, including Northern Ireland, when on a temporary stay in another EU Member State.

While the necessary preparations were in place as of the end of the transition period, the Government’s planned contingency reimbursement scheme for necessary medical expenses incurred by eligible residents of Northern Ireland during a temporary stay in another EU MS, is not now required. Further information can be found on the NHS website, on how residents of Northern Ireland can apply for a new GHIC.