BLOG: Will Brexit jeopardise access to reciprocal healthcare?

Two years ago, when skiing in the French Alps, my daughter had a ski accident and was taken to hospital for urgent care. I was lucky enough to hold a European Health Insurance Card, which allowed us to receive healthcare as if we were local residents, as without it the bill could have been quite expensive for me!

By
Elisabetta
Zanon

My personal experience is far from unique, as citizens are more and more mobile and increasingly willing to travel and spend time in other countries and therefore more likely to be in need of urgent or emergency care abroad.

The EU reciprocal healthcare system is a great asset and has been of huge assistance to an increasing number of EU citizens when travelling to another Member State.

But what will happen when the UK leaves the EU in terms of reciprocal healthcare arrangements?

In case the current system were to cease to apply, many people will be deprived of their right to receive free (or low cost) healthcare when travelling abroad and will be required to purchase private health insurance before travelling. For the elderly and those with long-term conditions, the costs could be prohibitive.

But EU reciprocal healthcare arrangements do not only benefit those travelling to other EU Member States for a short period of time (for example while on holiday or studying abroad). They are also essential for people such as British pensioners living in Southern Europe, who have access to healthcare in the country where they live through a system of bilateral reimbursement of costs regulated by EU law.  With Brexit looming, these citizens are feeling more and more anxious about their future right to healthcare.

Other groups of patients are worried too, such as those with rare or very complex diseases who have to travel to other EU Member States for diagnosis or treatment when these are not available in their own country, or those who decide to travel abroad to receive elective healthcare more quickly or because they prefer to be treated in a different EU country, for example, to be closer to their family.

EU reciprocal healthcare also covers situations where it is not the patient travelling, but instead it is the clinical services which cross the border. This is the case in telemedicine, when a healthcare professional in another EU country performs the medical procedure for a patient.

European Reference Networks

The provision of cross-border telemedicine services is rather limited today, due to a range of barriers that continue to exist, such as legal uncertainty on issues such as liability, data privacy, and reimbursement of costs.  Nevertheless, there are increasing efforts at EU level to address these challenges, including in the context of operational arrangements for the newly established European Reference Networks - the most advanced and innovative form of cross-border co-operation between healthcare providers across the EU.

Established in Spring 2017 to improve the diagnosis and treatment of rare or low prevalence complex diseases, 24 thematic European Reference Networks (gathering over 900 highly specialised healthcare units from 26 countries) will use a new type of IT platform to co-operate in the diagnosis and treatment of patients, as well as to conduct clinical collaborative research and educational activities.

The pilot phase of this IT platform, called Clinical Patients Management System, is due to start on 20 November 2017. Throughout the trial phase 15 European Reference Networks will start using the system to diagnose and treat real patients, with the aim of testing and validating it, with a view to a full roll out in Spring 2018.

This is a very important development which has the potential to revolutionise the delivery of EU cross-border healthcare for the benefit of patients, clinicians and healthcare providers alike. But will the UK be able to take advantage of these developments or will Brexit mean the end of reciprocal healthcare arrangements and collaborations between the UK and the EU27?

There is a lot at stake for patients and this is why it is crucial that Brexit negotiators do all they possibly can to ensure that patients will not be deprived of access to high quality, affordable healthcare, wherever in Europe it’s available.

For more information on Brexit and reciprocal healthcare:

www.nhsconfed.org/regions-and-eu/nhs-european-office/brexit/brexit-health-alliance/reciprocal-healthcare

www.nhsconfed.org/resources/2017/10/maintaining-reciprocal-healthcare-for-patients-after-brexit

Elisabetta Zanon

Director - NHS European Office

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