Louise O'Reilly (Dublin Fingal, Sinn Fein) | Oireachtas source

I will try to be as to the point and as constructive as possible in my remarks. The legislation will only be used in the extreme circumstance of Britain exiting the European Union without a deal. I hope that does not transpire, as do all Members. However, as the British Government does not appear to have much of a clue what it is doing, we must be honest and admit it is a distinct possibility, much as we all hope it does not come to pass.

Section 4 would confer extraordinary powers on the Minister for Health to continue any reciprocal health service arrangements as currently exist after a no-deal Brexit. This is a significant responsibility. I note that approval would have to be sought from the Minister for Finance and the Minister for Public Expenditure and Reform to so do. Obviously, we can only carry out our part of the bargain. One would hope that Britain would uphold its end by ensuring reciprocal provision of health services but, as ever with the British state, it cannot be trusted in regard to the North of Ireland. Is a contingency plan in place in case of an irate and sour Britain leaving without a deal and refusing to guarantee reciprocal health services? What situation would then pertain in respect of health services in general and, in particular, along the Border? The Bill provides for those needs to be covered in a reciprocal manner in the event of a no-deal Brexit. I hope the British Government honours such agreements as currently exist and does not use healthcare as a pawn in any fallout. No one wants the health service and our cross-Border services to be collateral damage in a no-deal Brexit.

Unfortunately, according to a health policy review published yesterday in The Lancet,the National Health Service will be damaged no matter what Brexit deal the British get. The review states that a no-deal Brexit is the worst scenario for the health service and would impact on the workforce, financing, availability of medicines and vaccines, sharing of information and medical research. In the aftermath of Brexit we must keep a close eye on standards of care qualifications and ensure that reciprocation between Ireland and Britain is of the same standard. Furthermore, given that all reciprocal health care arrangements between the UK and other continental European countries would cease in 2019 under a no-deal scenario, we must ensure that our health services are prepared for a possible increase in volume.

As all Members are aware, since the Good Friday Agreement there have been significant advances in cross-Border co-operation on health services. That is evidenced by the 30 service level agreements pertaining to North-South care, many memorandums of understanding and even more partnerships. These agreements cover matters such as ambulance cover in the Border areas, social care partnerships and routine health services. For instance, a memorandum of understanding between the ambulance services North and South ensures that ambulance services operate in a borderless fashion and respond to events immediately closest to them rather than deliberating over where emergency vehicles should travel from. Co-operation and Working Together is a cross-Border health and social care partnership comprising, from Northern Ireland, the Health and Social Care Board, the Public Health Agency, the Southern Health and Social Care Trust and the Western Health and Social Care Trust and, from the South, the Health Service Executive in the Border counties.

Sharing primary care and acute hospital services, as in the case of the cardiac catheterisation service provided to patients from Donegal at Altnagelvin Area Hospital, is another area of co-operation. I have visited Altnagelvin. I do not know if the Minister of State, Deputy Halligan, who is present, has done so. It is a fantastic service and there is great depth of feeling in Donegal about the need to retain it. It was built in partnership and without reference to a border. Essentially, it is a borderless service and it must be maintained.

On the European health insurance card, EHIC, is the Government working with the European Union to ensure that Irish citizens will continue to have access to the card and the benefits that come with it? This is a significant concern for many people to whom I have spoken who have children living in Britain as well as for our citizens in the North. The Government and the EU promised to protect the rights of Irish citizens in the North. This is an issue in respect of which those rights need to be protected.

I wish to raise a commitment given by the Minister for Health, Deputy Harris, regarding the provision of abortion care for women in the North. He made clear that the North is next. That was stated at Dublin Castle following the referendum. I know the Minister has met groups from the North regarding making that a reality. I was at the meeting. We must ensure that goal does not become collateral damage in a no-deal Brexit. Commitments were given by the Government to women in the North and should be delivered. Will the Minister, Deputy Harris, work with the Minister for Education and Skills, Deputy McHugh, regarding the recognition of professional qualifications of medical professionals and healthcare workers from Britain with equivalent education and training standards?

It is infuriating that we are here today making preparations for the North of our country to be pulled out of the European Union against the wishes of the majority of its residents and the wishes of the whole of this island and this House. It is a shame that we are not discussing increasing and improving cross-Border health services and working our way to an all-island health service, which is what Sinn Féin would like to see.

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