Denis Naughten (Roscommon-Galway, Independent) | Oireachtas source

Following on from the questions put by colleagues, I have a couple of specific questions for the Minister, Deputy Harris. Access to healthcare across the Border in Northern Ireland or in Britain is seamless at present because we are all members of the European Union and there are common travel area rights in regard to healthcare. My understanding is that these rights apply to only Irish and UK citizens. There are many EU citizens living here who are married to Irish citizens. Will they be able to avail of the common travel area healthcare provisions of which they can currently avail? What is the situation in regard to posted workers? This is another area that needs clarification.

The Minister, Deputy Harris, said in regard to the treatment abroad scheme, the European health insurance card scheme and the cross-Border health care directive that there will be a seamless transition beyond 29 March. Will he clarify that this remains the position and that it applies not only to Irish and British citizens but to all people legally resident here and EU citizens? Will he also clarify what the position will be on 1 January 2021, which is just 21 months away? I ask the latter question on behalf of people who are currently accessing healthcare in the UK for whom ongoing treatment will be required. For example, a young person receiving treatment in the UK for scoliosis will be returning to the UK for a number of years to access that service, well beyond 31 December 2020. People currently engaged with the health service in the UK need reassurance that they can continue to access that service beyond 31 December 2020.

My final question is related to the cross-Border health directive in terms of liability to the HSE and the treatment abroad scheme in terms of liability to Irish and EU citizens resident here. Currently, the HSE reimburses the health service in the UK for the cost of surgery under the cross-Border health directive. It also reimburses EU citizens legally resident here in respect of treatment in Northern Ireland or the UK under the treatment abroad scheme. These costs are based on the public system in the UK. As we are all citizens from within the European Union, the billing is based on the public cost of the service, as it would be for a British citizen. Post Brexit on 29 March 2019 or 31 December 2020, this might no longer be the position. Will those hospitals continue to bill Irish and EU citizens resident in Ireland as they currently do, which is on the public hospital system basis, or will they charge them as overseas citizens? If so, the cost would be prohibitive. In practical terms, it would mean that people would no longer be able to access those services because they would not be able to make up the differential in terms of financial cost. It would put a huge financial burden on the HSE in regard to the cross-Border health directive as well.

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