Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I thank the Acting Chairman and Seanad Éireann for facilitating what I hope will be the passage of this important legislation this afternoon. Of course, our Brexit preparedness work as a Government and as an Oireachtas continues. This is an important piece of legislation in terms of the Republic of Ireland ensuring that we provide supports to citizens in Northern Ireland. There is cross-party support, in this House and the other House, to make sure that we do that and that we fulfil not only our obligations under, but the spirit of, the Good Friday Agreement. Particularly from my perspective as Minister for Health, it is so appropriate that we have endeavoured to put in place a scheme which effectively means if somebody from Northern Ireland gets sick while on holiday in the European Union or, indeed, while in the European Union, we here in Ireland will ensure their costs are covered.

I welcome the opportunity to introduce the Bill. This Bill is being introduced on my own behalf, as Minister for Health, and on behalf of my colleague, the Minister for Children and Youth Affairs, as it contains two sets of legislative provisions. The health-related aspect concerns the provision of similar benefits to those available under European health insurance cards, EHIC, to eligible residents of Northern Ireland in the case of a no-deal Brexit. The Bill also includes amendments to the Childcare Support Act 2018, to provide for British citizens to have access to the forthcoming national childcare scheme on the same basis as Irish citizens.

Before discussing the provisions of the Bill in more detail, I will put this legislation in context. The legislation has been identified by Government as a clear priority in the context of ongoing contingency planning for a no-deal Brexit. I acknowledge and appreciate the co-operation of colleagues in this House, and indeed the other House, who facilitated the Bill for debate as a matter of priority, taking account of the short timeframe between publication of the Bill on Monday last and its introduction in the Seanad today. I also thank my officials and officials in the Department of Children and Youth Affairs and the Department of Foreign Affairs and Trade for what has been intense and sustained work and effort to ensure that we could have this legislation at this point. This tight timeframe has unfortunately been necessary due to the pressing urgency for the legislation to be enacted before the end of this month, given that the Government continues to plan for a no-deal Brexit.

Brexit has undoubtedly raised a number of issues regarding the provision of, and access to, health services that need to be addressed. In recognition of this, in April the Oireachtas enacted legislation which, if commenced, will allow for the continuation of reciprocal healthcare arrangements between the State and the UK. This was necessary to provide a statutory means to facilitate the continuation of a range of existing reciprocal healthcare arrangements between Ireland and the UK, after the UK leaves the EU.

In the context of planning for a possible no-deal Brexit, ensuring that the citizenship and identity provisions of the Good Friday Agreement are respected and upheld in all relevant policy areas is an important issue, and one that the Government remains very engaged on. The Government will continue to work with the UK to reinforce the message that the rights and entitlements of all those living in Northern Ireland are of fundamental importance and must be protected to the greatest extent possible. The Government is proactively working to ensure that people in Northern Ireland can continue to enjoy access to EU rights, opportunities and benefits, including the benefits of EHIC, in the future.

The way EHIC works is that the state that issues the card, in this case Ireland, meets the cost of any services accessed by the holder in another EU or EEA jurisdiction. The practical effect is that EU citizens can visit another member state and avail of necessary public healthcare during a temporary visit there. Therefore, the objective of this legislation is to ensure that if the UK leaves the EU without a withdrawal agreement, eligible residents in Northern Ireland will not be out of pocket if health expenses are incurred while on a temporary stay in another EU or EEA member state or Switzerland.

This Bill has been brought forward, therefore, to ensure continued provision of the equivalent benefits of EHIC to eligible residents of Northern Ireland, as part of our ongoing planning for a possible no-deal Brexit. It is important to note that in the event of an orderly Brexit, the transition period will ensure no effective change in terms of access to EU programmes, including EHIC, thus highlighting the benefit of a Brexit with a deal rather than a no-deal Brexit scenario.

Under the Good Friday Agreement, all the people of Northern Ireland are recognised as having the birthright to identify themselves and be accepted as Irish or British, or both, as they so choose, and accordingly the right to hold both Irish and British citizenship.In view of the various adverse effects of a no-deal Brexit outcome for EU citizens in Northern Ireland, among which is the loss of access to the benefits of EHIC when travelling to another member state, and recalling the relationship between the EU and the Good Friday Agreement, the Government is putting in place this measure in an effort to mitigate this loss to EU citizens, which includes Irish citizens as well as British citizens. The scheme will be based, as far as possible, on the rules that apply under EHIC. For example, the applicant must not travel for the purpose of receiving planned healthcare, and any co-payments which apply to residents of the country being visited will not be reimbursable.

Presentation of an EHIC by an EU citizen travelling to another member state, issued under governing EU legislation, generally results in accessing healthcare at a significantly reduced or no-cost basis, which is, of course, of benefit to patients. Given the limited timeframe to the end of October, and the absolute imperative to have a scheme in place for 1 November, the immediate priority is to devise and implement an approach which ensures that in the event of a no-deal scenario occurring, eligible residents of Northern Ireland can have access to arrangements that allow for them to be reimbursed for the cost of healthcare which may become necessary while on a temporary stay in an EU or EEA member state.

The scheme to be implemented is one where a patient will pay upfront for treatment received at the point of delivery. They will then claim reimbursement directly from the HSE following their return home. My Department has requested the HSE to design and build the ICT and administrative systems necessary to implement this scheme. I am pleased to say that this work is well under way. It is envisaged that the operational aspects underpinning the scheme will include an online application portal, with the aim of providing a user-friendly, single-step reimbursement application process for eligible residents in Northern Ireland. In order to ensure compliance with the rules of the scheme and guard against fraud, it will also be necessary to provide a robust system of verification of applications, including validating the applicant's eligibility status, for example, proof of residence in Northern Ireland, and validation of reimbursement claims, for example, by the provision of appropriate receipts when applying for reimbursement.

Part 3 of the Bill is designed to amend the Childcare Support Act 2018 in order to make provision for British citizens to access the national childcare scheme on the same basis as Irish citizens. The latter is a national scheme of financial support for parents towards the cost of quality childcare. Once introduced, it will replace the existing targeted childcare schemes with a single streamlined and user-friendly scheme, providing both universal and targeted childcare subsidies. An issue could arise for British citizens living in Northern Ireland who wish to access the scheme in the State, and register their children with childcare providers here, and also for British citizens moving to here to live. In the event of an orderly withdrawal of the UK from the EU, British citizens will be treated as nationals of EU member states for the period of the transition. However, in the event of a no-deal outcome or in the longer term, the policy approach reflected in this Bill, consistent with the principles and intent of the common travel area, is to make provision for British citizens to access the national childcare scheme in the State on the same basis as Irish citizens.

The amendments in Part 3 put beyond doubt that British citizens will be eligible to apply for the national childcare scheme in the event of a no-deal Brexit. As such, it offers assurance to British citizens living in Northern Ireland who wish to access the scheme and avail of childcare services in the State, as well as British citizens moving to Ireland to live.

I will now briefly outline the main provisions of the Bill. Part 1, section 1, provides the Short Title of the Bill and provides for the commencement of the various parts of the Bill. Section 2 is a standard provision concerning the paying of expenses in respect of the administration of the Bill. Section 3 sets out the definitions required under Part 2 of the Bill.

Section 4 makes provision for the implementation of a scheme for the reimbursement of expenses incurred by eligible persons resident in Northern Ireland in respect of necessary medical treatment. Section 5 provides that the Minister may, with the consent of the Minister for Finance and the Minister for Public Expenditure and Reform, make regulations to provide for the administrative arrangements to give full effect to the provisions of Part 2. It also outlines the principles and policies the Minister shall have regard to when drafting the regulations.

Section 6 provides that the HSE, for the purposes of Part 2 of the Bill, may enter into arrangements with competent institutions in other member states. Such arrangements may cover matters such as the processing of reimbursements, the calculation of the value of medical expenses to be reimbursed, the exchange of information between the two bodies and the facilitation of other administrative and technical co-operation in respect of the reimbursement of medical expenses.

Section 7 provides that the HSE may have regard to the decisions of the Administrative Commission for the Coordination of Social Security Systems in respect of the operation and administration of the EHIC as operated under EU Regulations 883/2004 and 987/2009. Section 8 requires the HSE to carry out a review of the operation of the Act not later than two years after its commencement and that the Minister must lay that review before the Oireachtas not later than one month after the report is received.

Part 3, section 9, provides for the definition of "principal Act" for the purposes of Part 3. Section 10 provides for an amendment to section 7 of the Childcare Support Act 2018 to make explicit reference to the eligibility of a British citizen to apply for financial support under the Act. Section 11 is a consequential amendment to section 15 of the Childcare Support Act to provide that payment will not be made where the person does not satisfy the eligibility criteria in section 7 of the 2018 Act, as amended now by section 10 of this Bill.

Statutory regulations will also be required in respect of Part 2 in order to define, as necessary, the administrative arrangements for the direct reimbursement scheme. Officials from my Department will progress the drafting of these regulations, in conjunction with the Office of the Attorney General, over the coming weeks. Officials from my Department are also working with the HSE, in tandem with drafting the detailed regulations, to finalise the development of an application process that can take account of the administrative, operational and validation aspects necessary to deliver on the Government's objective.

The provision of benefits similar to those available under EHIC to eligible residents of Northern Ireland has been identified by Government as a clear priority in the context of contingency planning for a no-deal Brexit. I greatly appreciate, therefore, the urgency this Bill is being dealt with and I thank Senators in advance for facilitating the smooth passage of the Bill.

From a healthcare perspective, the purpose of the Brexit omnibus legislation passed by this House and the Lower House in April was to ensure that the reciprocal arrangements could continue North, South, east and west. In many ways, this legislation is going one step further because it is not just looking at the reciprocal arrangements North, South, east and west but also at the rights and eligibility of people in Northern Ireland when they travel to the EU outside of Ireland for the purpose of healthcare. That is very welcome. It is this State stepping up to the mark in making sure that we look after people in Northern Ireland if and when the UK leaves the EU. That is even more important in the context of the Good Friday Agreement and in the context of the fact that a majority of people in Northern Ireland did not vote to leave the European Union. I commend the Bill to the House.