Brexit would affect Britons’ healthcare rights

by George Peretz and Panos Koutrakos | 29.03.2016

Over one million Britons live in another EU country – and many more go abroad for shorter periods. But whether it is for work, retirement, or just tourism, people travelling within the EU need to know they will be able to access medical care should the worst happen.

EU membership gives UK citizens a wide range of enforceable rights, including access to healthcare. Brexit could remove those rights.

First, EU law provides British tourists who travel in the EU, European Economic Area or Switzerland with a safety net. A British holidaymaker in, say, France has the right to seek emergency treatment under the same conditions that French patients enjoy. This right is attested by the European Health Insurance Card, available to British citizens free of charge. Anyone with experience of seeking emergency healthcare in countries like the United States will appreciate its value.

It’s not only British tourists who benefit – any British citizen has the right to seek medical treatment in any other EU country. If the treatment is necessary and available on the NHS, and if the NHS agrees – as it must if the waiting list is longer than medically advisable – the UK system will reimburse the cost of the treatment.

In addition, British citizens working and living in any other EU country have access to local healthcare on the same basis as citizens of that country, and at the host country’s expense.

British old age pensioners living in another EU country also have the right to healthcare there, which the UK ultimately pays for.

This system benefits British citizens in practical terms, and it does so without increasing the financial burden on the NHS. For instance, reimbursement is capped at the cost of the equivalent treatment on the NHS, and the NHS can seek reimbursement from (for example) France if it provides emergency healthcare to a French tourist.

Under EU law, the NHS is also required to provide and pay for treatment for – say – a German working in London. But then that person will have been paying taxes in the UK. In general, since EU workers in the UK tend to be younger and healthier than the average UK resident, they tend to pay more in tax than they take out.

If anything, the NHS has benefited from this set of arrangements – NHS trusts have sent patients to hospitals in other EU member states in order to reduce waiting lists since 2002. Some studies show that NHS has benefited financially from medical tourism.

So Brexit could undermine the rights that British citizens currently enjoy. The post-Brexit agreement that the British government would have to negotiate with the EU could of course cover some of them. But the scope, depth and duration of such arrangements are highly uncertain. And the agreement might well not provide for tourists, or for patients keen to avoid waiting lists in this country.

The healthcare rights we enjoy under EU law are specific, practical and make a difference. The risk of losing them illustrate clearly the dangers of Brexit. We might manage to negotiate to keep them – as Norway and Switzerland do. But that could not be guaranteed. Other options, such as the Canada model, would have a significant adverse impact on the welfare of British citizens, whether they are visiting or working abroad or simply wanting the option to be treated elsewhere in the EU.

George Peretz is a QC specialising in EU and public law. Panos Koutrakos is Professor of European Union Law at City University London and a barrister at Monckton Chambers.

Edited by Geert Linnebank