Brexit update - October 2019
An extension to the date by which the UK will leave the EU has been agreed. This date is flexible, but is currently set as January 31, 2020. During this time the UK Government says that it will continue to move forward on establishing and getting approval for the terms under which the UK will leave the EU. If this is achieved then the final exit date will be set. This date may be followed by a transition period, when trade deals and other negotiations will take place.
The European Health Insurance Card (EHIC) will continue to be valid during the extension period. This means that that the cost of dialysis and other medical treatment that an individual receives in the EU Member States and associated countries will continue to be covered. This may also continue during any transition period if no agreement has been reached on reciprocal healthcare arrangements by the exit date.
We do however recommend that people always take out appropriate travel insurance to cover aspects of healthcare the EHIC does not.
The current Withdrawal Agreement which was introduced to Parliament by Prime Minister Boris Johnson did not establish any replacement for the EHIC system. Instead, this was to be discussed during the transition period. At this point it is not possible to know what will be in any final Brexit deal
If the UK was to leave the EU without a deal despite this extension, the current situation is that the UK will try to secure deals on reciprocal healthcare with individual countries. They have currently done so with a number of countries including Spain and Ireland - healthcare coverage in specific countries.
If anyone has incurred costs in Spain already and had to pay for their dialysis at a public unit, we have been informed that this can be reimbursed via the NHS Business Services Authority on +44 (0) 191 218 1999 or on the NHS BSA website.
The UK Government had previously committed to provide support to the 180,000 UK nationals living in the EU who currently have their healthcare costs paid for by the UK for a six month period following a no-deal Brexit.
We will continue to monitor the situation and work to ensure people living with kidney disease are not at a disadvantage and can continue to travel to Europe without the threat of having to pay for their life-sustaining treatment.
Brexit update - September 2019
We know that many of you are wondering what will happen in kidney care after Brexit.
Update as of 23 September
The Department of Health and Social Care (DHSC) have announced today that in the event of no deal Brexit on 31 October 2019, contingency plans are in place for reciprocal healthcare arrangements. However these do not include kidney patients who wish or need to travel in Europe.
People already living in the EU who have their healthcare funded by the UK, including pensioners and students, will have their healthcare costs covered for six months if we leave without a deal. The UK Government has proposed to each EU Member State that, if we leave without a deal, existing healthcare arrangements should continue until 31 December 2020 in the same way that they do now.
Discussions are ongoing, but if arrangements with all Member States have not been finalised by 31 October, Health Secretary Matt Hancock, has today confirmed the Government will provide support to the 180,000 UK nationals living in the EU who currently have their healthcare costs paid for by the UK for a six month period following Brexit. This includes pensioners, students, those on disability benefits and UK workers temporarily posted in the EU. The Government has also committed to covering the costs of UK nationals in the EU who are in the middle of treatment when we leave the EU for up to a year.
Fiona Loud, Policy Director at Kidney Care UK, comments: "Whilst this announcement shows that some progress has been made on European healthcare arrangements, kidney patients who wish or need to travel in the EU remain in limbo. The government must sort reciprocal healthcare out for the good of all citizens, including kidney patients, after we leave the European Union."
We have been informed by the Department of Health and Social Care (DHSC) that the default position remains that we are leaving the EU on 31st October and therefore they are continuing to plan accordingly.
The government is procuring additional freight capacity, on which medicines and medical products, as ‘Category 1’ goods, have priority access. The Department of Health and Social Care (DHSC) is also leading a procurement exercise for an ‘express freight service’ to deliver medicines and medical products into the country, on a 24-48 hours basis.
NHS England has set out the measures the NHS is taking to prepare the NHS for a no deal EU Exit including the regional variations that will be felt across the country. Roadshows are in progress to communicate preparations to the NHS.
The Department will continue to work with charities, patient groups and other stakeholders to update them regularly as preparations progress. The DHSC has provided email routes to report any shortages of medicines or consumables. If you wish to report any shortages please let us know so we can pass your questions on.
It is very important that you continue to take out travel insurance if you plan to travel.
Planning exercises have been carried out in Kent for traffic management programmes for traffic getting through Kent but also to serve the NHS within the county.
Patients should be aware that there is a possibility of some drugs being swapped for another similar medication in the case of a shortage. It is not safe to swap an immunosuppressant without oversight from a kidney doctor. These are personalised medications prescribed to prevent transplant rejection, and should not be swapped at will. Great care, clinic visits and blood tests will be needed. If you are given any medication you don’t recognise, please refer to your kidney unit.
Kidney Care UK, alongside medical colleagues, have asked DHSC to ensure additional protection for transplant drugs to prevent any chance of this happening and await a satisfactory response. If you do experience any shortages there are dedicated Department of Health groups to report them to, and we are happy to on do this on your behalf
What has Kidney Care UK been doing?
Kidney Care UK takes part in the regular Department of Health and Social Care meetings and calls and shares the updates with you on our website.
We remain concerned about access to dialysis in the EU if we have a no deal Brexit. If there is a managed withdrawal there will be a transition period until December 2020 and you will be able to receive dialysis through the EHIC card. If there is no withdrawal agreement, and no reciprocal healthcare arrangements are made with EU countries before the end of October 2019 then UK haemodialysis patients will not be able to travel in Europe unless they pay. There is no travel insurance available for dialysis, because it is planned life-sustaining treatment for a pre-existing condition. We have worked with Sheffield University to get some clarity on the preparatory work in 5 selected EU countries and have just published this, a report outlining the impact a No Deal Brexit would have on dialysis care for kidney patients visiting selected EU countries.
We have recently written to 45 MPs to ask them to place health at the centre of Brexit negotiations and also to the new Minister with responsibility in this area, Edward Argar. We encourage you to write to your MPs also, copying us on their responses. Thank you to everyone who has done this so far; while Parliament was only open for 5 days recently there were 4 Parliamentary questions raised by different MPs about EHIC and dialysis.
Brexit news is everywhere but it is still not clear yet how it will affect citizens, especially kidney patients. There are several potential issues which may be caused by no deal being arranged, we have a summary of the issues on our page What a No Deal Brexit will mean for kidney patients
See our Open Letter on Brexit for kidney patients for more information
As you may know, we currently have an EHIC card (European Health Insurance Card) which enables dialysis treatment to be given free of charge in state-run units across the EU. This has been achieved by a reciprocal healthcare arrangement which, while not always perfect, is key to the ability to travel on dialysis.
For people who have kidney failure who need dialysis, the EHIC system is essential to allow them to travel in Europe and we are therefore eager to gain a clear picture of what is being done to secure this system after Brexit takes place and the UK leaves the EU.
Read the blog post from dialysis patient Nicola Hawkins, who writes about the life-changing access to healthcare granted by the EHIC.
Many thanks to Amanda Kirwan, who appeared on BBC Newsnight on 9 January to talk about what a no deal Brexit would mean to her. View an extract from the interview.
We need your help
To do this, we need your help to ensure that MPs are aware of the matter and recognise that it concerns a significant group of people. The more people who are prepared to write to their MP to raise this point, the more likely they are to raise it in turn; which will help keep EHIC on the agenda.
Write to your MP
Please write a letter to your MP to ask them to make sure EHIC is an integral part of negotiations. And please ask your family and friends to do the same. You can find your MP by clicking here and typing in your postcode.
Although the United Kingdom has given notice of its intention to leave the EU, we continue to be a member until Brexit actually takes place.
We would really like to encourage you to explain in your own words what it would mean to you if the EHIC system were lost and you were unable to receive dialysis free of charge when you travelled to Europe. Your personal views will allow MPs to understand why this is so important.
Please either send your note as an email or post your letter to the MP’s office .
Please send us a copy at firstname.lastname@example.org, Policy Director at Kidney Care UK, 3 The Windmills, St Mary’s Close, Turk Street, Alton GU34 1EF. Thank you to everyone that has done this so far.
The Healthcare (International Arrangements) Bill
The government has brought forward a new bill, the Healthcare (International Arrangements) Bill, which sets up the framework for people to continue to receive healthcare in EU countries after Brexit.
Kidney Care UK was invited to give verbal evidence on the Bill where we summarised some of the concerns for future travel for those on dialysis.
Previously, it progressed through parliament and our understanding is that it will help to provide the equivalent of EHIC and therefore dialysis when UK citizens travel in the EU.
The debate included discussion of dialysis being a reason to have this new law (see below).
Medications and Consumables
The government has prepared some updated information for patients on how they will continue to receive medicines and treatment if the UK leaves the EU without a deal on 29 March 2019. It states that there has been a comprehensive assessment of medicines supply to identify products that are manufactured the EU or wider European Economic Area (EEA) countries. It says that the Department of Health and Social Care has received very good engagement from industry on developing a six-week stockpile of prescription only medicines and pharmacy medicines to ensure supply for patients is maintained across the NHS. and has also secured contract agreements for additional warehouse space for stockpiled medicines, including ambient, refrigerated and controlled drug storage
You can read more on the government website (updated Jan 18 2019)
Meeting at the Department of Health and Social Care
Presently there are 29,000 people in the UK receiving dialysis treatment for kidney failure, and they have the right to travel freely. It is incredibly important that this continues, and so we are working to make policymakers, on behalf of kidney patients, and the media aware of the issue.
On the 14 September we attended a meeting with the Brexit reciprocal healthcare team at the Department of Health and Social Care.
A big thank you to Amanda and Stephen Kirwan and Maddy Warren who travelled to London with Policy Director Fiona Loud to explain to the DH how important it is to retain access to EHIC and travel in the EU after Brexit, and the practicalities of travel on dialysis. This fact-finding workshop will be followed up by another this year and Kidney Care UK were pleased that our concerns have at least been heard, although there is a very long way to go. The campaign for any future settlement to support the needs of kidney patients continues.
In August we wrote to the Secretary of State for Health, Matt Hancock, about our key Brexit concerns, and received a reply in September.
- Kidney Care UK letter to Matt Hancock - Brexit - 5 Aug 2018
- Matt Hancock reply to Kidney Care UK - Brexit - Sept 2018
We have given evidence about EHIC in two Parliamentary sessions, one of which was to the Health Select Committee. We were disappointed that the government response to it has been non-committal, and merely says that there will be some money set aside for staff to work on issues 'such as reciprocal healthcare’. We were encouraged by the stated wish to include reciprocal healthcare in a recent proposal developed at Chequers but nothing is clear yet.
We have met with and briefed a number of Members of the European Parliament (MEPs), who subsequently wrote a cross-party open letter to Jeremy Hunt to ask him to remember dialysis patients in the Brexit negotiations. This letter was picked up by the ‘I’ paper, the Independent and LBC radio. We have briefed the Conservative, Labour, LibDems and SNP MPs and written on several occasions to the Brexit Department and the Ministers for Brexit and Health.
However, as this, along with so many other Brexit issues, cannot be guaranteed, until or unless this is settled we will keep raising this issue on behalf of kidney patients, because the needs of people with long-term conditions will continue to cross borders. In the case of a hard Brexit we cannot know what the outcome will be.
We have received a letter from Sabine Weyand, the Deputy Chief Negotiator at the EU, who has told us that UK nationals would be treated as third country nationals after Brexit. However, she also said "Depending on the level of ambition of the UK, rights under the EHIC system may figure amongst the issues to discuss under the framework of the future EU-UK relations".
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