An update on Brexit

Travelling on dialysis

The government has now introduced a law for future healthcare arrangements, called the Healthcare (European Economic Area and Switzerland) Arrangements Act. This sets up a framework for negotiating healthcare with other countries in Europe; people on dialysis can currently receive their dialysis when they travel using this arrangement, with an European Health Insurance Card (EHIC). During the debates on this bill, the needs of kidney patients were raised, using verbal parliamentary evidence Kidney Care UK had previously given. Please note that while we welcome this development, it is a framework only and not an actual arrangement. 

This is an extract from a speech by Julie Cooper, MP for Burnley, making the case for the future of EHIC;

“These arrangements, which give full peace of mind for healthcare, must be protected.

I remind the House of the evidence given by representatives of Kidney Care UK. We heard that 29,000 people in the UK are dependent on dialysis, which involves three five-hour sessions per week to ensure survival. Under the current arrangements, if those people choose to holiday in the EU, they can easily pre-book slots for dialysis, with Kidney Care UK saying that that “means that people are able to go away with the confidence that they will be able to be supported and receive the treatment they need." [Official Report, Healthcare (International Arrangements) Public Bill Committee, 27 November 2018; c. 12, Q39.]

That also means that they and their families are able to get a much-needed break. Kidney Care UK also made the point that

“it is easier to go away for two weeks in Europe and take a break in that way than it is to get two weeks in a UK unit”––[Official Report, Healthcare (International Arrangements) Public Bill Committee, 27 November 2018; c. 14, Q43.]

Based on that evidence, the Minister concluded at the time that without a continuation of these arrangements it would be more or less impossible for sufferers of kidney disease to travel. I totally agree, and I am delighted that the Government appreciate the urgency of the situation in which we find ourselves and are giving their full support to this amended Bill. That is important because we may yet leave the EU with no deal, and there will be many British citizens listening nervously to this debate because they have already booked holidays—some of them will be departing at the weekend or in the coming weeks. However, they can now be reassured that the legislation will pass without further delay.

I reassure Baroness Chisholm that the main Opposition priority is always to ensure that those who need care get it. Further to that, we are right in the first instance to protect the rights that UK citizens already enjoy. In short, we must protect our rights to reciprocal healthcare in Europe before we seek to acquire global healthcare provision. Similarly, those UK citizens who have retired to the EU will be relieved to know that treatment for chronic health conditions and ongoing health support will continue to be provided for them, as it is now, without interruption.”

The full debate is on the parliament website

Next steps

The government has now written to each country to offer to make a healthcare arrangement with them, whether or not we have a deal. It is believed that Spain and Portugal are moving forward with creating their own legislation to make this happen. As of today there are no future arrangements but we will let you know if this changes and working closely with the Department of Health and Social Care so that they know how important this is to those of you who have holidays already booked. 

Medications and supplies

We have spoken to a number of suppliers, kidney healthcare colleagues and the Department of Health and Social Care. They all say that they have plans in hand, have taken advice, and as appropriate have reserved space using the additional transport routes which have been made available by ferry and air. 

Please continue to let us know about any shortages or issues you experience with your medicines or dialysis supplies. 

Serious shortage protocol

You may remember that we are concerned about a change to the law which made it possible for pharmacists to reduce or swap medicines if there is a serious shortage. For certain anti-rejection drugs this could be problematic. The following drugs should not be swapped without specialist advice: the group of medicines which act as calcineurin inhibitors, (CNIs) such as Tacrolimus and Cyclosporine and the mTor- inhibitors (mTORis) such as Sirolimus and Everolimus. 

With the Renal Association and Clinical Reference Group we offered to supply specific guidance and have now heard back from the Lords Health Minister Baroness Blackwood. She has asked the Department of Health and Social Care to meet us to discuss how this can be achieved and a meeting is planned.