HEALTHCARE arrangements between the UK and Europe could face a major shake-up if Brexit negotiations put an end to free movement.
For more than a decade, the European Health Insurance Card (EHIC) has guaranteed UK residents access to state-provided healthcare during a temporary stay in another European Economic Area (EEA) country or Switzerland, and provided the same rights to residents of those countries visiting the UK.
The arrangement means that a Scottish holidaymaker who suffers an illness or injury in Spain is automatically entitled to be treated by the country’s health service on the same basis as a Spanish resident, either at a reduced cost or in many cases for free, while the various member countries reimburse one another for the cost of having their residents cared for abroad.
The Brexit vote has led to warnings that travel insurance for Britons holidaying in Europe could “skyrocket” if EHIC becomes unavailable and insurers find themselves liable for medical treatment that might previously have been free.
However, advocates of Brexit said it could save UK taxpayers millions in “health tourism”.
Vote Leave said the UK has paid £6.2 billion since 2007-08 to other EU countries for giving health treatment to British citizens, but recouped only £405 million from EU members for treating their residents in the UK.
Critics insisted the figures were “hugely misleading” since British tourists and pensioners retired on the Continent were big users of EU health services, and there are far more British pensioners living in Europe than Europeans retired in Britain.
However, there have also been fears the NHS is recouping only a fraction of what EHIC costs it. In 2013-14 it was reimbursed just £50m for treating European tourists on the NHS, less than 20 per cent of the actual bill.
Leaving the EU would not necessarily mean an end to the EHIC arrangement, however, depending on the terms of the Brexit deal.
The insurance scheme is an EEA, rather than an EU, initiative, which means that countries which are non-EU but EEA members – such as Iceland and Norway – take part. However, a core plank of EEA status is the right of free movement, which would be at odds to efforts to crack down on immigration from Europe.
Switzerland, a non-EU and non-EEA country, offers EHIC under its own bilateral treaties with the EU, but has also guaranteed free movement in exchange for access to the single market.
A vote by Swiss citizens to set a cap on EU immigration, due to be put into law in February 2017, has led to warnings it will be excluded from the single market, likely spelling the demise of EHIC for Swiss residents.
So-called “special” member states like the Channel Islands take part in EU freedom of goods but not labour, services or capital - but nor do they participate in EHIC.
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