As part of its monitoring work, the IMA became aware that some health bodies within the UK may have been charging applicants who were later unsuccessful to the EUSS for treatment received during the period in which their application was being determined.
The IMA considers that this is incompatible with the Withdrawal and Separation Agreements which provide for rights which apply to EU and EEA EFTA citizens and their family members during the period in which their application to the scheme is being determined.
The IMA is currently working with the UK and devolved governments to establish whether patients have been incorrectly charged, how many people may have been affected and how they will be reimbursed. The IMA will also meet regularly with representatives from relevant departments to monitor the progress of this work.
As a result of the IMA’s work so far, the following progress has been made:
- Department of Health and Social Care: New legislation came into force in England on 18 February 2023 to amend the NHS Charging Regulations to remove provision which allowed for the charging of unsuccessful late applicants. Guidance on implementing the overseas visitor charging regulations has also been updated to reflect the changes to the NHS Charging Regulations.
- Welsh Government: New Legislation came into force in Wales on 1 February 2023 to amend the NHS Charging Regulations to remove provision which allowed for the charging of unsuccessful late applicants. Guidance on Hospital charges for overseas visitors: implementing EU Exit amendments has also been updated to reflect the changes to the NHS Charging Regulations.
- Scottish Government has confirmed that EU and EEA EFTA citizens who were living in Scotland on or before 31 December 2020 are able to access NHS healthcare on the same basis that they were prior to EU exit. It has also undertaken to review the information available on the Scottish Government and NHS inform websites to consider what additional information it could usefully provide for applicants to the EUSS scheme. It also confirmed that no issues of wrongful charging have been identified.
- The Department of Health (NI) has confirmed that the operational process to determine eligibility to access publicly funded healthcare in Northern Ireland, differs from other parts of the UK. Residence and eligibility are determined at the GP application and registration stage, with the result that an EU, EEA or Swiss patient who had registered with a GP before 31 December 2020 would not have to prove EUSS at a later date, except where they change GP.
Pam Everett, IMA Director of Operational Delivery said:
“The IMA has an important function to monitor how UK public bodies are protecting the rights of EU and EEA EFTA citizens and their family members and to promote the effective application of their rights.
“In this case, we have identified an issue that has the potential to affect many citizens and we are engaging with the relevant authorities to rectify it. We appreciate that it will take some time to gather information on the size and scale of the potential problem due to the localised nature of NHS bodies, so we are working closely with the relevant authorities to ensure that anyone who has been wrongfully charged will be reimbursed.”