EU citizens may have been wrongfully charged for NHS treatment, IMA finds

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:

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.”

Citizens’ rights body has recommended changes to health insurance card process

The Independent Monitoring Authority for the Citizens’ Rights Agreements (IMA) has the right to take action when it thinks that there are systemic issues which are affecting how the rights of EU citizens are being upheld by public bodies.

Following Brexit, citizens from the 27 EU countries and the EEA EFTA countries of Iceland, Liechtenstein and Norway living in the UK have to apply for UK-issued European Health Insurance Cards (EHIC) to ensure they have valid health insurance when they travel in the EU.

Earlier this year the number of people applying for the new UK EHICs appears to have overwhelmed the system with significant backlogs potentially resulting in difficulties for these citizens in accessing healthcare.

Citizens also reported that communication about the delay was reactive and mostly via social media leaving many uncertain about what was happening with their application.

The IMA wrote to both the Department for Health and Social Care (DHSC) and the NHS Business Services Authority (NHSBSA) about our concerns that citizens were experiencing difficulty in being able to obtain a health insurance card which could lead to issues for them if left the UK and then travelled to the EU and needed medical care.

As a result of our correspondence, DHSC and NHSBSA have agreed to implement a number of changes, the majority of which have now been completed.

These were to:

  • Add information about processing delays to the website to help manage expectations until the backlog is reduced.
  • Strengthen information about what to do whilst waiting for your EHIC including applying for a Provisional Replacement Certificate (PRC), if eligible, on the website.
  • Continue to issue proactive statements on social media sites should delays occur.
  • Add a message to the automated telephone system used for telephone applications to advise about the delays.

The NHSBSA has also advised of its plan to deal with the backlog of applications.

Chief Executive of the IMA, Dr Kathryn Chamberlain said:

“This is an important milestone for the IMA and one that I hope will make a real difference to the lives of EU citizens living in the UK. We are clear public bodies should be protecting the rights of citizens and where we see problems we will not hesitate to act.

“I am pleased that the DHSC and NHSBSA were responsive to our recommendations and note that the majority of changes have already been put in place. Where possible we will always try to work with public bodies to make changes needed as this will be the quickest way of making a difference to people’s lives.”

The IMA has informed those who made a complaint of this early case resolution of the outcomes and will continue to monitor the new UK EHIC application process for the next six months and provide a further update at that time.