Date Published: 20.07.2023
Status: Past
Type: Equal Treatment / non-discrimination
Outcome: Early case resolution
Last Updated: 20.07.2023

Health and Social Care Charges for Applicants to the EUSS (Northern Ireland)

Summary of Information

In December 2022 the IMA wrote to the Department of Health in Northern Ireland (DoHNI), who are responsible for policy on health in Northern Ireland, and asked them to confirm how they ensured the rights of all EUSS applicants to free Health and Social Care (HSC) treatment were upheld?  HSC is the NHS equivalent in Northern Ireland.   

Whilst no particular concerns were identified in respect of the relevant legislation or guidance, having had regard to the publicly available information, the IMA was unclear as to the position in respect of charging EUSS applicants (in-time and late) and joining family members. 

Summary of Actions and Evidence 

Upon receiving correspondence from the IMA, DoHNI confirmed that:  

  • Those in receipt of Certificates of Application (CoAs) are entitled to healthcare on the same basis as those with status under the EUSS, and in some circumstances an acknowledgement of receipt of application (where e.g., there was a delay in issuing a CoA) would be sufficient to allow access to healthcare, provided the individual meets the ordinary residence test. 
  • Joining family members in their first 3 months of residence in the UK would be entitled to free healthcare on the same basis as those with status, subject to meeting the ordinary residence test. 
  • It would strengthen its operational guidance and ensure appropriate dissemination amongst staff. 
  • It would review whether any erroneous charges had been made, explain its procedures in place to prevent errors and how it could remedy any if found.   


In correspondence with the IMA, DoHNI has also confirmed that:  

  • There have been no erroneous charges for healthcare. 
  • It has robust procedures in place to prevent erroneous charges and remedy them if any errors did occur. 
  • It has updated the operational guidance to provide more clarity around the position of pending applicants and joining family members. 
  • It has published the amended guidance and ensured relevant staff across all HSC Trusts are aware of the guidance and the updates. 

Summary of Decision

Based on the actions that DoHNI has undertaken, the IMA believes that the potential concerns identified are resolved with the issue concluded as an Early Case Resolution.   

For the avoidance of doubt, this decision does not prevent the IMA from acting further should matters of concern arise in relation to the charging of EU and EEA EFTA citizens with rights under the Citizens’ Rights Agreements for HSC care. The IMA would encourage affected citizens to continue to report any issues, whether related to this issue or otherwise.  

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