I am pleased to join the committee to discuss the regulations. It remains the Scottish Government’s clear position that the interests of Scotland would best be served by remaining in the European Union. The devastation to the worldwide economy that has been caused by Covid-19 has served only to strengthen that view.
However, as a responsible Government, we are duty bound to make necessary preparations to ensure that the Scottish statute book remains operable at the end of the transition period on 31 December this year.
At present, under the European cross-border healthcare directive, European Economic Area citizens have the right to obtain healthcare services in other EEA countries. However, the treatment must be the same as, or equivalent to, treatment that is provided by their home state. The patient pays for the treatment up front, and may claim reimbursement that is limited to the amount that the same or equivalent treatment would have cost had it been provided by the state at home—which, for our purposes, would be in Scotland and on the national health service.
Healthcare is a devolved matter, so the National Health Service (Cross-border Health Care) (Scotland) Regulations 2013 implemented the directive in Scotland where necessary. Importantly, the 2013 regulations set out the need for prior authorisation to travel for expensive specialist treatment.
The Cross-border Health Care (EU Exit) (Scotland) (Amendment etc) Regulations 2019 provided a mechanism to ensure there was no interruption to cross-border healthcare arrangements for people accessing healthcare through the directive after EU exit day, in the event of there being no deal. That would have applied to member states that agreed to maintain existing reciprocal arrangements with the United Kingdom for a transitional period until 31 December 2020. Cross-border healthcare requires basic reciprocal arrangements in order to operate.
The 2019 regulations were originally due to take effect on 29 March 2019. However, as a result of the European Union (Withdrawal Agreement) Act 2020, that was suspended, as the UK continued to be subject to EU law until the implementation period completion date—11 pm on 31 December 2020. The 2020 regulations reflect that position.
European reciprocal healthcare arrangements are separate from cross-border healthcare. Existing reciprocal healthcare arrangements will remain extant until the end of the implementation period, when reciprocal arrangements that are set out in the withdrawal agreement for existing participants in the EEA and UK will come into force. Negotiations between the UK and EU on wider reciprocal healthcare arrangements after the implementation period are on-going.
European cross-border healthcare has not featured in the negotiations between the EU and UK. Therefore, when the implementation period comes to an end, it will no longer be possible for UK citizens, including Scots, to exercise previous EU rights in that regard. The instrument therefore terminates the existing cross-border healthcare arrangements that are in place between the UK and the EU.
However, the instrument protects patients who find themselves in a transitional situation on implementation period completion day. That includes individuals who obtained prior authorisation for planned treatment before completion day, but who have not yet obtained the treatment; individuals who accessed healthcare abroad prior to completion day, but who have not yet completed the treatment or sought reimbursement; and, importantly, UK state pensioners from Scotland who live in other EEA countries and who need to access healthcare that is provided by the NHS while in Scotland. Those time-limited measures aim to prevent a sudden loss of cross-border healthcare rights for Scottish residents and pensioners from Scotland who reside in the EEA.
We consider the amendments to be technical for the most part. I hope that members agree that, as part of the Scottish Government’s overall programme of legislative planning for EU exit, the Cross-border Healthcare (EU Exit) (Scotland) (Amendment) Regulations 2020 provide necessary changes to protect Scottish residents’ rights to access cross-border healthcare, as far as that can be achieved for—[Inaudible.]
We are, of course, happy to take questions on the draft regulations.