The effects of Brexit on healthcare of British expats and inpats to the UK.

British Prime Minister Theresa May has said she will formally invoke Article 50, the two-year mechanism for exit from the EU, by the end of March 2017. As this deadline draws closer many British expats and non–British EU citizens living in the UK are voicing concerns about what effect Brexit will have on them and their families.

The UK’s future relationship with the EU following Brexit is still unknown. Nothing will change overnight. Britain will remain an EU member until Article 50 negotiations have concluded. After which point  the treaties that govern membership of the EU will no longer apply to the UK.

During the negotiation stage, British expats and EU inpats to the UK may experience little in the way of change. The UK will still be bound to adhere to EU policy, meaning that European Economic Area (EEA) nationals can enter the UK and remain there as workers, students or self-sufficient people.  Likewise, the rights of British expats living and working in other EU countries will remain unchanged.

However, the unknown is what will happen after the exit process concludes. EU citizens in the UK and British expats residing throughout the EU are understandably worried about their future. Amid this environment of turmoil, preparation and stability are key factors.

There are approximately 3 million non-British EU citizens living in the UK whose futures have been thrown into question due to Brexit. Of major concern is how their healthcare needs will continue to be met.

The impact of Brexit on health services is impossible to forecast. Currently EU citizens residing in Britain are entitled to receive treatment via the British National Health Service (NHS), post Brexit, automatic access to this service may be curtailed or cut altogether.

Brexit coincides with a period in which the NHS is facing operational and financial pressures. An economic shock in the aftermath of Brexit could mean the UK has less money to fund the NHS service.  Pre-referendum, the British treasury stated that a vote to leave the EU would result in ‘an immediate and profound economic shock, creating instability’ and that in the longer term the UK ‘would be permanently poorer’.

Simon Stevens, the chief executive of NHS England stated, “It would be very dangerous if at precisely the moment the NHS is going to need extra funding actually the economy goes into a tailspin and that funding is not there”.

If cuts in NHS funding are realised, the implications for an already struggling NHS would be significant. EU citizen’s resident in the UK are naturally concerned that without the protection of EU law, their access to NHS services may be limited or withdrawn.

The NHS is the UK’s largest employer, however in recent years it has struggled to recruit sufficient staff to operate the service. A shortfall of 50,000 full-time equivalents was reported in 2014. By 2020, the NHS is expected to face a shortage of around 16,000 primary care physicians. By 2022, nurse shortages are expected to reach 100,000.

This skills shortage has led to a heavy dependence from an overseas workforce, with over 10 percent of the NHS workforce currently employed from within the EU.

The need to recruit staff from other EU countries leaves the NHS in a precarious position when the UK exits the EU. If there is uncertainty surrounding the visa status of employees, Brexit may make recruitment from the EU more difficult for the NHS.

Professor Jane Dacre, president of the Royal College of Physicians, stated “healthcare professionals from Europe and around the world … are feeling anxious and confused about how welcome they are and will be in the future.”

Post-Brexit staff shortages coupled with funding cuts may lead to instability and poorer quality NHS service for both UK nationals and UK inpats.

Currently there are approximately 1.3 million British expats living in other EU countries. Under EU rules, they along with the 3 million EU citizens living in the UK have access to some free health care.

EU citizens are entitled to a European Health Insurance Card (EHIC), which gives access to health care during a stay in another EEA country. Under the EHIC scheme medical costs are reclaimed from the visitor’s country of residence via reciprocal health care agreements.

Health agreements such as these may cease to exist post-Brexit. Individual agreements may have to be made between the UK and each EU state, to agree on how British expats and EU citizens in the UK will receive health care.

An unintended consequence of Brexit, and further draw on NHS resources, could be a surge in the number of British expats returning to the UK. Campaigners for British expats, settled in Spain and France, have warned that Britons living in Europe may be forced to return to the UK unless the UK government can guarantee their healthcare will continue to be reimbursed by the NHS.

With reduced access to healthcare provision, British expats and EU citizens living in the UK will need to ensure they have adequate provision for private healthcare.

The EHIC does not replace healthcare cover. Instead the healthcare agreements between EU countries only provides for emergency medical treatment, and not cover for other associated costs such as repatriation, accommodation, out-patient services etc.

For peace of mind, it is essential that expats consider an international health insurancehealthcare plan. This is primarily aimed at expats who are living outside of their home country for an extended period of time.


Andy Seale, Head of Global Business at Allianz Worldwide Care, points out that the EHIC scheme “is not sufficient for expats on long stay assignments whose day-to-day or emergency healthcare needs will be very different”.

International health insurance “guarantees access to the highest level of healthcare cover for both routine checks and emergencies, with no ambiguity on service availability over the short, medium or long term” Seale stated.

Expats need to be prepared and make provisions for their healthcare needs, “They should examine their options to ensure they are prepared for whatever happens. As a rule, British expats and companies with teams based elsewhere in Europe should consider iPMI as the most robust healthcare solution.” Seale continued.

At Allianz Worldwide Care our international health insurance plans include cover for day-to-day medical expenses like visits to the doctor, as well as planned surgery, emergency treatment, maternity cover, out-patient care and dental plans, depending on the level of cover chosen. When you take out a health insurance plan for the first time, there will be waiting periods applied on certain medical conditions which can range from 10 months to 18 months depending on the condition.  It is important for people to be prepared.

Our healthcare plans include cover for chronic and congenital conditions and a wide range of pre-existing conditions, often without any additional exclusions or additional cost. We offer cover that is designed to be flexible, and allows expats to create a plan that best suits their needs.
 

• Fast access for all our members to treatment at a choice of private hospitals, with top of the range facilities and private ensuite rooms with our Classic and Premium plans at a time and place that suits you
• If your child is hospitalised in the UK, you have cover to send them to the best hospital and we will also pay accommodation costs for one parent staying in hospital with them
• Avoid the queues for NHS GP’s and go to a private GP at a time and place that suits you, where our Gold and Silver Out-patient plans offer a full refund on the doctor fees and all prescription costs and Bronze and Crystal refund up to €1,000/£830 per annum
• Avoid the queues for a consultant at the NHS and go faster to a Private Specialist, at a time and place that suits you
• Outpatient diagnostic tests prescribed by your private GP or specialist are fully refunded on all our Individual plans
• Repatriation for medical treatment back in your home country if you require
• Repatriation of human remains and travel costs of insured family members in this event of a death
• For a full list of benefits visit International Healthcare Insurance Benefits.

The prognosis for the healthcare provision of British expats and EU inpats to the UK in a post-Brexit world is unknown. These are early days, over the coming months and years clarity will ensue and a better perspective on the realities of Brexit will develop. But one thing is certain. “Brexit means Brexit”, the UK is leaving the EU, and expats need to be prepared for whatever the future holds.

Our international health insurance plan will give individuals and families peace of mind and confidence that their health, well-being and medical expenses will be covered while they live, work and study overseas. To get a quick quote for you or your family, click here.

We help corporate groups and organisations of all sizes select the right combination of support and services for their health and wellbeing needs. For a corporate quote, click here.