NHS European Office

Reciprocal healthcare

nurses and baby

Under current EU law, EU citizens benefit from rights to reciprocal healthcare when they are in any of the European Union's 28 member states.

These rights apply whether they are travelling temporarily between EU member states, for example, on holiday or studying abroad, residing permanently or long-term in another EU country, or when travelling to another EU member state specifically to receive pre-arranged medical treatment.

Reciprocal healthcare after Brexit - written ministerial statement

The government issued a statement on 19 March clarifying the situation for UK citizens who require healthcare in EU / European Free Trade Association (EFTA) countries, and EU/EFTA citizens requiring healthcare in the UK, after the UK leaves the EU.

The UK government has proposed to EU and EFTA member states that, even in the event of a no-deal scenario, the existing healthcare arrangements should be maintained until 31 December 2020.  Legislation has been brought forward in the UK to enable this to happen. This would minimise disruption and give peace of mind, during this period, to citizens requiring healthcare.

However, if this proposal is not acceptable to EU / EFTA member states, UK citizens travelling, working or living abroad will need to ensure they have comprehensive health insurance after EU exit. In addition the government has already committed for a limited period to fund certain UK nationals already undergoing treatment in the EU.

Citizens of EU and EFTA member states already living lawfully in the UK on exit day will continue to be entitled to NHS treatment as now. There are no guarantees for people arriving in the UK after this date.

Read the statement in full, which contains detailed guidance covering a range of scenarios.

Brexit negotiations and the impact of a possible no-deal

Once the UK leaves the European Union, these reciprocal rights will come to an end, unless both the UK and the EU agree to continue or replace them.

Both sides in the Brexit negotiations have agreed in principle to preserve reciprocal healthcare rights, at least for those citizens already residing in another EU country. However, until the final outcome of the talks is known, uncertainty remains.

In the event that no agreement is reached between the UK and the EU to continue with the existing rights to reciprocal healthcare, the consequences could be severe, for both patients and healthcare providers.

The NHS Confederation, through its membership of the Brexit Health Alliance, has looked at what effect this might have on patients in the NHS.

Brexit Health Alliance

The Brexit Health Alliance is campaigning for continued access to reciprocal healthcare rights post-Brexit.

This paper from the Alliance outlines how the current reciprocal arrangements work, the progress made so far in the Brexit negotiations and the implications of a possible no-deal or bad deal for both patients and healthcare providers.

Niall Dickson, chief executive of the NHS Confederation and co-chair of the Brexit Health Alliance, gave evidence to the EU Home Affairs Sub-Committee on Brexit, highlighting how both the Confederation and the Alliance is keen on maintaining EU-UK reciprocal healthcare arrangements post-Brexit. Watch a video recording of his evidence.

Blog posts

In October 2017, we published a series of blog posts in which patients and clinicians related their experience of how current reciprocal healthcare arrangements work for them and what the possible consequences might be should these arrangements no longer be in place post-Brexit.

  • The first of our blogs is from dialysis patient Nicola Hawkins, who describes how the right to access state-provided healthcare across the EU via the European Health Insurance Card (EHIC) has given her a better quality of life, as it allows her to travel on holiday to other parts of Europe, knowing that her dialysis healthcare is covered.
  • In this blog, Professor Chris Chapple, consultant urologist at Sheffield Teaching Hospitals and coordinator of eUROGEN, a European Reference Network for rare urogenital diseases, outlines why the UK's decision to leave the EU must not jeopardise patients' access to the best possible care, regardless of where they happen to live.
  • Rob Johnson was diagnosed with motor neurone disease in 2011. He and his family reside in France and in this blog, Chris James, director for external affairs at the MND Association, explains how Rob's healthcare needs are catered for by the French healthcare system and how his family is concerned that a no-deal outcome in the Brexit negotiations will be detrimental to his quality of life.
  • Professor Helen Cross, coordinator of EpiCARE, a European Reference Network for rare and complex epilepsies, writes about the innovative work being done by the network and her concern that patients with rare and complex epilepsies will be denied access to European expertise and new treatments, should the UK no longer be able to participate in European Reference Networks post-Brexit.
  • In their joint blog, dialysis patient Amanda and her partner Stephen explain how the European Health Insurance Card has helped Amanda feel less trapped by her treatment, by allowing her to dialyse while abroad and that were the EHIC to be discontined post-Brexit, the psychological effect on her would be detrimental.
  • In this post, Prof. Jill Clayton-Smith, a clinical geneticist, who collaborates with colleagues across the EU on the diagnosis, management and treatment of rare diseases, voices her concern that leaving the EU could jeopardise these collaborative working arrangements, which are not only useful for clinicians and researchers, but vital for patients.

Other resources

  • Kidney Care UK has produced a comprehensive factsheet on the vital importance of the European Health Insurance Card (EHIC) system to kidney dialysis patients and why the present EHIC system should be continued in its current form post-Brexit.
  • The European Commission has released a series of video testimonials where patients and clinicians explain how the newly established European Reference Networks will help to treat and manage rare or complex conditions. The NHS leads a quarter of these networks, which bring together leading providers from across Europe to tackle medical conditions that require highly specialised treatment and a concentration of knowledge and resources.


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