NHS: Brexit Will Cost £500m A Year for Health Service

Yes, yes, we know that Boris Johnson promised the NHS £350m a week but Brexit could actually end up costing the health system £500m a year. A report from the NHS-led Brexit Health Alliance found that if we don’t maintain reciprocal healthcare rights for UK and EU citizens there will be extra costs and financial burdens for the already cash-strapped health service.

Tit for Tat

Reciprocal healthcare arrangements give citizens from the EU and the European Economic Area, including Switzerland, access to health and social care anywhere in the EU for the same prices paid by local citizens.

There are four parts to the arrangements: the S1, S2 and S3 schemes and the more familiar EHIC – the European Health Insurance Card (left).

Losing those arrangements would make the healthcare of every UK citizen living in or visiting the EU fall back to the NHS.

Those citizens would have to buy expensive insurance or return to the UK for treatment, which is not always possible in emergency situations. If they choose to return, the NHS would face greater financial, staffing and ward pressures.

The health service would also come under strain from EU citizens no longer having free access, as there would need to be a cost recovery process for each EU patient. That is an administrative process where the NHS recoups the cost of treatment from the patient’s home country.

Doing that for the 3.2m EU citizens living in the UK and the 26m EU visitors each year would require an extraordinary amount of administrative resources and would increase the burden on frontline doctors and nurses who gather the appropriate legal data.

We know that cost recovery isn’t easy: the NHS already struggles to do it for non-EU citizens treated in the UK.

It’s estimated that only £500m of the £1.8bn spent each year treating foreign visitors is actually recoverable but the reality is that we collect just a fraction of that – around £100m a year at best, without the cost of recovery taken into account.

Those numbers won’t improve if the recovery workload explodes because of a “no deal” Brexit and if austerity measures continue to ravage the NHS.

If we leave the reciprocal healthcare agreements without having the personnel to recover costs, the NHS will haemorrhage money.

Reality Cheque

Leaving like that is a real possibility, especially with “no deal” being bandied about by prominent Tories. The British Medical Association has begged the UK Brexit negotiators to prioritise the EHIC and S schemes during their negotiations.

So far both sides have agreed that UK expat pensioners in the EU should retain their health access after Brexit but that is only provisional. No concrete or wider deal has been reached as it’s nearly impossible to keep such arrangements if the UK abandons freedom of movement and the single market.

The UK needs to keep the existing agreements or quickly form new ones in the Brexit negotiations. The worst case according to the NHS confederation would be a no deal “cliff-edge scenario” where the schemes will be entirely abandoned.

“The impact of the loss of reciprocal care on patients would be significant, especially given the number of beneficiaries that are pensioners living abroad,” the confederation warns.

“Evidence given to the House of Commons health select committee has suggested that many of them will be unable to fund private healthcare and so will be forced to return to the UK.”

Importantly, it costs the UK much less to treat its citizens abroad than it does to treat them at home. “This is due to both lower costs of care and to the use of co-payments in other healthcare systems… under existing reciprocal arrangements, on average it costs £2,300 to treat a UK pensioner in the EEA, significantly less than the average cost of £4,500 for treatment in the UK.”

By recklessly leaving the reciprocal healthcare schemes, the NHS could be saddled with 190,000 expat pensioners returning from the EU and the financial strain of those patients costing twice as much to treat domestically. It would face paying the healthcare costs of another 1m UK citizens living in the EU, and its already stretched staff and resources would be burdened with cost recovery from EU patients. In the end, a “no deal” Brexit could cost us far more than £500m – the true price may well be the viability of the NHS itself.

 

by Jo Davey

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