Letter from DHSC to the Department of Health Ireland on the reciprocal health measures in place between the UK and Ireland, 26 November 2021 (text only)


From:

Clara Swinson

Director General Global Health

Department of Health and Social Affairs

UK

For:

Muiris O’Connor

Assistant secretary

R&D and health analytics

health department

Ireland

Exchange of letters in accordance with paragraph 9.2 of the common travel area Protocol of agreement

Dear Muiris,

I have received your letter of 25 November 2021 regarding the Memorandum of Understanding between the Government of the United Kingdom of Great Britain and Northern Ireland and the Government of Ireland regarding common healthcare arrangements in the travel zone (in recognition of residence-based health systems) (“the call to action Health care Protocol of agreement‘) signed on December 18, 2020. I agree on the need to review the provisions of this Protocol of agreement in the context of the provisional application from 31 December 2020 of the Trade and Cooperation Agreement between the European Union and the European Atomic Energy Community, of the one part, and the United Kingdom of Great -Britain and Northern Ireland, on the other hand (“the ATC“), as indicated in point 9.2 of the call to action Health care Protocol of agreement.

I can confirm that after reviewing the provisions of the call to action Health care Protocol of agreement and the provisions relating to the reciprocity of health care ATC and after engaging and clarifying discussions between Irish and UK officials, the call to action Health care Protocol of agreement continues to be fully appropriate and no changes are required. However, I agree that it is necessary to confirm that, unless otherwise specified below, the provisions of the ATC take precedence over the call to action Health care Protocol of agreement.

From our helpful discussions, we understand that:

  1. the eligibility documents indicated in Annex A of the call to action Health care Protocol of agreement is recognized in addition to the eligibility documents prescribed in ANNEX SSCI-2 of the ATC for the purposes of proving eligibility for necessary healthcare in the UK or Ireland as a visitor and proving eligibility for comprehensive healthcare in the UK or Ireland as a cross-border/cross-border worker

  2. the eligibility documentation of an eligible person over the age of 18 is recognized in lieu of the documentation of an eligible person under the age of 18, in cases where the latter is dependent on the former and seeks the necessary health care, as indicated in sub-paragraph 3.3 of the call to action Health care Protocol of agreement

  3. the eligibility documents set out in Appendix A may not be sufficient for reimbursement of immigration health costs under the ATC, although these documents remain valid when a person who has benefited from reimbursement seeks to justify his right to health care. Where this requirement could cause short-term issues due to historical arrangements in place between the UK and Ireland regarding S1 documentation, it is expected that the UK and Ireland will work together to identify alternative documentation requirements on a temporary basis.

  4. cross-border ambulance cooperation agreements as defined in paragraph 3.2.b.ii of the call to action Health care Protocol of agreement will continue to be respected

  5. cross-border/frontier workers residing in the UK may apply for means-tested access to be an eligible patient in their own right under the Irish healthcare system, as set out in paragraph 5.2 of the call to action Health care Protocol of agreement

  6. cross-border/cross-border workers residing in Ireland who are British or Irish citizens and who are insured on the basis of their employment in the UK are eligible to access assisted reproduction services in the UK to the extent that these services are available for a local resident in the UK health commissioning area where they are employed and on the same basis as a local resident in that area. Should state-provided assisted reproduction services become available in Ireland at a later time, reciprocal arrangements will be made for eligible UK resident cross-border/frontier workers who are insured in Ireland on the basis of employment in Ireland can access these services on the same basis as a local resident

In the event of a reduction in the reciprocal health coverage offered by the ATCany relevant provision of the call to action Health care Protocol of agreement will apply, while a review of the call to action Health care Protocol of agreement may also be appropriate to ensure that the general objectives set out in its recitals continue to be achieved.

The United Kingdom of Great Britain and Northern Ireland remains committed to the enduring relationship between the United Kingdom and Ireland, which is represented in the call to action. Thank you and your team for your continued cooperation in reciprocal healthcare and I am ready and willing to continue our work together for the benefit of the UK and Ireland.

Cordially,

Clara Swinson,

Director General Global Health
Department of Health and Social Affairs

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