European Union Committee
Brexit: reciprocal healthcare

13th Report of Session 2017-19 - published 28 March 2018 - HL Paper 107



Chapter 1: Introduction

Overview: reciprocal healthcare and Brexit

Chapter 2: How reciprocal healthcare works

The European Health Insurance Card (EHIC)

Box 1: The European Health Insurance Card (EHIC)

Figure 1: The four routes to reciprocal healthcare

The S1 scheme

Box 2: S1 scheme

The S2 scheme

Box 3: S2 scheme

Patients’ Rights Directive

Box 4: EU Directive on Patients’ Rights in Cross-border Healthcare

Box 5: Reciprocal healthcare reimbursements

Chapter 3: Reciprocal healthcare and citizens’ rights

UK citizens resident in the EU/EEA

EU/EEA citizens in the UK

Patients with diabetes

Dependents and children


Chapter 4: The Joint Report

Box 6: Personal scope of the Joint Report

UK citizens in the EU27 post-Brexit

EU27 citizens in the UK post-Brexit

The Joint Report in law


Chapter 5: The future relationship and reciprocal healthcare

Affected groups

Short-term visitors

Box 7: Features of the travel insurance market

Patients with long-term conditions

Box 8: Arranging dialysis abroad

Patients with rare diseases

People with disabilities

Table 1: Overview of agreement in principle on reciprocal healthcare rights

The effects of loss of reciprocal healthcare arrangements


Chapter 6: The implications of Brexit for the NHS and insurers

The NHS and healthcare providers

Box 9: Cost recovery in the NHS



Box 10: Features of the UK private medical insurance market

Issues facing insurers

Opportunities for the insurance industry


Chapter 7: Reciprocal healthcare provision in Northern Ireland and the Republic of Ireland

Cross-border healthcare on the island of Ireland

Practical effects of losing access to cross-border healthcare

Structures supporting cross-border healthcare

Belfast/Good Friday Agreement

Box 11: Belfast/Good Friday Agreement and cross-border healthcare

Common Travel Area

The Joint Report and Northern Ireland


Chapter 8: Reciprocal healthcare provision and devolution

Devolved administrations


Summary of conclusions and recommendations

Appendix 1: List of Members and declarations of interest

Appendix 2: List of witnesses

Appendix 3: Call for evidence

Evidence is published online at and available for inspection at the Parliamentary Archives (020 7219 3074).

Q in footnotes refers to a question in oral evidence.

© Parliamentary copyright 2018