2019 No. 784

Exiting The European Union, Northern Ireland
Health And Personal Social Services

The Health Services (Cross-Border Health Care and Miscellaneous Amendments) (Northern Ireland) (EU Exit) Regulations 2019

Made

Coming into force in accordance with regulation 1

The Secretary of State makes these Regulations in exercise of the powers conferred by section 8(1) of, and paragraph 21 of Schedule 7 to the European Union (Withdrawal) Act 2018 F1.

In accordance with paragraph 1(1) of Schedule 7 to that Act, a draft of this instrument has been laid before Parliament and approved by a resolution of each House of Parliament.

Annotations:
Amendments (Textual)

PART 1Introductory

Citation, commencement, interpretation and extentI31

1

These Regulations may be cited as the Health Services (Cross-Border Health Care and Miscellaneous Amendments) (Northern Ireland) (EU Exit) Regulations 2019 and come into force on exit day F2.

2

In these Regulations—

  • “the Order of 1972” means the Health and Personal Social Services (Northern Ireland) Order 1972 F3;

  • “the 2013 Regulations” means the Health Services (Cross-Border Health Care) Regulations (Northern Ireland) 2013 F4.

3

These Regulations extend to Northern Ireland only.

PART 2Cross-border health care

CHAPTER 1Amendment of primary legislation

The Health and Personal Social Services (Northern Ireland) Order 1972I12

1

The Order of 1972 is amended as follows.

2

In Article 2(2) (interpretation) omit the definitions of “EEA agreement”, “EEA state” and “Regulation (EC) No. 883/2004”F5.

3

Omit Articles 14B to 14E (reimbursement of the cost of health care services secured in another EEA state) F6.

4

In Article 45 (travelling expenses of patients, etc.) F7 omit paragraph (1)(a)(ii) and (iii).

CHAPTER 2Amendment of secondary legislation

Health and Personal Social Services General Dental Services Regulations (Northern Ireland) 1993I43

1

The Health and Personal Social Services General Dental Services Regulations (Northern Ireland) 1993 F8 are amended as follows.

2

In regulation 2 (interpretation) omit the definitions of—

a

“the Directive”, and

b

“visiting patient”.

3

In Schedule 2 (terms of service for dentists)—

a

in paragraph 3—

i

in sub-paragraph (2)(b)(iv) omit “or”;

ii

omit sub-paragraphs (2)(b)(v) and (3).

b

omit paragraph 23A.

Health and Personal Social Services (General Medical Services Contracts) Regulations (Northern Ireland) 2004I54

1

The Health and Personal Social Services (General Medical Services Contracts) Regulations (Northern Ireland) 2004 F9 are amended as follows.

2

In regulation 2 (interpretation) omit the definitions of—

a

“the Directive”, and

b

“visiting patient”.

3

In regulation 15 (essential services)—

a

in paragraph (3) for “registered patients, temporary residents and visiting patients”, substitute “ registered patients and temporary residents ”;

b

in paragraph (5) for “registered patients, temporary residents and visiting patients”, substitute “ registered patients and temporary patients ”.

4

In Schedule 4 (fees and charges), in paragraph 1 omit sub-paragraphs (l) and (m).

5

In Schedule 5 (other contractual terms)—

a

in paragraph 3 (attendance outside practice premises), in sub-paragraph (4) omit “or a visiting patient”;

b

omit paragraph 15A (application to the contractor for regulation 15(3) and (5) services);

c

omit paragraph 32A (assignment of a person to a contractor for regulation 15(3) and (5) services);

d

omit paragraph 40(4);

e

omit paragraphs 41(2)(e) and 41(4)(i);

f

in paragraph 78, omit sub-paragraph (2).

The Health Care (Reimbursement of the Cost of EEA Services etc.) Regulations (Northern Ireland) 2012I65

In the Health Care (Reimbursement of the Cost of EEA Services etc.) Regulations (Northern Ireland) 2012 F10 omit regulation 4.

The Health Services (Cross-Border Health Care) Regulations (Northern Ireland) 2013I76

The 2013 Regulations are revoked.

General Dental Services (Amendment) Regulations (Northern Ireland) 2013I97

In the General Dental Services (Amendment) Regulations (Northern Ireland) 2013 F11 omit regulations 2, 3 and 4.

The Health and Personal Social Services (General Medical Services Contracts) (Amendment No. 2) Regulations (Northern Ireland) 2013I108

In the Health and Personal Social Services (General Medical Services Contracts) (Amendment No. 2) Regulations (Northern Ireland) 2013 F12 omit regulations 2, 3, 4 and 5(3) to (6).

Provision of Health Services to Persons Not Ordinarily Resident Regulations (Northern Ireland) 2015I119

1

The Provision of Health Services to Persons Not Ordinarily Resident Regulations (Northern Ireland) 2015 F13 are amended as follows.

2

In regulation 2(1) (interpretation) omit the definitions of—

a

“Directive 2011/24/EU”,

b

“out of hours period”,

c

“out of hours provider”,

d

“out of hours services”, and

e

“visiting patient”.

3

Omit regulation 25(visiting patients under Directive 2011/24/EU).

The Health Services (Cross-Border Health Care) (Amendment) Regulations (Northern Ireland) 2015I1210

The Health Services (Cross-Border Health Care) (Amendment) Regulations (Northern Ireland) 2015 F14 are revoked.

CHAPTER 3Savings

Saving of Article 14B of the Order of 1972 for pre-F20IP completion day casesI211

1

Despite the revocations made by regulations 2, 5, and 6, Article 14B of the Order of 1972 continues to have effect on and after F20IP completion day in relation to any qualifying EEA expenditure which was incurred on or after 10 May 2012 and before 27 December 2013 and was not reimbursed under that Article before F20IP completion day.

2

In Article 14B as saved by this regulation, paragraph (5) is to be read as if for the words “circumstances where Article 20 or 27(3) of Regulation (EC) No. 883/2004 applies” there were substituted “ circumstances where, immediately before F20IP completion day, Article 20 or 27(3) of Regulation (EC) No. 883/2004 would have applied ”.

3

The definition of “Regulation (EC) No. 883/2004” in Article 2(2) of the Order of 1972 continues to have effect for the purposes of Article 14B as saved by this regulation, but as if in that definition there were inserted at the end “as that Regulation had effect immediately before F20IP completion day”.

4

In Article 14B as saved by this regulation “EEA state” has the meaning given by Schedule 1 to the Interpretation Act 1978 F15.

5

In this regulation “qualifying EEA expenditure” has the same meaning as in Article 14B of the Order of 1972 as that Article had effect immediately before F20IP completion day.

Saving of Articles 14D and 14E of the Order of 1972 for pre-F21IP completion day casesI1412

1

This regulation applies despite the revocations made by regulations 2, 5, and 6.

2

Article 14D of the Order of 1972 continues to have effect on and after F21IP completion day in relation to qualifying EEA expenditure which—

a

was incurred (and not reimbursed under that Article) before F21IP completion day,

b

was incurred on or after F21IP completion day on the provision of a service which was provided, or began to be provided, before F21IP completion day, or

c

was incurred on or after F21IP completion day on the provision of a service that was authorised under Article 14E of that Order—

i

before F21IP completion day, or

ii

on or after F21IP completion day on an application under Article 14E made before F21IP completion day.

3

But nothing in this regulation—

a

requires reimbursement of qualifying EEA expenditure incurred on the provision of a service which was provided after the later of—

i

the end of one year beginning immediately after the day on which F21IP completion day falls, or

ii

where an authorisation for the provision of the service specified a period within which the service must be provided, the end of the specified period.

4

In Article 14D as saved by this regulation, paragraph (9) is to be read as if for the words “circumstances where Article 20 or 27(3) of Regulation (EC) No. 883/2004 applies” there were substituted “ circumstances where, immediately before F21IP completion day, Article 20 or 27(3) of Regulation (EC) No. 883/2004 would have applied ”.

5

Article 14E of the Order of 1972 continues to have effect on and after F21IP completion day in relation to an application for authorisation under that Article which was made, but not determined, before F21IP completion day.

6

The following definitions continue to have effect for the purposes of Articles 14D and 14E of the Order of 1972 as saved by this regulation—

a

the definitions in Article 14B of that Order which are applied by Article 14D(15) as saved by this regulation, and

b

the definitions in Article 2(2) of the Order of 1972 of “Regulation (EC) No. 883/2004”, but as if there were inserted at the end of that definition “as that Regulation had effect immediately before F21IP completion day”.

7

Any reference to an EEA state other than the United Kingdom—

a

in Article 14D as saved by this regulation , or

b

in a definition applied by Article 14D(15) as so saved,

is to be read in relation to times after F21IP completion day as a reference to an EEA state.

8

In that Article and in any such definition, “EEA state” has the meaning given by Schedule 1 to the Interpretation Act 1978.

9

In this regulation “qualifying EEA expenditure”, and “service” have the same meaning as in Article 14D of the Order of 1972 as that Article had effect immediately before F21IP completion day (except that, for the purposes of this paragraph, references in that Article or in any definition applied by paragraph (15) of that Article to an EEA state other than the United Kingdom are to be read, in relation to times after F21IP completion day, as references to an EEA state).

Further saving of Articles 14D and 14E of the Order of 1972: cross-border arrangementsF1613

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Health and Personal Social Services General Dental Services Regulations (Northern Ireland) 1993F1614

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

The Health and Personal Social Services (General Medical Services Contracts) Regulations (Northern Ireland) 2004F1615

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Saving of the 2013 Regulations for pre-F22IP completion day casesI816

1

In relation to a case where paragraph (2) or (3) applies, the 2013 Regulations continue to have effect on and after F22IP completion day in so far as they relate to the National Contact Point and visiting patients as if the revocations made by regulations 6 and 10 of these Regulations had not been made, but with the modifications set out in Schedule 1.

2

This paragraph applies where—

a

a service within Article 14B(3) or Article 14D(4) of the Order of 1972 was provided or began to be provided, or was authorised to be provided, before F22IP completion day, or

b

an application for authorisation under Article 14E of that Order was made before F22IP completion day.

3

This paragraph applies where a cross-border healthcare service was provided or began to be provided to a visiting patient before F22IP completion day in the circumstances referred to in Regulation 11 (health care charges) or regulation 12 (exemption from health care charges for certain persons who reside in another member State) of the 2013 Regulations.

4

But nothing in this regulation imposes an obligation in relation to a charge to a visiting patient for a service which was provided after the end of one year beginning immediately after the day on which F22IP completion day falls.

5

In this regulation “charge”, “cross-border healthcare service” and “visiting patient” have the same meaning as they had in the 2013 Regulations immediately before F22IP completion day.

Further saving of the 2013 Regulations: cross-border arrangementsF2317

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Provision of Health Services to Persons Not Ordinarily Resident Regulations (Northern Ireland) 2015F2418

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

PART 3Miscellaneous amendments

F25The Health and Personal Social Services (General Medical Services Contracts) (Prescription of Drugs Etc) Regulations (Northern Ireland) 2004I1319

1

The Health and Personal Social Services (General Medical Services Contracts) (Prescription of Drugs Etc) Regulations (Northern Ireland) 2004 are amended as follows.

2

In Schedule 2 (drugs, medicines and other substances that may be ordered only in certain circumstances), in the entry in column 2 of the table relating to patients with erectile dysfunction—

a

for sub-paragraph (b) (including the “or” at the end) substitute—

b

a man who is a national of an EEA State who—

i

immediately before IP completion day was entitled to treatment by virtue of Article 7(2) of Council Regulation 1612/68 as extended by the EEA Agreement or was entitled to treatment by virtue of any other enforceable EU right;

ii

has erectile dysfunction and was on 14th September 1998 receiving a course of treatment under a national health insurance system of an EEA State for that condition with any of the drugs listed in sub-paragraph (a); and

iii

immediately before IP completion day was receiving a course of treatment for the condition mentioned in paragraph (ii) of this sub-paragraph with any of the drugs listed in sub-paragraph (a); or

b

for sub-paragraph (c) (including the “or” at the end) substitute—

c

a man who is not a national of an EEA State but who is the member of the family of such a national and who—

i

immediately before IP completion day had an enforceable EU right to be treated no less favourably than the national in the provision of medical treatment;

ii

has erectile dysfunction and was on 14th September 1998 receiving a course of treatment for that condition with any of the drugs listed in sub-paragraph (a); and

iii

immediately before IP completion day was receiving a course of treatment for the condition mentioned in paragraph (ii) of this sub-paragraph with any of the drugs listed in sub-paragraph (a); or

PART 4Supplementary

EU-derived rightsI1620

1

EU-derived rights, powers, liabilities, obligations, restrictions, remedies and procedures cease to be recognised and available in domestic law so far as they are inconsistent with, or are otherwise capable of affecting the interpretation, application or operation of, provision made by these regulations.

2

In this regulation “EU-derived rights, powers, liabilities, obligations, restrictions, remedies and procedures” means any rights, powers, liabilities, obligations, restrictions, remedies and procedures which continue to be recognised and available in domestic law by virtue of section 4 of the European Union (Withdrawal) Act 2018 (including as they are modified by domestic law from time to time).

3

In this regulation “domestic law” means the law of Northern Ireland.

Signed by the authority of the Secretary of State for Health and Social Care.

Stephen Hammond Minister of State, Department of Health and Social Care

SCHEDULE 1Modifications to the 2013 Regulations for pre-F18IP completion day cases

Regulation 16

Annotations:
Amendments (Textual)
F18

Words in Sch. 1 heading substituted (31.12.2020 immediately before IP completion day) by The Reciprocal and Cross-Border Healthcare (Amendment etc.) (EU Exit) Regulations 2020 (S.I. 2020/1348), regs. 1, 15(a)

I151

The modifications of the 2013 Regulations referred to in regulation 16 are that those Regulations are to be read as if—

a

in regulation 2 (interpretation)—

i

in the definition of “resident patient”, for “the United Kingdom is” there were substituted “ immediately before F17IP completion day the United Kingdom was ”;

ii

in the definition of “visiting patient”, for “a member State other than the United Kingdom is” there were substituted “ immediately before F17IP completion day a member State other than the United Kingdom was ”;

b

in the heading to regulation 5 (national contact point: information about treatment in another member State), for “another member State” there were substituted “ a member State ”;

c

in regulation 5—

i

for references to “other member States” there were substituted “ member States ”;

ii

for the reference to “another member State” there were substituted “ a member State ”;

d

regulation 5A (National Contact Point: information about prescriptions intended to be used in another member State) were omitted;

F26e

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f

regulation 7 (National Contact Point: duty to consult) were omitted;

g

in regulation 12—

i

in paragraph (2) for “P is” there were substituted “ immediately before F17IP completion day P was ”;

ii

in paragraph (2)(a), for “is resident” there were substituted “ was resident ”;

iii

in paragraph (2)(b), for “is the competent member State” there were substituted “ was the competent member State ”;

iv

in paragraph (4)(b) at the end there were inserted “as it had effect immediately before F17IP completion day”;

h

the schedule (elements that must be included in prescriptions intended to be used in another member State) were omitted.

F19SCHEDULE 2Modifications to the 2013 Regulations for cross-border arrangements

Regulation 17

Annotations:
Amendments (Textual)
F19

Sch. 2 omitted (31.12.2020 immediately before IP completion day) by virtue of The Reciprocal and Cross-Border Healthcare (Amendment etc.) (EU Exit) Regulations 2020 (S.I. 2020/1348), regs. 1, 16

F191

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(This note is not part of the Regulations)

These Regulations are made in exercise of the powers conferred by section 8 of the European Union (Withdrawal) Act 2018 in order to address failures of retained EU law to operate effectively and other deficiencies arising from the withdrawal of the United Kingdom from the European Union.

These Regulations amend the Health and Personal Social Services (Northern Ireland) Order 1972, the Health and Personal Social Services General Dental Services Regulations (Northern Ireland) 1993, the Health and Personal Social Services (General Medical Services Contracts) Regulations (Northern Ireland) 2004, the Health Care (Reimbursement of the Cost of EEA Services etc.) Regulations (Northern Ireland) 2012, the Health Services (Cross-Border Health Care) Regulations (Northern Ireland) 2013, the General Dental Services (Amendment) Regulations (Northern Ireland) 2013, the Health and Personal Social Services (General Medical Services Contracts) (Amendment No. 2) Regulations (Northern Ireland) 2013, the Provision of Health Services to People Not Ordinarily Resident Regulations (Northern Ireland) 2015, the Health Services (Cross-Border Health Care) (Amendment) Regulations (Northern Ireland) 2015, and the Health and Personal Social Services (General Medical Services Contracts) (Prescription of Drugs Etc.) Regulations (Northern Ireland) 2004, to amend access to Cross-Border Health Care to visiting patients as a result of the UK's exit/withdrawal from the European Union.

An impact assessment has been prepared for this instrument however it has no impact on businesses, charities or the voluntary sector.