These Regulations amend the National Health Service (Charges to Overseas Visitors) Regulations 1989 (“the Principal Regulations”), which provide for the making and recovery of charges for relevant services provided under the National Health Service (Wales) Act 2006 (c. 42) to certain persons not ordinarily resident in the United Kingdom.

Regulation 1 contains commencement and interpretation provisions. Except for regulation 9, these Regulations come into force on implementation period completion day, as defined in Schedule 1 to the Legislation (Wales) Act 2019 (anaw 4). Regulation 9 comes into force immediately before implementation period completion day.

Regulation 2 amends regulation 1 of the Principal Regulations to insert definitions of “the 2014 Act”, “competent institution”, “equivalent document”, “immigration rules”, “listed healthcare arrangements”, “Regulation (EC) No 883/2004”, “Regulation (EEC) No 1408/71” and “relevant services”. It also amends the existing definition of a “member of the family”.

Regulation 3 amends regulation 4 of the Principal Regulations. Paragraphs (1) to (3) make minor amendments as a result of the United Kingdom’s exit from the European Union. Paragraph (4) provides an exemption from charges for overseas visitors in circumstances where this is captured by a reciprocal agreement with a country listed in Schedule 2 to the Principal Regulations or with an EEA state or Switzerland under a listed healthcare arrangement. Paragraph (5) provides that where a person with an S2 healthcare certificate is given leave to stay in the United Kingdom for the purposes of their treatment, and has the immigration health charges waived, charges can be made for the provision of relevant services that are not authorised by the S2 healthcare certificate.

Regulation 4 amends regulation 4A of the Principal Regulations to reflect the fact that the term “Member State” will not capture the United Kingdom after implementation period completion day.

Regulation 5 inserts new regulations 4B, 4C and 4D into the Principal Regulations.

Regulation 4B provides that persons who are in scope of Title III of Part 2 of the withdrawal agreement, Title III of Part 2 of the EEA EFTA separation agreement or the Swiss citizens’ rights agreement are able to continue to receive relevant services without charge where there is a right to this under Regulation (EU) No 883/2004. It also provides that the family members of such a person will be entitled to receive relevant services without charge, subject to specific conditions.

Regulation 4C provides that a United Kingdom national in receipt of a United Kingdom pension who is ordinarily resident in an EEA state or Switzerland and who has a United Kingdom issued S1 healthcare certificate (or equivalent document) will receive relevant services without charge. It also provides that the family members of such a person will also be entitled to receive relevant services without charge. Regulation 4D provides that a person who makes a late application under Appendix EU to the immigration rules will not be charged for relevant services which are provided while their application is being determined. If that application is unsuccessful they will be charged for the provision of those relevant services and, if an application is successful and if charges have been made and recovered, these will be repaid.

Regulation 6 amends regulation 5 of the Principal Regulations by adding “a British citizen” to the categories of persons who will be exempt from charges for needs arising treatment after implementation period completion day.

Regulation 7 inserts a new regulation 5A into the Principal Regulations as a result of the United Kingdom’s exit from the European Union. The new regulation provides that where an overseas visitor from an EEA state or Switzerland has either received treatment before implementation period completion day or is part way through treatment on implementation period completion day, the charge which applied before implementation completion day will apply in respect of that treatment.

Regulation 8 adds Bosnia and Herzegovina, the Faroe Islands, Kosovo, Liechtenstein, Montenegro, North Macedonia and Serbia to the list of countries in Schedule 2 to the Principal Regulations which concerns reciprocal agreements. Regulation 8 also removes from the list of countries in Schedule 2 Barbados, Iceland, Russian Federation, the Union of Soviet Socialist Republics and Yugoslavia.

Regulation 9 revokes the National Health Service (Charges to Overseas Visitors) (Amendment) (Wales) (EU Exit) Regulations 2019 which were prepared for a “no deal” EU Exit and which do not reflect the provisions of the EU withdrawal agreement, the EEA EFTA separation agreement or the Swiss Citizens’ rights agreement.

The Welsh Ministers’ Code of Practice on the carrying out of Regulatory Impact Assessments was considered in relation to these Regulations. As a result, a regulatory impact assessment has been prepared as to the likely costs and benefits of complying with these Regulations. A copy can be obtained from the Department of Health and Social Services, Welsh Government, Cathays Park, Cardiff, CF10 3NQ.