Impact of Brexit on the healthcare system

For the present, Brexit – Great Britain’s withdrawal from the European Union (EU) on 1 February 2020 – will not lead to any changes in the area of healthcare for citizens or companies. Such are the stipulations of the Withdrawal Agreement.

The transition phase, during which EU legislation on social law coordination and the recognition of professional qualifications generally still applies, will last until the end of 2020. As Great Britain will remain within the EU’s Single Market and the customs union during this time, there will also be no changes to the movement of medicinal products and medical devices until the end of 2020.

Health and long-term-care insurance

Healthcare coverage, the uptake and billing of health and long-term care insurance services in the respective other country, as well as the recognition of insurance periods, will all stay the same until the end of 2020.

The European health insurance card, for instance, will remain valid over this period. Additionally, the withdrawal agreement stipulates that people, who have already commenced planned care in Great Britain or in Germany before expiry of the transition phase, will continue to possess the right to pursue that treatment.

From Germany's perspective, health insurance contracts signed before the end of the transition phase by people already resident in Great Britain before exit date with German private health insurers (substitute health and long-term care insurance) can continue as before. Since individual cases can differ greatly, particularly with long-term care insurance, it is recommended that those insured persons consult their insurance companies in case of doubt.

Recognition of professional qualifications

Until the end of 2020, there will be no changes with regard to the recognition of professional qualifications in healthcare. Until then, an application for recognition of professional qualifications filed by an EU or UK citizen to a competent authority in the receiving country or country of employment will still be determined according to EU rules. The citizens concerned are therefore urged to apply for recognition of their professional qualifications as early as possible and before the end of the transition phase. Professional qualifications recognised before the end of the transition phase retain their validity within the other country, including the right to exercise the profession on the same terms as nationals.

Medicinal products and medical devices

Goods, therefore also medicinal products and medical devices, which were legally placed on the market before the end of the transition phase, will retain the right to be traded in the markets of the EU and Great Britain after the transition phase until they reach their end consumers, without requiring product changes or renewed labelling.

According to the Higher Federal Authorities within the remit of the Federal Ministry of Health, there is currently no concrete evidence that the United Kingdom's withdrawal from the EU will lead to serious problems with the supply of medicinal products or vaccines in Germany.

Depending on the risk class of a medical device or an in vitro medical device, manufacturers must work together with a Notified Body when pursuing the conformity assessment of their device. During the transition phase, British Notified Bodies are able, in principle, to continue to issue certificates for medical devices and in vitro diagnostic medical devices. Manufacturers concerned should be aware of the fact that there is currently no guarantee that British Notified Bodies will continue to be authorised to operate following expiry of the transition phase. The same applies to the validity of certificates from British Notified Bodies.

What will happen after the transition phase?

During the transition phase until the end of 2020, agreements will be negotiated regarding the future relationship between the European Union and Great Britain. These negotiations about the future relationship are expected to commence early March 2020.

During the negotiations on how to go forward following the transition phase, the Federal Ministry of Health will be addressing three areas:

Citizens' rights with respect to health and long-term care insurance and coverage in case of illness or long-term care needs

When the transition phase ends, the EU regulations on social security coordination (EC) 883/2004 and 987/2009, as well as the Directive on Patients' Rights in Cross-border Healthcare (Directive 2011/24/EU), will no longer apply to Great Britain. In certain cases, this would lead to problems with health care coverage, in the uptake and billing of health and long-term care insurance services in the other country, as well as with the recognition of insurance periods.

Recognition of professional qualifications in healthcare

When the transition phase ends, the Professional Recognition Directive 2005/36/EC will no longer apply to the UK, which means its regulations governing the recognition of the professional healthcare qualifications of doctors, dentists, pharmacists, midwives, nurses and healthcare workers may no longer be applied between the UK and the EU.

Movement of medicinal products and medical devices

Ensuring the population’s uninterrupted supply of medicinal products, vaccines and medical devices is of utmost priority to the Federal Government.

Losing the contribution the British licensing authority (MHRA – Medicines and Healthcare Products Regulatory Agency) made towards handling the workload resulting from European marketing authorisation procedures and approval procedures for clinical trials means that the authorities of the other Member States, such as the German licensing authorities BfArM and PEI, will be taking over a growing number of tasks. Provision has been made for increasing their staff accordingly.

Good to know

German Liaison Agency Health Insurance (Deutsche Verbindungsstelle Krankenversicherung – Ausland) Since the specifics of each case and the questions asked frequently vary, we recommend that affected citizens contact their health insurance fund or health insurance carrier in Germany directly.

For general information related to health insurance, please contact the citizens’ hotline of the Federal Ministry of Health at: +49(0)30340606601. A contact form is also available.

Up-to-date information on the state of negotiations provided by the Federal Foreign Office.

Overview of Brexit preparations by the Federal Government, the EU Commission and trade associations

On the EU Commission’s website, you will find questions and answers on the withdrawal of the United Kingdom from the European Union on 31 January 2020

In addition, the EU Commission has published a Guidance Note relating to the Agreement on the United Kingdom's withdrawal from the EU on Citizens' rights, which explains, amongst others, the provisions on the coordination of social security systems and on the recognition of professional qualifications."Entsprechend auch im Englischen Text

Moreover, the EU Commission has published a communication and so-called readiness notices to prepare for the end of the transition phase at the end of 2020. The documents identify legal changes that stakeholders will have to adapt to regardless of the outcome of the ongoing negotiations between the EU and the UK on a future relationship and that will be necessary in any case after the transition period.

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