Official Report: Minutes of Evidence

The Chairperson (Mr Gildernew): The next statutory rule deals with the provision of health services on and after EU exit day. I invite Patricia Quinn-Duffy — you are very welcome here, Patricia — from the Department of Health to brief the Committee on the SR.

Ms Patricia Quinn-Duffy (Department of Health): Thank you, Chairman. The SR was laid in preparation for a no-deal exit on the first exit date of 29 March 2019. It is a regulation to amend the Provision of Health Services to Persons Not Ordinarily Resident Regulations (Northern Ireland) 2015, which provide exemptions from being charged for healthcare for certain visitors who come to Northern Ireland. The regulation was to amend existing EU regulations that would no longer apply in the case of a no deal — initially, it was to remove references to EU regulations that would not apply — and to make provision for people who have rights that, it was felt, should continue in the event of a no deal, where possible — such people as frontier workers, retired cross-border frontier workers and students already studying at school or university. That is what the regulation is designed to do.

The reason why the SR was laid in the Assembly is that there were difficulties and delays in coming to a UK-wide agreement on certain exemptions, which meant that using the withdrawal Act would have delayed the implementation of the regulations until well after 29 March. The decision was made to use the Northern Ireland legislation to ensure that the cohorts of people in Northern Ireland could still attain healthcare without being charged, as they were at the time and currently do.

The regulation has a commencement date of exit day, which has been deferred through amendments to the withdrawal Bill. The European Union (Withdrawal Agreement) Bill is due for Royal Assent today, and the regulation will be deferred until the end of the implementation period. In a nutshell, that is what this is to do.

Will this remain until the end of implementation? I imagine that there will probably be a review to make sure that it is still relevant following the negotiations that will happen within this year and to ensure that anyone who has an exemption keeps it, because, obviously, the withdrawal agreement Act will enshrine a number of rights for people who are already here.

The Chairperson (Mr Gildernew): Am I right in thinking, Patricia, that this was designed to deal with a no-deal scenario?

Ms Quinn-Duffy: Yes.

The Chairperson (Mr Gildernew): Now, it has been rolled on, in any case, into a situation in which there will, potentially, be a deal.

Ms Quinn-Duffy: There will be a deal. It will be deferred until the end of the implementation period, but, during that implementation period, there will be ongoing negotiations between the UK and the EU. Whatever comes out of that, there may be changes or additions to this. As it is a sort of international agreement, decisions may well be made here on what Northern Ireland decides to offer.

The Chairperson (Mr Gildernew): I suppose that there is an understanding that there will be issues with people from across Europe travelling or working back and forth. We have an additional complication here: we have an entire border corridor and beyond of people who traverse the border regularly to work, live, get married, care for relatives and all that that involves. They often pay tax on the Northern side. There is a concern that this would apply only to people who are currently in that situation and that future students and people who take up job opportunities in the future would be deprived of the rights that currently exist.

Ms Quinn-Duffy: Yes. The legislation was for a no deal and was for the people who already had rights. Those decisions will have to be looked at in the implementation period and will not be subject to this legislation.

The Chairperson (Mr Gildernew): What consultation has been completed in relation to this?

Ms Quinn-Duffy: As with the EU exit legislation, no consultation was carried out on this legislation.

Ms Dolan: Thanks, Patricia. This might seem like an obvious question, but when is exit day? Is it 31 January?

Ms Quinn-Duffy: Yes, 31 January is exit day. The withdrawal agreement Bill defers any EU exit no-deal legislation until the end of the implementation period, which is 31 December 2020.

Ms Dolan: On another note, as the Chairperson mentioned, in terms of cross-border workers and workers, students and visitors from across Europe, this is such a complex matter. I know that we spoke about our time limitations, but this needs further scrutiny. I propose that we push this back a week to look at it in further detail.

The Chairperson (Mr Gildernew): I will go to other members with questions, and we will come back to that, Jemma.

Ms Bradshaw: Thank you, Patricia. The presentation that you gave us a few months ago on how you were preparing for an EU exit was very useful.

I have just two quick questions. Will there be reciprocal arrangements across the border?

Ms Quinn-Duffy: The UK and Ireland have opened negotiations on a longer-term reciprocal arrangement. That is under way.

Ms Bradshaw: Will it be in effect on 1 February?

Ms Quinn-Duffy: No. On 1 February, all EU legislation will apply as currently. There will be no changes to rights or access until the end of the implementation period, which will be 31 December 2020.

Ms Bradshaw: Does that mean that the border healthcare directive will still be in place?

Ms Quinn-Duffy: That will be in place until 31 December this year.

Ms Bradshaw: OK, so, if people have their applications in now, they will still be covered.

Ms Quinn-Duffy: Yes, they will.

Ms Bradshaw: OK, thank you.

Ms S Bradley: Thank you, Patricia. I appreciate the information so far. I note that you said that there was no consultation. I would like to understand better the thinking or the author behind this, as presented. I appreciate that negotiations will be going on and that it is almost temporary legislation to fill a legislative void, but is there any likelihood of an impact on those negotiations? What came to mind for me, for example, was an EU student in Dublin who comes North for a trip or some sort of experience linked to their studies. If they were in this part of the island, had a fall and presented at an accident and emergency department, after this period, that would exclude them, if I am right.

Ms Quinn-Duffy: Yes.

Ms S Bradley: I really think that there seems to be an obvious lack of the logic that we live on an island.

Ms Quinn-Duffy: When the UK leaves the EU, many people will not be exempt. The idea behind these amendments was to establish for the main groups of people who have current rights, such as frontier workers, cross-border workers, retired cross-border workers and people who are studying currently, that they can continue to do so and not be concerned about what happens to their healthcare after exit.

What happens in the new scenario will be a new relationship. We did not consider those decisions because they really are decisions that a Minister should make on behalf of Northern Ireland and in connection, then, with whatever the UK and the EU come to an arrangement on.

Ms S Bradley: At first glance, to me, it seems very lacking. I take it for what it is — I see it as a temporary measure or a plug — but I am not sure that it has encompassed enough even as that, even with that weight on it.

Ms Quinn-Duffy: To be honest, in a no-deal scenario, it does not cover everyone who would have had a right currently. They would not all have transferred, really because the reciprocity would not be there. A Northern Irish person travelling to Ireland or to the rest of Europe would not, without a reciprocal arrangement, be entitled to the same conditions had we continued the whole range of healthcare provision.

Those decisions, however, are being negotiated on a UK-EU basis. Also, the no deal was trying to get UK-EU bilaterals. There were lots of negotiations ongoing on those, and they were accounted for in this, so certain countries would potentially have had coverage. It is complicated and convoluted, but, as I say, it does not cover everyone, in every circumstance, whom they would have covered currently.

Ms S Bradley: Chair, I appreciate that the costings of any options would have to be worked through, but I am concerned that, if we set this as a marker that is in place whilst those delicate negotiations happen and we are talking about reciprocal arrangements, I certainly would not like to be visiting the person at the other side of this. There could be a further reaching-out to make sure that the landing place for any reciprocal relations in the longer term is a lot more generous than this.

Mr Stewart: Thank you, Patricia. I agree with much of what has been said. Initially, we were probably filing this under, "Hopefully, never required", given that the document was prepared in the eventuality of a no deal, prior to where we got to, with Brexit day looming and then the transition period. The status quo will remain in every way, shape and form that we know until 31 December this year. If the full detail of the deal between the UK and the EU is ironed out, it will, hopefully, deal with everything that is in the document, so that it will not be required. If it does not, the detail of the document will be completely edited, updated or amended, so it will, hopefully, be much more comprehensive.

I am sympathetic to the proposal, and it is good that we duly note what is in here, take the bits that are good and realise how much is missing. Looking to what might happen towards the end of this year, if, at some point before then, it looks like we are going towards that cliff edge, we need to make sure that we take on board everything that has been said and that the document is fit for purpose then. I hope that it never needs to see the light of day, Chair, because it would be worrying for all the reasons that members have pointed out. All the things that are lacking in it show how poorly informed and poorly prepared we would have been.

The Chairperson (Mr Gildernew): You mentioned, Patricia, that there are cases where reciprocity is not in place, but we could also attract negativity in doing this. There are elements of that out there already in the community, so we need to be really careful. I suggest that, if there are no other questions for Patricia at this stage, we will let her go.

Mrs Cameron: On the back of the queries so far, what would be the implication if we were to defer this for a week at this stage, given that this is our first meeting back after three years?

Ms Quinn-Duffy: If it is deferred and if the withdrawal agreement Bill gets Royal Assent today, the legislation will not be commenced until the end of the year in any respect, so I am not sure that there are any potential difficulties. We expect the Bill to get Royal Assent today. I doubt that it will not. It is highly unlikely. I do not think that there is anything else I can say.

Mrs Cameron: Is it fair to say, then, that, if we go ahead with it today —

Ms Quinn-Duffy: It still will not be commenced.

Mrs Cameron: There will still be no impact.

Ms Quinn-Duffy: Yes.

The Chairperson (Mr Gildernew): Maybe we should take advice from the Clerk on that.

The Committee Clerk: I can confirm that there is time in the statutory period. We have another meeting or two in hand when you could come to a final view on this, if you should wish to defer consideration.

The Chairperson (Mr Gildernew): OK. We will consider that.

I think that we can let Patricia go, if there are no other questions arising. Thank you, Patricia.