International Healthcare
International healthcare is a small and important element of general healthcare policy in the UK. Reciprocal Healthcare agreements can support people from the UK to obtain access to healthcare in other countries (and vice versa for people from other countries who visit the UK).
	In 2019 Parliament enacted the Healthcare (European Economic Area and Switzerland Arrangements) Act 2019 ("HEEASAA") to establish a legal basis for the Secretary of State to fund and implement reciprocal healthcare, and share necessary data, after the UK left the European Union (EU). In anticipation of a possible no deal scenario, the Act contained powers to implement new bilateral agreements with individual Member States and to establish detailed unilateral arrangements to support certain people to access healthcare in the European Economic Area (EEA) or Switzerland if no bilateral arrangements were in place.
	On 20 December 2020 the UK signed the Trade and Cooperation Agreement (TCA) with the EU. The TCA contains a Protocol on Social Security Coordination which provides UK Nationals with access to a range of social security benefits, including reciprocal healthcare cover when they are in the EU and Switzerland.
	The Government is now looking to strengthen the UK’s relationships with countries across the globe and improve international healthcare cooperation. The Reciprocal Healthcare provisions in this Act amend HEEASAA to enable the Secretary of State to also implement comprehensive reciprocal healthcare agreements with countries outside the EEA and Switzerland.
	Prior to the provisions in this Act, the Secretary of State only had powers under HEEASAA to implement comprehensive reciprocal healthcare agreements within the EEA and Switzerland. The limited geographical scope of the powers in HEEASAA meant that the Secretary of State did not have the necessary powers to implement reciprocal healthcare agreements with countries outside of the EEA and Switzerland, including, for example, British Overseas Territories and Crown Dependencies, other than the ability to exempt individuals from charges for relevant NHS services.
	As a result, although the UK entered into a number of reciprocal healthcare agreements with countries outside the EEA and Switzerland, such as with Australia and New Zealand, they were limited in scope because of the absence of financial reimbursement or data sharing powers. For example, under the terms of reciprocal healthcare agreements the UK entered into with countries outside the EEA and Switzerland, UK nationals could access emergency treatment should they require it, however, access to haemodialysis for kidney patients was restricted or not included within the scope of these agreements..
	The provisions expanding HEEASAA to countries outside the EEA and Switzerland enable the Secretary of State to make regulations for the purpose of giving effect to healthcare agreements, including provision for the reimbursement of healthcare costs. The provisions also provide the devolved authorities (Scottish Ministers, Welsh Ministers and a Northern Ireland department) with a concurrent regulation making power to give effect to healthcare agreements in devolved areas of competence.
	Further, the amendments to HEEASAA will enable the Secretary of State to make discretionary payments, in exceptional circumstances, but only in countries with which the UK has a reciprocal healthcare agreement. This remains a necessary power which will allow the Secretary of State to support UK nationals abroad where due to exceptional circumstances they require to access healthcare abroad but fall outside the scope of a reciprocal healthcare agreement.
	They will extend the existing data sharing provisions in section 4 HEEASAA to Rest of World countries to provide a legal basis for facilitating data processing to support the making of payments and giving effect to healthcare agreements. This data sharing will be fully in line with UK GDPR.
	Now the Government has a reciprocal healthcare agreement with the EU, this section also removes the power in HEEASAA to establish detailed unilateral healthcare arrangements as these are no longer needed.
	No reciprocal healthcare arrangements are made or changed as a direct result of this legislation.