I move: "That the Bill be now read a Second Time."
I welcome the opportunity to introduce this Bill to the House. I am very grateful to Members of both Houses for their speedy consideration of this legislation, which is very much part of the ongoing Brexit preparedness work of this Government. I acknowledge the constructive engagement of Sinn Féin and other parties in Northern Ireland on the need for this legislation. Members will be aware that we passed the Withdrawal of the United Kingdom from the European Union (Consequential Provisions) Bill 2019, also known as the Brexit omnibus Bill, in this House in April. The purpose of that Bill, from a health perspective, was to deal with north, south, east and west reciprocal healthcare arrangements, but the Bill before us this evening goes above and beyond that. This legislation represents the Government fulfilling its obligations under the Good Friday Agreement and adhering not just to the letter but to the spirit of that agreement in making sure that people from the North, when they holiday in the EU, outside of the Republic of Ireland, can access healthcare in emergency situations. We are talking about situations where, for example, somebody goes to Spain on holiday and gets ill suddenly. The Bill also contains provisions relating to British citizens accessing our childcare scheme.
This Bill is being introduced on my behalf, as Minister for Health, and on behalf of my colleague the Minister for Children and Youth Affairs, as it contains two sets of legislative provisions. The health related aspect concerns the provision of similar benefits to those available under European health insurance card, EHIC, to eligible residents of Northern Ireland in the case of a no-deal Brexit. The Bill also includes amendments to the Childcare Support Act 2018 to provide for British citizens to have access to the forthcoming national childcare scheme on the same basis as Irish citizens.
This legislation has been identified as a clear priority in the context of contingency planning for a no-deal Brexit. As I said, I acknowledge and appreciate the co-operation of colleagues in this House who have facilitated the Bill for debate as a matter of priority. The tight timeframe involved has, unfortunately, been necessary due to the pressing urgency for the legislation to be enacted before the end of the month, given that the Government continues to plan for a no-deal Brexit while obviously hoping for a better outcome. In the context of planning for a possible no-deal Brexit, ensuring that the citizenship and identity provisions of the Good Friday Agreement are respected and upheld in all relevant policy areas is a very important issue upon which the Government is very engaged. The Government continues to work with the UK to reinforce the message that the rights and entitlements of all those living in Northern Ireland are of fundamental importance and must be protected. We are actively engaged in ensuring that people in Northern Ireland can continue to enjoy access to important EU rights, opportunities and benefits into the future, including the benefits of EHIC.
The operation of the EHIC scheme requires that the state that issues the card, in this case Ireland, meets the cost of any services accessed by the holder in another EU or EEA jurisdiction. EU citizens can then visit another member state and, if required, avail of necessary public healthcare during a temporary visit there. Therefore, the objective of this legislation is to ensure that if the UK leaves the EU without a withdrawal agreement, eligible residents in Northern Ireland will not be out of pocket if necessary health expenses are incurred while on a temporary stay in another EU or EEA member state or in Switzerland.
Under the Good Friday Agreement, all the people of Northern Ireland are recognised as having the birthright to identify themselves and be accepted as Irish or British, or both, as they may so choose, and accordingly the right to hold both Irish and British citizenship. In view of the various adverse effects of a no-deal Brexit outcome on EU citizens resident in Northern Ireland, among which is the loss of access to the benefits of the EHIC scheme when travelling to other member states, and recalling the important role the EU plays in supporting the Good Friday Agreement, the Government is putting in place this measure in an effort to mitigate this loss to EU citizens, which includes Irish as well as British citizens. The scheme will be based as far as possible on the current EHIC rules. The applicant must not travel for the purpose of receiving planned healthcare, for example, and any co-payments that apply to residents of the country being visited will not be reimbursable.
Under existing arrangements, EU citizens travelling to another member state who present an EHIC can generally access healthcare at a significantly reduced or no cost basis, which is of significant benefit for these patients. Therefore, the immediate priority now for this House, given the limited timeframe to the end of October and the absolute imperative to have a scheme in place for 1 November 2019, is to devise and implement an approach that ensures, in the event of a no-deal scenario occurring, that eligible residents of Northern Ireland can have access to arrangements that allow them to be reimbursed for the cost of healthcare that may become necessary while on a temporary stay in an EU or EEA member state.
Under the scheme, patients will pay upfront at the point of delivery for their treatment and claim reimbursement directly from the HSE on their return home. My Department has requested the HSE to design and build the ICT and administrative system and this is well under way. In summary, the operational aspects underpinning the direct reimbursement scheme will include an online application portal, with the aim of providing a user-friendly, single-step reimbursement application process for eligible residents in Northern Ireland.
As I stated in the Seanad, this is not a perfect model but it is, after significant engagement with the Office of the Attorney General, the Department of Foreign Affairs and Trade and the European Commission, the best model we can put in place to give access to residents of Northern Ireland after 31 October in the case of a no-deal Brexit which will be as equivalent as possible to that available under the EHIC scheme.
Part 3 proposes to amend the Childcare Support Act 2018 to make provision for British citizens to access the national childcare scheme, a scheme of financial support for parents towards the cost of quality childcare, on the same basis as Irish citizens. Once introduced, it will replace existing targeted childcare schemes with a single, streamlined and user-friendly scheme providing both universal and targeted childcare subsidies. An issue could arise for British citizens living in Northern Ireland who wish to access the scheme and register their children with childcare service providers in the State, and also for British citizens moving to the State to live. In the event of an orderly withdrawal of the UK from the EU, British citizens will be treated as nationals of EU member states for the period of transition. However, in the event of no deal or in the longer term, the policy approach reflected in the Bill, consistent with the principles and intent of the common travel area, is to make provision for British citizens to access the national childcare scheme in the State on the same basis as Irish citizens. The amendments in Part 3 put beyond doubt that British citizens will be eligible to apply for the national childcare scheme in the event of a no-deal Brexit. As such, it offers assurance to British citizens living in Northern Ireland who wish to access the scheme and avail of childcare services in the State, as well as to British citizens moving to Ireland to live.
I will now outline the various provisions of the Bill. In Part 1, section 1 provides the Short Title of the Bill and provides for the commencement of the various Parts of the Bill.
Section 2 is a standard provision concerning the paying of expenses relating to the administration of the Bill.
In Part 2, section 3 sets out the definitions required for Part 2 of the Bill.
Section 4 makes provision for the implementation of a scheme for the reimbursement of expenses incurred by eligible persons resident in Northern Ireland in respect of necessary medical treatment.
Section 5 provides that the Minister may, with the consent of the Minister for Finance, make regulations to provide for administrative arrangements to give full effect to the provisions of Part 2. It also outlines the principles and policies to which the Minister shall have regard when drafting the regulations.
Section 6 provides that the HSE, for the purposes of Part 2 of the Bill, may enter into arrangements with competent institutions in other member states.
Section 7 provides that the HSE may have regard to the decisions of the administrative commission for the co-ordination of social security systems regarding the operation and administration of the European health insurance card scheme as operated under EU Regulation 883/2004.
Section 8 requires the HSE to carry out a review of the operation of the Act no later than two years after its commencement and the Minister must lay that review before the Oireachtas no later than one month after the report is received.
In Part 3, section 9 provides for the definition of "Principal Act" for the purposes of Part 3 of the Bill.
Section 10 provides for an amendment to section 7 of the Childcare Support Act 2018 to make explicit reference to the eligibility of a British citizen to apply for financial support under the Act.
Section 11 is a consequential amendment to section 15 of the Childcare Support Act 2018 to provide that payment will not be made where the person does not satisfy the eligibility criteria in section 7 of the 2018 Act.
Statutory regulations will be required in respect of Part 2 in order to define as necessary the administrative arrangements for the direct reimbursement scheme. Officials from my Department are progressing the drafting of these regulations in conjunction with the Office of the Attorney General.
We have identified on a cross-party basis in both Houses of the Oireachtas this area as a clear priority and part of our contingency planning. By looking to the rights of residents of Northern Ireland in accessing healthcare in EU member states other than Ireland, it goes above and beyond the aim of the Withdrawal of the United Kingdom from the European Union (Consequential Provisions) Act to simply ensure reciprocal rights continued North, South, east and west. I know from speaking to communities in the North that the Bill will be warmly welcomed there. I acknowledge that it is not a perfect fit. It is not what we envisaged when we endeavoured to look at the issue of European health insurance cards but, following significant engagement by officials across a range of Departments and with the Commission, it is a positive step forward in what I hope will be a temporary arrangement or will not occur. As we work towards being prepared for a no-deal Brexit while continuing to do all we can to avoid it, it is important that we pass this legislation.