PART 1 Introductory

Citation, commencement, interpretation and extent

1. —(1) These Regulations may be cited as the Health Services (Cross-Border Health Care and Miscellaneous Amendments) (Northern Ireland) (EU Exit) Regulations 2019 and come into force on exit day .

(2) In these Regulations—

“ the Order of 1972 ” means the Health and Personal Social Services (Northern Ireland) Order 1972 ;

“ the 2013 Regulations ” means the Health Services (Cross-Border Health Care) Regulations (Northern Ireland) 2013 .

(3) These Regulations extend to Northern Ireland only.

PART 2 Cross-border health care

CHAPTER 1 Amendment of primary legislation

The Health and Personal Social Services (Northern Ireland) Order 1972

2. —(1) The Order of 1972 is amended as follows.

(2) In Article 2(2) (interpretation) omit the definitions of “EEA agreement”, “EEA state” and “Regulation (EC) No. 883/2004 ” .

(3) Omit Articles 14B to 14E (reimbursement of the cost of health care services secured in another EEA state) .

(4) In Article 45 (travelling expenses of patients, etc.) omit paragraph (1)(a)(ii) and (iii).

CHAPTER 2 Amendment of secondary legislation

Health and Personal Social Services General Dental Services Regulations (Northern Ireland) 1993

3. —(1) The Health and Personal Social Services General Dental Services Regulations (Northern Ireland) 1993 are amended as follows.

(2) In regulation 2 (interpretation) omit the definitions of—

(a) “the Directive”, and

(b) “visiting patient”.

(3) In Schedule 2 (terms of service for dentists)—

(a) in paragraph 3—

(i) in sub-paragraph (2)(b)(iv) omit “or”;

(ii) omit sub-paragraphs (2)(b)(v) and (3).

(b) omit paragraph 23A.

Health and Personal Social Services (General Medical Services Contracts) Regulations (Northern Ireland) 2004

4. —(1) The Health and Personal Social Services (General Medical Services Contracts) Regulations (Northern Ireland) 2004 are amended as follows.

(2) In regulation 2 (interpretation) omit the definitions of—

(a) “the Directive”, and

(b) “visiting patient”.

(3) In regulation 15 (essential services)—

(a) in paragraph (3) for “registered patients, temporary residents and visiting patients”, substitute “ registered patients and temporary residents ” ;

(b) in paragraph (5) for “registered patients, temporary residents and visiting patients”, substitute “ registered patients and temporary patients ” .

(4) In Schedule 4 (fees and charges), in paragraph 1 omit sub-paragraphs (l) and (m).

(5) In Schedule 5 (other contractual terms)—

(a) in paragraph 3 (attendance outside practice premises), in sub-paragraph (4) omit “or a visiting patient”;

(b) omit paragraph 15A (application to the contractor for regulation 15(3) and (5) services);

(c) omit paragraph 32A (assignment of a person to a contractor for regulation 15(3) and (5) services);

(d) omit paragraph 40(4);

(e) omit paragraphs 41(2)(e) and 41(4)(i);

(f) in paragraph 78, omit sub-paragraph (2).

The Health Care (Reimbursement of the Cost of EEA Services etc.) Regulations (Northern Ireland) 2012

5. In the Health Care (Reimbursement of the Cost of EEA Services etc.) Regulations (Northern Ireland) 2012 omit regulation 4.

The Health Services (Cross-Border Health Care) Regulations (Northern Ireland) 2013

6. The 2013 Regulations are revoked.

General Dental Services (Amendment) Regulations (Northern Ireland) 2013

7. In the General Dental Services (Amendment) Regulations (Northern Ireland) 2013 omit regulations 2, 3 and 4.

The Health and Personal Social Services (General Medical Services Contracts) (Amendment No. 2) Regulations (Northern Ireland) 2013

8. In the Health and Personal Social Services (General Medical Services Contracts) (Amendment No. 2) Regulations (Northern Ireland) 2013 omit regulations 2, 3, 4 and 5(3) to (6).

Provision of Health Services to Persons Not Ordinarily Resident Regulations (Northern Ireland) 2015

9. —(1) The Provision of Health Services to Persons Not Ordinarily Resident Regulations (Northern Ireland) 2015 are amended as follows.

(2) In regulation 2(1) (interpretation) omit the definitions of—

(a) “Directive 2011/24/EU”,

(b) “out of hours period”,

(c) “out of hours provider”,

(d) “out of hours services”, and

(e) “visiting patient”.

(3) Omit regulation 25(visiting patients under Directive 2011/24/EU).

The Health Services (Cross-Border Health Care) (Amendment) Regulations (Northern Ireland) 2015

10. The Health Services (Cross-Border Health Care) (Amendment) Regulations (Northern Ireland) 2015 are revoked.

CHAPTER 3 Savings

Saving of Article 14B of the Order of 1972 for pre- IP completion day cases

11. —(1) Despite the revocations made by regulations 2, 5, and 6, Article 14B of the Order of 1972 continues to have effect on and after IP completion day in relation to any qualifying EEA expenditure which was incurred on or after 10 May 2012 and before 27 December 2013 and was not reimbursed under that Article before IP completion day .

(2) In Article 14B as saved by this regulation, paragraph (5) is to be read as if for the words “circumstances where Article 20 or 27(3) of Regulation (EC) No. 883/2004 applies” there were substituted “ circumstances where, immediately before IP completion day , Article 20 or 27(3) of Regulation (EC) No. 883/2004 would have applied ” .

(3) The definition of “Regulation (EC) No. 883/2004 ” in Article 2(2) of the Order of 1972 continues to have effect for the purposes of Article 14B as saved by this regulation, but as if in that definition there were inserted at the end “as that Regulation had effect immediately before IP completion day ”.

(4) In Article 14B as saved by this regulation “ EEA state ” has the meaning given by Schedule 1 to the Interpretation Act 1978 .

(5) In this regulation “ qualifying EEA expenditure ” has the same meaning as in Article 14B of the Order of 1972 as that Article had effect immediately before IP completion day .

Saving of Articles 14D and 14E of the Order of 1972 for pre- IP completion day cases

12. —(1) This regulation applies despite the revocations made by regulations 2, 5, and 6.

(2)Article 14D of the Order of 1972 continues to have effect on and after IP completion day in relation to qualifying EEA expenditure which—

(a) was incurred (and not reimbursed under that Article) before IP completion day ,

(b) was incurred on or after IP completion day on the provision of a service which was provided, or began to be provided, before IP completion day , or

(c) was incurred on or after IP completion day on the provision of a service that was authorised under Article 14E of that Order—

(i) before IP completion day , or

(ii) on or after IP completion day on an application under Article 14E made before IP completion day .

(3) But nothing in this regulation—

(a) requires reimbursement of qualifying EEA expenditure incurred on the provision of a service which was provided after the later of—

(i) the end of one year beginning immediately after the day on which IP completion day falls, or

(ii) where an authorisation for the provision of the service specified a period within which the service must be provided, the end of the specified period.

(4) In Article 14D as saved by this regulation, paragraph (9) is to be read as if for the words “circumstances where Article 20 or 27(3) of Regulation (EC) No. 883/2004 applies” there were substituted “ circumstances where, immediately before IP completion day , Article 20 or 27(3) of Regulation (EC) No. 883/2004 would have applied ” .

(5)Article 14E of the Order of 1972 continues to have effect on and after IP completion day in relation to an application for authorisation under that Article which was made, but not determined, before IP completion day .

(6) The following definitions continue to have effect for the purposes of Articles 14D and 14E of the Order of 1972 as saved by this regulation—

(a) the definitions in Article 14B of that Order which are applied by Article 14D(15) as saved by this regulation, and

(b) the definitions in Article 2(2) of the Order of 1972 of “Regulation (EC) No. 883/2004 ”, but as if there were inserted at the end of that definition “as that Regulation had effect immediately before IP completion day ”.

(7) Any reference to an EEA state other than the United Kingdom—

(a) in Article 14D as saved by this regulation , or

(b) in a definition applied by Article 14D(15) as so saved,

is to be read in relation to times after IP completion day as a reference to an EEA state.

(8) In that Article and in any such definition, “ EEA state ” has the meaning given by Schedule 1 to the Interpretation Act 1978.

(9) In this regulation “qualifying EEA expenditure”, and “service” have the same meaning as in Article 14D of the Order of 1972 as that Article had effect immediately before IP completion day (except that, for the purposes of this paragraph, references in that Article or in any definition applied by paragraph (15) of that Article to an EEA state other than the United Kingdom are to be read, in relation to times after IP completion day , as references to an EEA state).

Saving of the 2013 Regulations for pre- IP completion day cases

16. —(1) In relation to a case where paragraph (2) or (3) applies, the 2013 Regulations continue to have effect on and after IP completion day in so far as they relate to the National Contact Point and visiting patients as if the revocations made by regulations 6 and 10 of these Regulations had not been made, but with the modifications set out in Schedule 1.

(2) This paragraph applies where—

(a) a service within Article 14B(3) or Article 14D(4) of the Order of 1972 was provided or began to be provided, or was authorised to be provided, before IP completion day , or

(b) an application for authorisation under Article 14E of that Order was made before IP completion day .

(3) This paragraph applies where a cross-border healthcare service was provided or began to be provided to a visiting patient before IP completion day in the circumstances referred to in Regulation 11 (health care charges) or regulation 12 (exemption from health care charges for certain persons who reside in another member State) of the 2013 Regulations.

(4) But nothing in this regulation imposes an obligation in relation to a charge to a visiting patient for a service which was provided after the end of one year beginning immediately after the day on which IP completion day falls.

(5) In this regulation “ charge ”, “ cross-border healthcare service ” and “ visiting patient ” have the same meaning as they had in the 2013 Regulations immediately before IP completion day .

PART 3 Miscellaneous amendments

The Health and Personal Social Services (General Medical Services Contracts) (Prescription of Drugs Etc) Regulations (Northern Ireland) 2004

19.—(1) The Health and Personal Social Services (General Medical Services Contracts) (Prescription of Drugs Etc) Regulations (Northern Ireland) 2004 are amended as follows.

(2) In Schedule 2 (drugs, medicines and other substances that may be ordered only in certain circumstances), in the entry in column 2 of the table relating to patients with erectile dysfunction—

(a) for sub-paragraph (b) (including the “or” at the end) substitute—

“ (b) a man who is a national of an EEA State who—

(i) immediately before IP completion day was entitled to treatment by virtue of Article 7(2) of Council Regulation 1612/68 as extended by the EEA Agreement or was entitled to treatment by virtue of any other enforceable EU right;

(ii) has erectile dysfunction and was on 14th September 1998 receiving a course of treatment under a national health insurance system of an EEA State for that condition with any of the drugs listed in sub-paragraph (a); and

(iii) immediately before IP completion day was receiving a course of treatment for the condition mentioned in paragraph (ii) of this sub-paragraph with any of the drugs listed in sub-paragraph (a); or ” ;

(b) for sub-paragraph (c) (including the “or” at the end) substitute—

“ (c) a man who is not a national of an EEA State but who is the member of the family of such a national and who—

(i) immediately before IP completion day had an enforceable EU right to be treated no less favourably than the national in the provision of medical treatment;

(ii) has erectile dysfunction and was on 14th September 1998 receiving a course of treatment for that condition with any of the drugs listed in sub-paragraph (a); and

(iii) immediately before IP completion day was receiving a course of treatment for the condition mentioned in paragraph (ii) of this sub-paragraph with any of the drugs listed in sub-paragraph (a); or ” .

PART 4 Supplementary

EU-derived rights

20. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Regulation 16

SCHEDULE 1 Modifications to the 2013 Regulations for pre- IP completion day cases

1. The modifications of the 2013 Regulations referred to in regulation 16 are that those Regulations are to be read as if—

(a) in regulation 2 (interpretation)—

(i) in the definition of “resident patient”, for “the United Kingdom is” there were substituted “ immediately before IP completion day the United Kingdom was ” ;

(ii) in the definition of “visiting patient”, for “a member State other than the United Kingdom is” there were substituted “ immediately before IP completion day a member State other than the United Kingdom was ” ;

(b) in the heading to regulation 5 (national contact point: information about treatment in another member State), for “another member State” there were substituted “ a member State ” ;

(c) in regulation 5—

(i) for references to “other member States” there were substituted “ member States ” ;

(ii) for the reference to “another member State” there were substituted “ a member State ” ;

(d) regulation 5A (National Contact Point: information about prescriptions intended to be used in another member State) were omitted;

(e) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(f) regulation 7 (National Contact Point: duty to consult) were omitted;

(g) in regulation 12—

(i) in paragraph (2) for “P is” there were substituted “ immediately before IP completion day P was ” ;

(ii) in paragraph (2)(a), for “is resident” there were substituted “ was resident ” ;

(iii) in paragraph (2)(b), for “is the competent member State” there were substituted “ was the competent member State ” ;

(iv) in paragraph (4)(b) at the end there were inserted “as it had effect immediately before IP completion day ”;

(h) the schedule (elements that must be included in prescriptions intended to be used in another member State) were omitted.

Regulation 17

SCHEDULE 2 Modifications to the 2013 Regulations for cross-border arrangements

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