Asked by: Baroness Quin (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what steps they are taking, if any, to ensure continued access for British citizens to health services in the EU after Brexit, including continued access to the benefits of the European Health Insurance Card.
Answered by Baroness Blackwood of North Oxford
The agreement we have reached with the European Union is that until 31 December 2020 there will be no changes to reciprocal healthcare access for pensioners, workers, students, tourists and other visitors, the European Health Insurance Card scheme, or planned treatment.
People who have settled in the EU or United Kingdom before 31 December 2020, will continue to have life-long reciprocal healthcare rights provided they remain covered under the terms of the Withdrawal Agreement. This means existing healthcare arrangements will not change for those UK nationals who are resident in the EU and EU citizens in the UK before 31 December 2020, for as long as they are living in that country and covered by the agreement.
We want to continue discussing the future of reciprocal healthcare arrangements with the EU as part of the future relationship discussions.
Asked by: Baroness Quin (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what arrangements they have made with the EU for the European Health Insurance Card to continue to be used by British citizens when travelling within the EU.
Answered by Lord O'Shaughnessy
The current structure of European Union rules and regulations will apply during the implementation period, and this includes cover under the European Health Insurance Card (EHIC) scheme.
With regard to EHIC cover under the Withdrawal Agreement, where the United Kingdom, or an EU 27 Member State, is responsible for the healthcare of those within scope of the social security coordination part of the Withdrawal Agreement, such individuals will be entitled to EHIC cover for as long as they remain in scope. We have also agreed to protect the rights of individuals who are in a cross-border situation at the end of the implementation period, and entitled to an EHIC, to continue to benefit from that scheme for as long as that cross-border situation in the State they are in continues.
In the White Paper of July 2018, The future relationship between the United Kingdom and the European Union, the UK Government has stated that it is seeking agreement on reciprocal healthcare including continued participation in the EHIC scheme.
Asked by: Baroness Quin (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether they have discussed the subject of the UK's future participation in the European Health Insurance Card scheme in their Brexit negotiations with the European Commission.
Answered by Lord O'Shaughnessy
We have agreed reciprocal healthcare arrangements for the purposes of the Withdrawal Agreement with the European Union. The current structure of EU rules and regulations will apply until the end of the implementation period, including the European Health Insurance Card (EHIC) scheme.
Individuals in scope of the Withdrawal Agreement will be entitled to reciprocal healthcare cover on the terms laid out under that deal.
Reciprocal healthcare rights for individuals not in scope of the Withdrawal Agreement will be a matter for further negotiation with the EU. We have been clear that we want all current and future United Kingdom EHIC holders to benefit from EHIC rights, subject to a reciprocal deal.
At every step of the negotiations we will work to ensure the best possible outcome for the British people.
Asked by: Baroness Quin (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether they plan to ensure that UK citizens can participate in the European Health Card scheme (1) during, and (2) after, the transition period following the UK's withdrawal from the EU.
Answered by Lord O'Shaughnessy
We have agreed reciprocal healthcare arrangements for the purposes of the Withdrawal Agreement with the European Union. The current structure of EU rules and regulations will apply until the end of the implementation period, including the European Health Insurance Card (EHIC) scheme.
Individuals in scope of the Withdrawal Agreement will be entitled to reciprocal healthcare cover on the terms laid out under that deal.
Reciprocal healthcare rights for individuals not in scope of the Withdrawal Agreement will be a matter for further negotiation with the EU. We have been clear that we want all current and future United Kingdom EHIC holders to benefit from EHIC rights, subject to a reciprocal deal.
At every step of the negotiations we will work to ensure the best possible outcome for the British people.
Asked by: Baroness Quin (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of the possible increases in travel insurance for UK citizens if the UK were no longer to be part of the European Health Insurance Card scheme after Brexit.
Answered by Lord O'Shaughnessy
The Department has not made a formal assessment of the possible increases in travel insurance for United Kingdom citizens if the UK were no longer to be part of the European Health Insurance Card scheme after Brexit.
However, the Department engages regularly with the Association of British Insurers and industry to discuss matters relating to reciprocal healthcare and this will continue.
Asked by: Baroness Quin (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, in the light of proposals to restrict access to prescription-based vitamin D maintenance, whether they will undertake a study into how such proposals might affect at-risk groups, as set out in NICE Guidelines 56-2, and in particular those in the at-risk groups on low or fixed incomes.
Answered by Lord O'Shaughnessy
NHS England undertook a study into how the proposals in the consultation Conditions for which over the counter items should not routinely be prescribed in primary care: A Consultation on guidance for CCGs might affect at-risk groups by accompanying the consultation with a full Equality and Health Inequalities Impact Assessment. The Impact Assessment, Equality and Health Inequalities – Full Analysis Form – Conditions for which over the counter items should not routinely be prescribed in primary care sets out how the proposals may affect groups protected by the Equality Act 2010 and those people on low income and ethnic minorities, including those at-risk groups, as set out in National Institute for Health and Care Excellence guidelines. Copies of the consultation and Impact Assessment are attached.
In the summer months most people should be able to get all the vitamin D they need from sunlight on the skin. It is also found in some foods – oily fish, red meat, liver, egg yolks and fortified foods – such as most fat spreads and some breakfast cereals.
The Advisory Committee on Borderline Substances states that vitamins and minerals should be prescribed only in the management of actual or potential vitamin or mineral deficiency, and are not to be prescribed as dietary supplements. We understand that NHS England’s current consultation is in line with this. Prescribing vitamin D for maintenance would be classed as a treatment for prevention or as a dietary supplement.
Asked by: Baroness Quin (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether they intend to ensure that women over 60 years old are routinely offered bone density scans to ascertain bone health.
Answered by Lord O'Shaughnessy
Fracture liaison services (FLS) provide secondary prevention for fragility fractures. These services identify patients in secondary and/or primary care who have suffered a fragility fracture and assess the patient’s risk of future fragility fracture in a timely fashion. A FLS then provides advice and/or therapy to reduce that risk.
The National Institute for Health and Care Excellence (NICE) evidence based guideline Osteoporosis: assessing the risk of fragility fracture, updated in February 2017, sets out best practice on management of fracture risk in patients with osteoporosis. A copy of the guideline is attached. The guidance recommends that clinicians consider assessment of fracture risk in all women aged 65 years and over and all men aged 75 years and over. Women aged less than 65 years and men aged less than 75 years should be considered for assessment in the presence of certain risk factors, such as a family history of hip fracture or low body mass index.
Regarding bone density scanning, NICE recommends it be considered after patients have first been assessed using a validated risk assessment tool, such as FRAX, which clinicians can use to evaluate the 10-year probability of bone fracture risk in patient. The guidance also recommends other circumstances where bone density scanning should be considered, including for patients who are to undergo treatment which may affect bone density, such as certain treatments for breast or prostate cancer.
Asked by: Baroness Quin (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether they intend to ensure that all NHS users over 50 years old have access to Fracture Liaison Services to identify the link between any fracture and the bone health of the patient.
Answered by Lord O'Shaughnessy
Fracture liaison services (FLS) provide secondary prevention for fragility fractures. These services identify patients in secondary and/or primary care who have suffered a fragility fracture and assess the patient’s risk of future fragility fracture in a timely fashion. A FLS then provides advice and/or therapy to reduce that risk.
The National Institute for Health and Care Excellence (NICE) evidence based guideline Osteoporosis: assessing the risk of fragility fracture, updated in February 2017, sets out best practice on management of fracture risk in patients with osteoporosis. A copy of the guideline is attached. The guidance recommends that clinicians consider assessment of fracture risk in all women aged 65 years and over and all men aged 75 years and over. Women aged less than 65 years and men aged less than 75 years should be considered for assessment in the presence of certain risk factors, such as a family history of hip fracture or low body mass index.
Regarding bone density scanning, NICE recommends it be considered after patients have first been assessed using a validated risk assessment tool, such as FRAX, which clinicians can use to evaluate the 10-year probability of bone fracture risk in patient. The guidance also recommends other circumstances where bone density scanning should be considered, including for patients who are to undergo treatment which may affect bone density, such as certain treatments for breast or prostate cancer.