Question to the Department of Health and Social Care:

To ask Her Majesty’s Government, further to the Written Answer by Lord Prior of Brampton on 13 June (HL566), what the calculation systems are for payments by the UK to France, Ireland and Spain for the cost of providing treatment to people for whom the United Kingdom is responsible under European Union law.

Other European Economic Area (EEA) countries and Switzerland reimburse the United Kingdom for the cost of the National Health Service providing treatment to people they are responsible for under European Union law, including UK nationals insured in another EEA country or Switzerland. In the same way, the Department, on behalf of the UK Government, reimburses other EEA countries and Switzerland for the cost of providing healthcare treatment to people we are responsible for under EU law, irrespective of nationality.

As insurability under EU law is not determined on the basis of nationality, it is not possible to provide information on the number of citizens from each country covered by these rules.

Payment arrangements from the UK to France, Spain and Ireland are as follows:

France:

- All categories of insured persons: Actual costs (meaning the UK is billed for actual healthcare usage)

Spain:

- Temporary Visitors: Actual costs

- All other categories: Average costs (a lump sum is billed, irrespective of the amount of healthcare received)

Ireland:

- Temporary Visitors (not including planned treatment claims or workers): Formula agreement

- Planned Treatment claims: Actual costs

- Workers: Waiver agreement between the two countries

- All other categories: Average costs

The decision on whether to bill on the basis of average costs is for individual EEA countries to make.