The British Devil


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European governments did not adopt mechanisms to allow their citizens to access healthcare elsewhere for reasons of altruism. The welfare of a drunken participant in a stag party in Prague or Krakow never entered their thinking.

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Quite simply, a single European labour market would be impossible if those moving for employment, either permanently, or as was initially the case with those working in the coal and steel industry in the French-German border, on a daily basis, could not be assured that they would be looked after if they became ill. Moreover, arrangements to provide health cover were only part of a much larger package, covering areas such as pension entitlements, occupational and industrial injury benefits, and maternity benefits.

Obviously, if the arrangements to provide health cover are there to facilitate the free movement of people, then it is difficult to see a rationale for maintaining them in respect of a country that has decided to restrict free movement. In other words, by taking back control of its borders, the United Kingdom has said very clearly that it wants to opt out of all the arrangements that go with that. But surely, the supporters of Brexit will argue, if the European Union refuses to continue these arrangements, it will be doing so to punish the British.

This has now become the standard refrain when they are told that something will no longer be possible.

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The reality is, that as healthcare is a national competence, the European Union has no powers to make an agreement with a third country, as the UK will become. In both cases, the other countries are required to adopt European Union law, without having any say in its development. They are also required to accept free movement of people. The absence of a clear dispute resolution system in the latter, coupled with widespread concerns about the nature of the agreement between the EU and Switzerland, mean that a similar arrangement with the UK is virtually impossible.

Given that healthcare is a national competence, European Union member states are allowed to make bilateral agreements with any country they choose. The United Kingdom already has a number of these , mainly with its dependent territories and with Australia and New Zealand.

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Until it had similar arrangements with the states that emerged from the USSR and still has them with the countries that were part of Yugoslavia. However, the persistence of these arrangements seems almost certainly because the work of terminating them has never reached the top of the agenda of the relevant department within the UK government, even if it was clear who that was.

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Other member states have dozens of such arrangements, entered into for a variety of reasons. In some cases, they reflect links going back to the colonial period. Others, involving countries aspiring to EU membership, act as a symbol of this aspiration.

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A few more have been adopted under pressure from large corporations, seeking to ensure provision for their workers in countries such as India. However, what is striking is that the UK has not entered into any such agreements for many decades.

The clear implication is that, if the UK wants to maintain some sort of healthcare coverage for its residents in the rest of the EU, including those nationals of other EU member states legally resident and working in the UK when they return home, then it will have to negotiate bilateral agreements with each of the other 27 governments.

It is not obvious that all of them will see this as a priority. An alternative would be to wait until all of them had agreed among themselves about a mechanism to cooperate with external countries, but this could take a very long time.

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It is something that has been discussed for many years, particularly with respect to the countries of North Africa , many of whose citizens work within the EU. However, it has never been possible to reach agreement even on limited provisions covering issues such as pensions. It may also be possible to find a way of agreeing something with groups of member states, such as the Ibero-American agreement , involving Spain, Portugal, and a number of countries in Latin America.

The UK proposal is viewed on the Irish side as a hybrid version of a previous proposal, tabled by the British in June, that would keep the UK aligned with the EU on customs, but for a time-limited period.


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EU officials await a formal proposal from the UK on its backstop plan, which Ms May has promised to provide shortly. A proposal is required if a deal on the withdrawal agreement is to be reached by the next meeting of EU leaders at the European Council summit on October 18th.

Simon Carswell Public Affairs Editor. No customs union means border posts are inevitable. Explore the Border Crossings mapped: what happened in the Troubles and how they are today.

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