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Where reciprocal arrangements have been agreed, you may need one of the following:.

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Once you have the relevant forms, register them with the Overseas Healthcare Team. Send a copy of your forms to:. This will apply until the end of your course, even if it finishes after exit day. You may also be asked to demonstrate that you began your course before the UK left the EU. You should buy insurance to cover your healthcare as you would if visiting another non-EU country. If the UK reaches a reciprocal healthcare agreement with your home country, you would be able to access healthcare in the same way you can now until 31 December See student health tips.

For more advice, see moving to England from outside the EEA. Page last reviewed: 28 August Next review due: 28 August Such arrangements would not affect the rights of individuals covered by the Citizens' Rights Agreements with Norway, Iceland, Liechtenstein and Switzerland, as set out below If there is a no-deal Brexit and you are considering moving to the UK after the day the UK leaves the EU, you should check with your health insurance authority what has been agreed.

EHIC: European Health Insurance Card explained

State pensioners or benefit holders If you receive a state pension or another exportable benefit from Norway, Iceland, Liechtenstein or Switzerland, you will need to check with the relevant authorities to see if they are responsible for your health costs in England. But "the relentless drive towards ever greater cost savings through contracting out has, in many cases, had a disastrous effect on service quality".

Low pay and poor working conditions are two of the main causes of poor quality care, yet the benchmark of tendering and awarding contracts is cost rather than quality. Many NHS managers now recognise that "privatisation is not an infallible cure for service inefficiencies". Pressure from the families of hundreds of those who have died or been left disabled, brain-damaged or in severe pain as a result of inadequate care in private facilities led to a Care Standards Act in to enforce standards in private hospitals, and residential and nursing homes in the UK.

Analysis of the quality of care provided by for-profit entities in the United States casts further doubts on the assertion that the private sector provides better quality. But if quality of private and public care could be assured, evaluated by public health concerns rather than economic benchmarks such as the number of patients being treated or the length of waiting times, 99 it may be argued that using state money to pay a commercial company to provide health care services is no different from using it to fund public services.

Moreover, private services, it is said, can fill the gaps in the public system. In practice, the move to for-profit providers undermines the public sector in several ways even though this private sector depends upon the public sector. When public and voluntary hospitals and health services have to compete with commercial providers for funding, whether provided by the state in the form of per-person public funds or private insurance or co-payments additional payments by patients , less money ends up flowing into the public system.

Competition also leads to competition for patients -- the private sector tends to take the healthier and wealthier. Typically, the public sector is left to care for more vulnerable people whilst at the same time contending with cutbacks in funding. The inevitable result is a loss of preventative services: the public sector has less money for these services, while the private sector is not interested in them.

Private health providers do not aim to provide health care to society, but health products or surgical procedures to individuals. They will not supply inherently unprofitable care to anyone, least of all to those who are in no position to pay for it.

Changes in health care provision in the United States and Latin America over the past two decades illustrate these trends clearly. In the early s in the US, a growing number of hospitals, health maintenance organisations HMOs, or insurer-type intermediaries between employers and hospitals , nursing homes, home care services and hospices became for-profit companies publicly traded on stock exchanges. HMOs, transformed from a social form of medicine into multibillion-dollar businesses depending on a mixture of public funding, private health insurance and user charges, acquired non-profit hospitals cheaply and gained effective control over US hospitals.

The pursuit of market share, the search for profitable admissions and relentless cost-cutting came to dominate all aspects of health care, even that provided by socially-oriented entities. By the late s, pressure to protect profit margins had led to insurers and hospitals avoiding sick patients, the micro-management of physicians, a worsening of staff-to-patient ratios, and the outright denial of care to many.

Instead of exercising greater efficiency in the use of available resources and greater integration of preventive and treatment services, the industry merely tries to avoid costs. Latin America, meanwhile, particularly Chile, Colombia, Peru, Argentina, Brazil, Mexico and Venezuela has become a testing ground for the privatisation of health care in the name of "reform", pushed by the World Bank, Inter-American Development Bank and US-trained national economists, and by the export targets of US health care providers and insurers.

Private insurers tend to select the "best risks", mainly young and healthy people. They reject those with chronic illnesses and leave behind those who cannot afford the insurance. Private companies tend not to operate in the countryside where health services have always been sparse. Yet private operators rely on the very state health and social services that they are undermining. They take trained and experienced staff from the state system, select patients whose needs the public services have already identified, offer only the profitable services they want to, and set up private facilities, ranging from laboratory analysis to residential care, which can be rented or contracted out to the public service.

The WTO itself acknowledges that:. New private clinics may well be able to attract qualified staff from public hospitals without In Brazil, the private sector can now offer , doctors for one-quarter of the population, whilst the public sector has fewer than 70, doctors for everyone else. As Public Services International concludes, such private health care "is never cheaper or more comprehensive than state care".

Healthcare for EU citizens after Brexit

In India, under the influence of World Bank reforms, medical care has been handed over to the private sector without mechanisms to ensure the quality and standards of treatment. Infectious disease control programmes run by the state have been disrupted by being deprived of funds. Similar results have occurred in Sub-Saharan Africa.

Healthcare, Health Insurance and Education Services

Private provision, in other words, is not an effective means to promote public health. Yet without good public health, the health of every individual is endangered. As Geof Rayner of the UK Public Health Association points out, "a market-based approach to health not only drives up the costs of health care, but it can also lead to disinterest in the factors that make people ill.

A consumer society promises -- falsely -- that medical technology can fix diseased individuals, and that good health can be bought and sold in the marketplace rather than being something to promote or work for.

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The World Trade Organisation, not the World Health Organisation, is, according to some, the international agency with the greatest impact on health. Trade policies have a substantial influence on health and the environment, while measures to protect the environment and human health are often regarded as trade barriers. WTO agreements do allow regulations to be exempt from their rules because of public health concerns, but the exemptions have been narrowly formulated and interpreted on the grounds that countries could use health and safety regulations as covert trade barriers. The dispute settlement process compares like commodities with like, ignoring to a large extent the processes and practices involved in producing them.

State of Health in the EU

It requires any regulations stricter than international standards to be based on scientific risk assessment. The implications for health, safety and environmental concerns are serious. For instance, no account is taken of the differences between a small-scale manufacturer and a multinational company, nor between production processes based on high labour standards and those based on low standards.

There is no requirement for the trade experts who comprise tribunals to concern themselves with public health. Public health and safety measures which are the "least trade restrictive" are favoured. Voluntary measures are favoured over compulsory ones -- labelling or fines over taxation, bans or advertising restrictions.

Views: Education in health innovation

Individual responsibility is favoured over public responsibility. The Trade Related Intellectual Property Rights Agreement TRIPs sets minimum standards of protection for all forms of intellectual property: patents, copyrights, trademarks, and industrial designs and licences. It obliges governments not to disclose of information of commercial value provided for marketing licences, for instance, for pharmaceuticals and agricultural products. TRIPs allows patents to be granted on products and processes for 20 years.

It allows patents on seeds, pharmaceutical drugs, genes and diagnostic tests, and also on minor innovations which are more "discoveries" than an "inventions". TRIPs does not promote free trade: it protects monopoly rights rather than encourages competition. TRIPs has recently gained international public attention because of its implications for the access people in the South have to pharmaceutical drugs, particularly AIDS drugs in Africa.

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But this is just the tip of the iceberg of TRIPs-related health concerns. Patents increase the prices of pharmaceutical drugs which are paid for in most countries by the sick or from health budgets, whether public or insurance based. Thus research on products which have large potential markets -- obesity, ageing, impotence and baldness -- prevails over health policy interests.

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Public institutions and public funding often carry out and support much of the basic research and product development needed before pharmaceutical drugs are brought to market, but this input is rarely recognised in the awarding of patents. The use and promotion of TRIPs thus encourages the misallocation of public funds to corporate marketing efforts, shifting money from the sick and the poor to corporate shareholders. Moreover, intellectual property rights are hindering the dissemination of knowledge and technology. Industrial countries currently hold 97 per cent of all patents worldwide, while 80 per cent of patents granted in developing countries belong to residents of industrial countries.

Any country wishing to implement stricter standards has to base them on scientific risk assessment. The interpretation of this risk assessment, and thus the possibility of stricter standards, has implications for health policies. Disputes involving the SPS Agreement have raised issues about the burden of proof, the use of precaution, and definitions of risk assessment, scientific evidence and necessity.

Take, for example, regulations covering potentially hazardous methods of production, such as those which have potential carcinogenic or hormonal impacts if people are exposed to them over the long-term or at low-level doses. Such regulations are more open to challenges under the WTO than regulations governing finished products because of known evidence of the immediate and specific hazards caused by such products. The WTO disputes panel has generally ruled that public policy measures not supported by sufficient quantitative scientific evidence violate WTO rules.

Precautionary measures, however, may be appropriate for risks which are small but which have potentially catastrophic consequences. The US has recently called for sections of Codex invoking the precautionary principle to be removed entirely. The Agreement on Technical Barriers to Trade TBT encourages countries to use internationally-agreed standards for their technical regulations but the regulations cannot be more "trade restrictive" than necessary.

The International Standards Organisation ISO , for example, is an industry-based organisation not an inter-governmental one like Codex which has been accepted by the TBT as eligible to draw up international standards. The ISO has recently become involved in setting water standards, raising concerns that such standards will be ratcheted downwards to reflect industry preferences and priorities rather than public health.

TBT thus has implications for the production, labelling, packaging and quality standards of pharmaceuticals, biological products and foodstuffs. Besides these specific WTO agreements, various socio-economic factors associated with the current expansion of international trade have direct impacts on health as well. Poverty remains the main cause of ill health.