People on either side of the Northern Irish border could face delays and complications in accessing medical treatment if the United Kingdom leaves the European Union in a no-deal scenario at the end of October.
And its down to one thing: data.
Under Europes tough privacy standards, doctors, hospital workers and other medical staff in the Republic of Ireland will no longer be able to share patient records automatically with their counterparts in Northern Ireland and the rest of the U.K. unless complex data protection agreements are in place by October 31.
This represents a problem for thousands of Irish patients who currently rely on access to health care treatments across the border, taking advantage of provisions in the Good Friday Agreement between the Republic and Northern Ireland that allow people to seek care in either country. Any restrictions on transferring medical records across the border could create substantial treatment delays or even put patients at risk if they are unable to access treatment.
“Were talking about real people being hurt as collateral damage in this political standoff,” said Stephen McMahon, co-founder of the Irish Patients Association, an advocacy group in Dublin. “The very last thing we want to hear about is that some patients die because they couldnt get treatment in Northern Ireland.”
In the last three years, more than 4,000 applications were approved for Irish residents to receive medical treatment in the United Kingdom.
Patients in Donegal, a western county in the Republic, for instance, currently travel across the border for care at cancer treatment centre in Derry/Londonderry. But in the event of a no-deal, their medical records, including vital cancer-related documents, could face significant delays, potentially leading to life-threatening outcomes if doctors were unable to treat them.
Concerns over patient care come amid growing tensions over the Northern Ireland border issue that is front and center of the Brexit deadlock.
It also underscores the many unintended consequences of a no-deal Brexit for people living in Ireland who routinely move between the U.K. and the Republic for medical treatment, education and more than 100 other forms of cross-border cooperation between London and Dublin. Doctors are already warning about possible medicine shortages if the U.K. leaves without a Withdrawal Agreement and complications for medical staff who either live or have qualifications from the Republic to continue working in the North.
No deal for data
Under a potential no-deal Brexit, existing EU cross-border health care arrangements between the U.K. and EU will stop. These include emergency health care for holidaymakers under the European Health Insurance Card program, as well as for British citizens living in other EU countries who receive local health care services.
London says its working on securing reciprocal health care deals with each EU country to continue existing arrangements.
Both the British and Irish governments have promised to continue offering cross-border health care between Northern Ireland and the Republic | Charles McQuillan/Getty Images
Both the British and Irish governments have promised to continue offering cross-border health care between Northern Ireland and the Republic, no matter what Brexit deal is eventually agreed.
In a statement to POLITICO, Irelands Department of Health said it has made arrangements with its U.K. counterparts to maintain routine and emergency health services for both British and Irish residents, including existing specialized treatments currently available to patients on both sides of the border.
Northern Irelands Department of Health told POLITICO it is working with its Irish counterparts on ways for patient data to move freely between both jurisdictions in the event of a no-deal Brexit.
But when asked which legal mechanisms it would rely on to transfer peoples health care information, Irelands Department of Health admitted that it would be the responsibility of individual health care providers to ensure they could legally move patient data to the U.K. in compliance with EU privacy standards.
With a potential no-deal Brexit just over two months away, several Irish doctors said they are unaware of the additional steps needed to transfer patient data legally.
In response to questions about how data would be transferred between the U.K. and Ireland, Northern Irelands Department of Health referred POLITICO to a section of Europes new privacy rules, the General Data Protection Regulation, or GDPR, that do not relate to international data. The agency later said individual hospitals and doctors practices would be responsible for arranging legal agreements with their southern counterparts.
“I am particularly concerned that they dont seem to know which articles in GDPR relate to cross-border transfers,” said Daragh OBrien, managing director of Castlebridge, a data protection consultancy in Dublin. “Its like basing your opinion of Professor Snape on the first two Harry Potter books. The important stuff is later on.”
Doctors across borders
Cross-border medical treatment in Ireland has become part of daily life.
In the last three years, more than 4,000 applications, representing roughly €38 million in cross-border medical procedures, were approved for Irish residents to receive medical treatment in the U.K., according to an investigation by the Detail.
Northern Irelands Department of Health said individual hospitals and doctors practices would be responsible for arranging legal agreements with their southern counterparts | Sean Gallup/Getty Images
Many of these cross-border doctor visits are carried out as part of coordinated, EU-funded programs aimed at reducing health care costs for local providers and offering specialized services not available on one side of the border.
The cross-border system “is currently working well for families and patients on both sides of the border,” said Sarah Quinlan, chief executive of The Childrens Heartbeat Trust, a charity in Belfast that supports families traveling for medical treatment in the Republic of Ireland and other parts of the U.K. Her organization has received assurances from London and Dublin that nothing will change in the event of a no-deal Brexit.
The lack of clarity over medical data transfers will test those promises.
If the U.K. leaves the EU without a Brexit agreement, London has said it will continue to allow data held by U.K. entities to move freely to the EU. Patient records held in Northern Ireland will still be transferred to the Republic and other parts of the soon-to-be 27-country bloc.