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The European Council agreed to delay the United Kingdom’s withdrawal date until 31 January 2020.

At the request of the UK, the Withdrawal Agreement and Political Declaration adopted by the EU member states in November 2018 were partly renegotiated in autumn 2019. The European Council (Art. 50) endorsed the revised agreement and approved the revised declaration on 17 October 2019. The British Parliament and the European Parliament still have to give their consent to the agreement.

The EU believes that it is a fair outcome that secures the interests and unity of the EU, while safeguarding peace and stability on the island of Ireland.

The EU and its Member States have also made preparations for a no-deal scenario in which the UK withdraws from the EU without an agreement.

Brexit may affect the availability of medicines, social security and medical care

The Ministry of Social Affairs and Health, together with other authorities and actors, has prepared for the United Kingdom’s possible withdrawal from the European Union without an agreement.

If the UK leaves the EU without an agreement, this may have effects on areas such as social security, medicines and medical care.

Preparations have been made for disruptions in the availability of medicines

Brexit may affect the availability of some medicines in the EU. The Ministry of Social Affairs and Health, together with pharmaceutical sector’s authorities and stakeholders, has explored the potential abnormal situations and the related risks. Steps have been taken to prepare for various scenarios.

In order to be granted marketing authorisation in the EU, medicines must meet the standards specified by the EU. If marketing authorisation has been granted in the UK, the pharmaceutical company in question must take steps to transfer the authorisation holder to another EU country. According to the Finnish Medicines Agency, the majority of pharmaceutical companies have transferred their marketing authorisations or activities to an EU or EEA country to make sure their operations can continue normally after Brexit. The Finnish Medicines Agency has issued guidelines to marketing authorisation holders and other organisations on how take the necessary action to prevent supply failures.

Situation updates will be provided, and cooperation with other actors in the pharmaceutical industry will continue in order to effectively manage the availability of medicines. If any problems arise, pharmaceutical companies, pharmaceutical wholesalers and pharmacies will work with health care professionals to identify substituting products in order to ensure uninterrupted care to patients.

The Finnish National Institute for Health and Welfare has looked into the availability of vaccinations and established that, according to the information the Institute has received, availability problems will not occur.

National Supervisory Authority for Welfare and Health monitors medical devices

National Supervisory Authority for Welfare and Health (Valvira) monitors medical devices in close cooperation with authorities of other EU Member States and the Commission. If Brexit enters into force, it causes problems for all authorities monitoring the safety of equipment. Joint approaches and practical arrangements to achieve a Brexit interpretation are currently being discussed, taking into account existing legislation.

Right of UK citizens living in Finland to social security and medical care

The right to social security is not based on citizenship but on whether you are staying or working in Finland and resident here legally. With regard to Social Insurance Institution’s (Kela) benefits, residence in Finland is usually determined in accordance with social welfare legislation. In other words, Kela decides whether you are entitled to social security because you live in Finland.

If you live in Finland or are moving here, first your municipality of residence is determined under the Municipality of Residence Act. The Registry Office enters the information about your municipality in the Population Information System. Then, because you have a municipality of residence in Finland, you have the right to access the municipal health and social services. However, anybody staying in Finland will have access to urgent medical treatment and the basic social services, Some Kela benefits are only available to those who have a municipality of residence in Finland.

UK citizens’ right of residence is protected by a special act until 2020 if the UK leaves the EU without a withdrawal agreement. According to the act, the right of residence will continue for those British citizens who have registered their residence before the date of Brexit. The continued right of residence also secures British nationals’ right to social security because residence-based social security is only available to people who are staying in Finland legally. The act entered into force on 30 March 2019.

A municipality’s resident has the right to access the municipal health and social services. Therefore, if you are a British national, you should contact your Local Register Office before Brexit and check that your municipality of residence, which has been determined on the basis of an EU citizen’s right of residence, has been entered in the Population Information System.

Using health services in Finland after a no-deal Brexit

The resident of a municipality always has the right to access municipal health services in Finland, irrespective of their nationality. In the event of a no-deal Brexit, the situation would remain as it is at present for British citizens who reside in Finland and have a home municipality here. They would still be able to use public health services like other municipal residents.

A no-deal Brexit would affect the right of UK citizens to seek treatment if they are staying in Finland temporarily, for example as tourists. A European Health Insurance Card or a British passport would no longer prove the patient's right to treatment.

Sudden illness

If people become ill and need urgent medical care in Finland, public healthcare services must provide care regardless of the patient’s nationality. The decision on the provision of treatment is made by a healthcare professional.

A British patient who has received urgent treatment would be charged for all the costs of treatment. Upon returning to the UK, patients could look into whether they are entitled to any compensation for the costs.

The Finnish public service provider could also invoice a private insurance company for the costs of urgent treatment, provided that the patient has travel or medical expenses insurance, for example. This would be possible only in cases where the provider of the care and the insurance company have already agreed on the invoicing arrangement.

The patient could also seek urgent care from private healthcare service providers. In that case, the patient would pay for the services in accordance with the service provider's price list. The patient would not receive reimbursement for the costs from the Social Insurance Institution (Kela) in Finland.

Seeking non-urgent care

After a no-deal Brexit,  Finland’s public healthcare services would no longer have an obligation to receive British patients seeking non-urgent treatment because that obligation had been based on EU legislation. In addition, a prior authorisation under EU Regulation 883/2004 (form S2 or E 112) could no longer be used.

UK citizens could use private healthcare services like others. The service provider and the patient would agree on the costs of the services and on how the costs will be paid. Upon returning to the UK, patients could look into whether they are entitled to any compensation for the costs.

Continuing treatment in Finland

When the UK's withdrawal from the EU enters into force, persons who had already sought care in public healthcare services based on prior authorisation under EU regulation 883/2004 would be entitled to continue receiving treatment in accordance with their care plan. The costs of such treatment would be administered in the same way as before Brexit. In other words, the Social Insurance Institution of Finland (Kela) would invoice the state that had issued the prior authorisation, in most cases the UK.

If a patient had received prior authorisation (form S2) for the treatment to be provided by public healthcare services in Finland but the treatment had not started before Brexit entered into force, the patient must make sure, before starting the treatment, whether the issuer of the prior authorisation will pay the care costs or whether the patient him/herself is responsible for the costs.

If a public healthcare provider takes a patient into care, it should charge the patient for the care or, if necessary, ensure payment of the care costs from the issuer of the prior authorisation (contact details in form S2). The provider of the treatment would charge the issuer of the prior authorisation directly.

Social security for Finns living in the UK

In the event of a no-deal Brexit, if you are a beneficiary living in the UK, you will continue to receive your earnings-related pension and any benefits based on insurance covering accidents at work and occupational diseases. If you live in the UK, you can also apply for these Finnish benefits if you have been subject to the Finnish legislation on the basis of your work. 

Payment of national pension to pensioners living in the UK would stop in case of a no-deal Brexit because paying national pension benefits is based on EU legislation.  However, paying national pension benefits will continue for one year after a no-deal withdrawal.

If you have left Finland to go to the UK to look for work and are using the U2 form, your right to receive unemployment allowance from Finland will end on the date when the UK leaves the EU. 

A no-deal withdrawal has also been taken into account in EU legislation. The EU Regulation (EU) 2019/500 establishing contingency measures in the field of social security coordination following the withdrawal of the United Kingdom from the Union was adopted on 25 March 2019. The Regulation will ensure that the principles of EU law will apply for the benefit of those who, for example, have worked both in the UK and in an EU member state and earned social security benefits. The Regulation is binding on all EU member states.

Inquiries

Elina Asola, Senior Specialist, tel. +358 295 163 437, [email protected] (Pharmaceutical service)
Marja-Terttu Mäkiranta, Senior Ministerial Adviser, Legal Affairs, tel. +358 295 163 170, [email protected] (EU social welfare legislation)