Equal rights in Northern Ireland threatened by Brexit

Legal equality between Irish and British residents in the region has largely relied on EU membership.

The U.K.’s membership in the EU was the glue that helped hold together the Good Friday peace agreement — Brexit threatens to unstick it.

With just weeks until Brexit day, a significant portion of Northern Ireland’s 1.9 million residents could find themselves losing rights that their neighbors continue to enjoy — for example to education, medical care and some types of housing.

The potential consequences of a no-deal departure, which have been largely overlooked thus far, are set to impact hundreds of thousands Irish citizens who are native to the region. In a series of House of Commons votes Tuesday night, MPs indicated they want to avoid no deal. But an attempt to prevent it happening on March 29 failed to win support, meaning the cliff edge is still very much in sight.

It is particularly alarming in Northern Ireland’s febrile and polarized political atmosphere, where all citizens, whether they identify as British or Irish, were promised that they would continue to be treated equally after Brexit.

The region has had no government for two years and a potential hard border with the Republic of Ireland threatens to provoke a return to violence between the region’s mostly Protestant unionists and largely Catholic nationalists. A car bomb earlier this month in Northern Ireland’s second city Derry (also known as Londonderry) highlighted that the potential for violence is not far from the surface.

Sinn Féin MEP Martina Anderson called the situation for rights in Northern Ireland “dire” | Ahmad Gharabli/AFP via Getty Images

“We have a situation that Irish citizens [would] have no legal connection to the jurisdiction or country in which we are born,” said Martina Anderson, a Sinn Féin MEP. “The last thing we need in Northern Ireland is a differentiation of rights.

“The situation is dire,” Anderson said, adding that her constituents regularly contact her worried about the situation post Brexit and that neither British nor Irish governments have done enough to reassure them.

Equal rights

Under the terms of the 1998 Good Friday Agreement, which largely put an end to decades of conflict over Northern Ireland’s constitutional status, people born in the region are entitled either to British or Irish passports (or both) and are guaranteed equal rights regardless of their nationality. About 20 percent of Northern Ireland’s population holds only an Irish passport, according to 2011 census data.

The U.K.’s membership in the EU had papered over many of the tricky details of the arrangement, but with Brexit due to happen on March 29 with or without a deal, those legal ambiguities are due to be exposed.

“We’re actually in quite a difficult situation,” said Daniel Holder, the deputy director of the Committee on the Administration of Justice, an independent human rights group. “No one’s really working on it.”

Researchers found that few of the provisions of the Common Travel Area are included in domestic law.

The list of issues to sort out is long: from immigration rules, to rights related to residency, access to education, social security and health care. To take one example, under Northern Irish health care legislation, only British citizens or European Economic Area citizens are currently entitled to certain types of home help or community care. But EEA citizens, including Northern Ireland-born Irish citizens, stand to lose this benefit after Brexit if there is no deal and hence no transition period.

Similar concerns exist over education, where it remains unclear whether Irish citizens will be able to pay the (less expensive) home rate for Northern Irish universities. Although few expect a sudden post-Brexit hike in fees, it would be legally difficult for universities to discriminate in favor of Irish citizens over, for example, Spanish or French students, according to Holder.

A research paper commissioned by the Joint Committee of the Irish Human Rights and Equality Commission and the Northern Ireland Human Rights Commission came to similar conclusions about the need to clarify post-Brexit rights.

Politicians commonly invoke the earlier Common Travel Area between the U.K. and Ireland as guaranteeing a fallback for ensuring a range of rights for citizens of both jurisdictions. However, the human rights researchers found that few of the provisions of the CTA are included in domestic law.

“The CTA is written in sand, and its terms are much more limited than is often believed to be the case,” the report says.

“There is a need to identify clearly rights and entitlements that stem from EU law” — Les Allamby, Chief Commissioner of Northern Ireland’s Human Rights Commission

Other rights, currently enjoyed by all residents of the island, are set to be disrupted. Take health care access along the 500-kilometer border. Due to overlapping EU rules in a number of areas, all-island health care currently exists for situations such as emergency health care provisions and access to highly specialized treatments such as radiotherapy. Cancer patients in the northern county of Donegal, in the Republic of Ireland, are entitled to receive radiotherapy in neighboring Derry’s Altnagelvin Hospital, just over the border.

Fill the gaps

Holder said the British government has only very lately been thinking of all the implications of leaving the EU for Irish citizens in Northern Ireland, if at all, and that there is an urgent need to introduce legislation to fill the gaps.

Chief Commissioner of Northern Ireland’s Human Rights Commission Les Allamby largely agreed. “There is a need to identify clearly rights and entitlements that stem from EU law,” he told POLITICO.

“To provide legal certainty and clarity, we need a formal Common Travel Area treaty to cover immigration rules, travel rights, residency, and related rights to education, social security, work, health, security and justice,” he added.

There are indications that both the British and Irish governments are aware of the need to move quickly. Ireland’s Deputy Prime Minister Simon Coveney said earlier this month that a new bilateral agreement between Dublin and London is “ready to go.” No similar announcement followed from the British government, however.

Ireland’s Deputy PM Simon Coveney | John Thys/AFP via Getty Images

A spokesperson for the U.K.’s Department for Exiting the EU said the government is “working to ensure that the necessary steps are taken to protect all these rights.

“The people of Northern Ireland who are Irish — and thus EU citizens — will continue to have access to rights, opportunities and benefits that come with EU citizenship,” she added.

5 ways the UK’s health plan falls flat

Theresa May promised a £20.5 billion spending boost but there’s concern it won’t go far enough.

There’s life beyond Brexit, according to the U.K. government. Nobody else seems convinced.

Prime Minister Theresa May visited a hospital in Liverpool on Monday to lead a carefully choreographed announcement of the new 10-year plan for the National Health Service. Designed to show the government is capable of doing more than just leaving the EU, the plan aims to “save almost half a million more lives” in the next ten years by focusing on prevention and making better use of digital health services.

With most domestic policy initiatives on hold because of Brexit, the government has promised a £20.5 billion spending boost by 2023-24 to back up its health plans — money May said will come in part from the windfall to be enjoyed when the U.K. stops sending money to Brussels.

But the reactions from health care providers focused largely on the uncertainties facing the NHS ahead of Brexit, both in terms of finance and the departure of EU27 nationals that will worsen staffing issues. (Few believe a Brexit windfall is likely despite the Vote Leave’s red bus.) Lengthening wait times for services was another politically sensitive issue set aside in the government’s announcement.

“This is not about miracles — money will be tight and staffing will remain a headache for years to come,” Niall Dickson, chief executive of the NHS Confederation, which represents health service providers, said in reaction to the plan. Warning of the risks of “over-promising,” Dickson said: “Our plea is that politicians be honest about the trade-offs that will be required and that we are realistic about what can be achieved given the ever-increasing demands of an ageing population.”

Health groups say the £20.5 billion budget increase by 2023-24 unveiled in June is not enough to get the NHS back on track following years of austerity

The announcement also suffered from the government’s strategy of pre-announcements: major policy initiatives from new cancer screening to mental health service improvements had been widely previewed, leaving praise confined to celebrating the “vision” of tying those initiatives together.

Here’s five reasons why the plan failed to match expectations.

1. Not enough money

Health groups say the £20.5 billion budget increase by 2023-24 unveiled in June is not enough to get the NHS back on track following years of austerity. The figure amounts to a 3.4 percent increase in funding, but think tanks such as the Nuffield Trust say a 4 percent boost is needed at least to “put the NHS on a sustainable footing.”

“Ultimately, there is a need for honesty about how far the £20.5 billion over five years will stretch,” British Medical Association (BMA) council chair Chaand Nagpaul said Monday. “World class care requires world class funding and the investment in the long-term plan will still leave the U.K. falling behind comparative nations like France and Germany.”

Britain’s Health Secretary Matt Hancock | Ben Stansall/AFP via Getty Images

Plus there’s concern a no-deal Brexit would deplete the promised funding — “the extra costs and tasks required would eat up the first instalments, stopping progress dead in its tracks,” Nigel Edwards, chief executive of the Nuffield Trust, said in a statement.

Health Secretary Matt Hancock has promised the extra funds will be available “irrespective” of the outcome of Brexit talks with the EU, which doesn’t quite fit with May’s suggestion it will come in part from money London will no longer be sending to Brussels.

2. Ignoring staffing woes

Staffing shortages are top of the list for nearly 60 percent of U.K. voters when asked where the extra NHS cash should be spent, according to a poll by The Times, but the government’s plan kicks that can down the road.

The plan promises “NHS staff will get the backing they need” by balancing “supply and demand across all staff groups.” The funding for hiring, training and professional development of NHS staff “has yet to be set by government” and won’t be published until “later in 2019,” it said.

Staff “are routinely struggling to cope with rising demand and, as a result, are subject to low morale, stress and burnout” — Chaand Nagpaul, BMA council chair 

The BMA, which represents doctors, and NHS Providers, which represents various NHS staff, cautioned the NHS will be hard-pressed to make good on the plan’s promises if it doesn’t improve the staffing situation. One in 11 posts are estimated to be vacant and the situation is predicted to worsen after Brexit, with the King’s Fund, Health Foundation and Nuffield Trust predicting a shortfall of around 250,000 NHS staff by 2030.

Nagpaul of the BMA said doctors and staff “are routinely struggling to cope with rising demand and, as a result, are subject to low morale, stress and burnout.”

3. Hedging on waiting times

The government’s plan commits to reducing waiting times for mental health services across the board, ranging from children to adults and community-based care to crisis situations.

But as the NHS continues to come up short on waiting times for emergency care and routine surgery, the new plan offers no clear path forward other than to say “sufficient funds” will be allocated to local NHS services to cut long waits.

NHS chief Simon Stevens | Tolga Akmen/AFP via Getty Images

“We also need immediate, practical solutions and the necessary investment for hospitals to deliver both in the long and short-term,” said Nagpaul of the BMA.

NHS chief Simon Stevens said there should be “tougher, faster” standards when it comes to emergency room waiting times in an interview with BBC Radio 4 on Monday, and suggested the existing four-hour guideline by which NHS progress is judged needed to be updated. “The problem with that is it doesn’t distinguish between turning up at A&E with a sprained finger and turning up with a heart attack,” he said. He declined to commit to specific targets.

4. Mixed messages on prevention

One of the main pillars of the government’s plan is prevention — stopping health problems before they start by trying to reduce smoking and drinking or increase exercise, for instance.

While many groups supported this move, they couldn’t help but note the hypocrisy of the fact that government funding for local public health services has been cut in recent years. The latest projections are a cut of £85 million for 2019-20, to £3.1 billion.

“The reforms we all know are needed to the way we pay for care have been kicked into the long grass again and again” — Nigel Edwards, chief executive of the Nuffield Trust

Nagpaul of the BMA urged the government to take bolder stances on issues such as a minimum unit price for alcohol and restricting sugar in food.

“The reforms we all know are needed to the way we pay for care have been kicked into the long grass again and again,” said the Nuffield Trust’s Edwards.

5. Raised expectations

U.K. Chancellor Philip Hammond hit the nail on the head when he wrote in the Daily Mail on Monday: “The leaders of the NHS must now ensure they get the basics right. Alongside greater quality of care and ending waste, the public will demand that progress is made on the back of their investment.”

The widely-touted funding rise will leave people expecting a better and more efficient NHS, which requires delivery on the basics such as wait times that the plan doesn’t address.

The government’s major targets are focused around specific diseases: the plan aims to prevent 150,000 heart attacks, strokes and dementia cases, and 55,000 cancer-related deaths, and help 380,000 more people get treatment for anxiety and depression. As Conservative Party MP and health select committee chair Sarah Wollaston noted, some of the priorities mirror those set out in the previous five-year plan, “many of which remain unfinished business.”

“The last plan was undermined by the cuts to social care, public health, capital and training budgets and it is important not to see this repeated,” Wollaston wrote in a blog post.

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