Healthcare (International Arrangements) Bill — House of Lords, 2019-02-05
Topic: Health
Andrew Lansley (Conservative, Centre-right): I will come on to precisely that point about new agreements and the extent to which we need to amend existing legislation to give effect to such agreements I will say a word about what we are trying to achieve here. I do not think we should underestimate that the Government have committed to the significant, continuing—effectively permanent—cost of providing healthcare across the European Union for those who have been resident in the United Kingdom. As we have heard, this is £630 million-plus per year. There is not a corresponding expenditure in this country by other countries because it is only a fraction of that for other EU citizens and residents coming to the United Kingdom. This is quite a generous provision. It is not the case that every beneficiary of this would be eligible for healthcare in the United Kingdom. For example, a pensioner who goes to live in Spain might ordinarily cease to be resident in the United Kingdom and hence to be eligible for NHS care. So this is not simply to provide NHS care to people wherever they happen to be, nor should it be interpreted as such. It is a very specific provision Equally, there might be people who are in exactly the same position as a pensioner going to live in Spain but who go to live in Florida. We do not, and are not proposing to, provide such healthcare there. That is not simply because the American Government do not provide a reciprocal benefit for Americans in the United Kingdom, because the legislation does not require reciprocal healthcare. It enables the Secretary of State to provide healthcare for UK residents in other countries. The reason is straightforward and rather ironic. We propose to legislate to give continuing healthcare provision across Europe as a consequence of the freedom of movement provisions, while at the same time proposing to get rid of those freedom of movement provisions If we were to follow through the logic of ending freedom of movement, which allows people to live and work in other European countries and pensioners to have access to the social security regulations in other countries, we would scrap all this. But that would not be popular. It would feel very unfair and, as my noble friend Lord Kakkar—if he will forgive me for calling him that—said, this matters a great deal to people. They would be extremely anxious and distressed by the removal of something that they had been accustomed to receiving in the past But it may not be available in the future. We cannot say that the European health insurance card will be offered to people and available for travel and work in the future as it has been in the past, although I say to the noble Lord, Lord Foulkes, that I have just looked it up. The website is there. The bit where the Department of Health tells you about the European health insurance card is still online, but it unfortunately has to tell people that, because we do not know where we will be after 29 March, they might be advised to take out travel insurance The point I come back to is this: we are making a provision and we should recognise that we are doing that so as not to take away something of considerable importance for many people who have come to rely on it. We do not want to create that distress. It is a long-term commitment and I hope that people will recognise the value of that. We cannot go around extending it easily. I am not aware of any proposals for bilateral agreements with other countries to extend this healthcare benefit elsewhere. If there are any I would be very interested to hear of them I hope that we will be able to replicate the current structures as far as we can in the way in which this is managed in the future, but it is important that we give proper scrutiny. I will say three things. First, we must be able to have continuity delivered rapidly if necessary. Secondly, like treaties, new agreements must be subject to prior agreement within Parliament about the basis on which the Government should conclude them, rather than Parliament simply being given the opportunity to renege on them or not. Thirdly, when it comes to the amendment of legislation, we should be very clear that not only must any Henry VIII provision that amends primary legislation be subject to the affirmative procedure, but regulations that seek to amend, repeal or revoke direct EU legislation—retained EU law of a significant character—should, equally, be subject to affirmative resolution. The drafting here does not recognise the sources of law with which we have to deal and the way in which we should deal with them in the future Subject to all of that, I hope that we will not spread alarm. I hope that noble Lords on the Liberal Democrat Benches will at least recognise that there is a purpose to this legislation and that in our further consideration we will ensure that it is entrenched and the Bill passes with that purpose firmly in place.