Healthcare (International Arrangements) Bill — House of Lords, 2019-02-05
Topic: Health
Roualeyn Hovell-Thurlow-Cumming-Bruce (Crossbench, Unknown): My Lords, it is a pleasure to welcome the noble Baroness, Lady Blackwood of North Oxford, and I congratulate her on her fine maiden speech. She has certainly hit the ground running by going straight on to the Front Bench. I thank the Library as well for its excellent briefing for this debate I laud the efforts of the Government to recreate or replicate the pre-Brexit arrangements within the EEA and EU, while anticipating the future. It is of course of mutual benefit to EEA citizens as well—the noble Lord, Lord O’Shaughnessy, referred to this. But given our apparent failure to collect our share of the cost inflicted on the NHS, in my opinion those countries would be mad not to agree. Given the important comments on Henry VIII powers raised by the noble Lords, Lord Foulkes and Lord Marks, and particularly by the noble Baroness, Lady Barker, I should declare my membership of the Delegated Powers and Regulatory Reform Committee. We were not preparing furniture for throwing through the windows My concern is the failure to accurately calculate the cost of our great National Health services as supplied to foreign nationals. The current arrangement with the EU and the EEA allows for a reconciliation on a pro-rata basis for cost recovery—quite right, very sensible and fair. However, it is evident that we in UK cannot work out how much those users from overseas—possibly not those carrying the appropriate cards—cost the NHS. It appears that there is no universal, accurate mandatory recording system in place at the point of delivery In my local hospital, which is a very large NHS one, to try to set about recovering costs, people walk around with clipboards inquiring of people in the hospital who have not given the necessary data information on arrival, trying to find out where they have come from and whether or not they are entitled. It is ridiculous. You can imagine the success rate of the people with the clipboards, trying to find out information from those who are not entitled, in particular from those who know they are abusing the system. There have been attempts to improve these systems, but we see continued—extensive, probably—financial shortfall in this area, partly from Europe and particularly from those outside the European Union. We proudly boast that our great NHS is free at the point of delivery. It certainly is; it appears to be free for the whole world. There have been attempts to overcome this unintended anomaly, but hospitals and others are reluctant debt collectors; they are, after all, in the healing business, not the banking business. We need to design a system that works without asking the health industry to collect the money. An ID system that works and is not easily abused must be capable of simple introduction—they seem to do it elsewhere very effectively I was going to refer to statistics. We have heard a lot about the numbers of UK residents living in Europe, the number of retirees living in warmer climes, those who use medical services in continental Europe because they have been referred, and so on. But the fact is that there are apparently some 3 million EU nationals living in the UK, and 1 million British nationals living in the EU. Yet we recover only 10% of what they recover. I do not get the arithmetic. I am sure I will be corrected—