Reciprocal and Cross-Border Healthcare (Amendment etc.) (EU Exit) Regulations 2020 — House of Lords, 2020-11-16
Topic: Mixed Topics
James Bethell (Conservative, Centre-right): My Lords, I express admiration and gratitude for the stamina of the noble Baroness, Lady Thornton, for sitting through this debate several times. I have also sat through it several times. I fear that some of my answers will be the same as those the noble Baroness and others will remember I am grateful for this debate. It is a quite reasonable and touching reminder of a key fundamental that travel is massively valued, particularly by those who travel for work, for study and to see relatives, but also by the population generally. Travel is of huge personal and financial value and protecting your health when you travel is incredibly important. People have a close association with that and are naturally deeply concerned about it. I agree with those noble Lords who emphasised the importance of these arrangements and in no way do I undervalue the importance of the EHIC programme and its successor to the British public In the withdrawal agreement we have a robust framework for some reciprocal rights that include significant long-term and traditional protections for EU and UK nationals. This piece of legislation is very much in that spirit. It is there so that UK legislation remains functional by reflecting the withdrawal agreement and the transition period and ensures that there are appropriate protections in place for those accessing healthcare under the cross-border healthcare directive. As veterans of this area will know—I apologise if this creates a sense of déjà vu—I remind noble Lords that the changes in this instrument do not concern the future relationship with Europe. The UK has made it very clear, and we continue to work on the fact, that we want to agree clear arrangements for providing healthcare cover for tourists, short-term business visitors, service providers and for all manner of British people who are travelling to the EU and vice versa However, any agreed arrangements will be entirely subject to the outcome of those negotiations. There is nothing I can do at this Dispatch Box to answer the great many perfectly valid but completely unanswerable questions that have been put about what those future arrangements might look like. However, I can update the House: the UK has had constructive discussions with Switzerland and the EEA/EFTA states of Norway, Iceland and Liechtenstein on our future relationship, including social security co-ordination and reciprocal healthcare. Those are promising and reflect well on our conversations with the EU. The progress of those discussions is, however, linked to the outcome of the EU negotiations on social security co-ordination, so I cannot offer concrete guarantees in that department To answer a point made by the noble Baroness, Lady Thornton, some people will be eligible for a UK EHIC under the terms of the withdrawal agreement. A new EHIC has been developed for those who are eligible, including people living, working and studying in the EU before the end of the transition period. We made that very clear very early on. Anyone with an S1 form or studying in a member state can apply for the new EHIC on the NHS website. For those not covered by the withdrawal agreement, the EHIC may not be valid from 1 January 2021, as the noble Baroness rightly pointed out. The Government are open to working with the EU to establish necessary healthcare arrangements that provide healthcare cover for tourists, short-term business visitors and service providers, but those conversations have not been finalised Future healthcare cover for tourists is subject to the future relationship. I understand that it is extremely frustrating not to be able to find exactly what that will look like. I acknowledge that one group which is particularly concerned will be those with pre-existing conditions; they will find it the most challenging to find the right travel insurance if there is no arrangement with the EU on necessary healthcare. This is something we are looking at closely. On a practical note, we know that getting insurance can be more difficult for those with long-term conditions. To support people, the Money Advice Service has recently launched an insurance directory for people with a serious medical condition, which brings together specialist firms with the aim of making it easier to find travel insurance that provides the right health cover. I understand that that service is proving of value In response to my noble friend Lord Bourne, communication has been incredibly important and we have gone about it in an energetic way. We have sought to prepare citizens for the change at the end of the transition period with advice tailored for different audiences, helping them to understand their choices and to act in their own best interests. Information is available and has been updated regularly on the NHS pages and GOV.UK to ensure that people are clear about their reciprocal healthcare rights. The Foreign, Commonwealth and Development Office has been leading a campaign, supported by DHSC reciprocal healthcare advisers, to UK-insured people living in the member states, and my understanding is that those communications have been effective The noble Lord, Lord Greaves, asked about readiness to implement the withdrawal agreement. I reassure him that the DHSC has made good progress, working openly and collaboratively with other social security departments and its operational delivery partners in NHS England, NHS Improvement and the NHS Business Services Authority, to ensure that reciprocal healthcare arrangements will be successfully implemented for those covered by the agreement. I also confirm that UK S1 holders in the EU and UK students studying abroad can now apply for their new EHIC under the withdrawal agreement The noble Baroness, Lady Jolly, asked about Ireland, and it is good news that we seem to have made progress on our arrangements for Ireland. The UK and Irish Governments have been discussing future arrangements for healthcare co-operation within the common travel area. Great progress has been made in these talks. These arrangements will ensure that residents of the UK and Ireland will continue to be able to access necessary healthcare when visiting the other country and benefit from co-operation between UK and Irish healthcare providers, regardless of the outcome of the negotiations with the EU. The example the noble Baroness gave of ambulances travelling across the border was very powerful These arrangements build on previous commitments that UK and Irish citizens who are living in the other country will continue to be able to access healthcare on the same terms as local citizens. The Healthcare (European Economic Area and Switzerland) Arrangements (EU Exit) Regulations 2019, which we debated previously, provide the mechanisms to implement these arrangements, so there should be no interruption in healthcare arrangements between the UK and Ireland The noble Lord, Lord Willis, asked about money reclaimed from other countries. That amount has grown substantially over the last five years. I cannot give the precise number that the noble Lord asked for, but the amount recovered from overseas healthcare visitors has risen to £760 million in 2019-20. That is a substantial amount, but we are continuing to work to make sure that all that money is reclaimed effectively These essential measures are being put in place to protect those who seek to travel abroad. For that reason, I beg to move.