European Union (Withdrawal Agreement) Bill

Debate between Baroness Altmann and Baroness Blackwood of North Oxford

Report: 2nd sitting (Hansard - continued) & Report stage & Report: 2nd sitting (Hansard - continued): House of Lords
Tuesday 21st January 2020 Lords Chamber

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Blackwood of North Oxford) (Con)]

My Lords, it is always a pleasure to speak to the really important issue of reciprocal healthcare, which touches on a lot of UK and EU citizens’ lives. This House has rightly tested this issue robustly and it is right that we consider it today.

The withdrawal agreement Bill guarantees that reciprocal healthcare arrangements, including for pensioners, workers, students, tourists and other temporary EEA or Swiss visitors, will not be affected during the implementation period. During this time, there will be no change to reciprocal healthcare schemes, such as S1 and EHIC, nor to the S2 route which enables planned treatment. Importantly, I can provide assurance that the European Union (Withdrawal Agreement) Bill also guarantees lifelong, reciprocal healthcare entitlements for people so long as they remain within the scope of the citizens’ rights agreements. This includes UK nationals who will have moved to the EU before 31 December 2020, as well as EU citizens who will have become resident in the UK before this time. I hope that that explanation is clearer than my letter.

Last year, as has been mentioned, this House spent a considerable amount of time holding informed and important debates scrutinising the provisions of the then Healthcare (European Economic Area and Switzerland Arrangements) Bill. With the permission of the noble Baroness, Lady Brinton, I will call it HESA. We agreed that this was a key piece of legislation, providing the UK with options to implement any future reciprocal healthcare arrangements, subject to negotiation with the EEA states or with Switzerland after the UK leaves the EU. I understand the desire to know the outcome of these negotiations but, as they are obviously in the future, I am not able to give exact details, other than to say we want to ensure the best possible outcomes.

Following that scrutiny and the assent of Parliament…

[Baroness Altmann (Con)]

I thank my noble friend for giving way. A number of us on these Benches are deeply uncomfortable with what we are being told, as she well knows. We are willing to give the Government the benefit of the doubt and we hope that this trust will be repaid. We are talking about people’s health and lives: there really is nothing much more important. Will my noble friend take this back to the department, or can she assure us that there will be full information available to all citizens so that they know about this risk at the end of 2020 and can make the appropriate decisions? None of us knows what is going to happen after the end of this year.

[Baroness Blackwood of North Oxford]

My noble friend Lady Altmann makes a very important point. We have tried to ensure that the information is available and communicated. I am happy to review the clarity of this information and to do everything we can to improve it. My noble friend is absolutely right. We need for anxiety to be at the lowest level and for people to be prepared as possible. I can assure the House that we are doing everything we can to work in the best interests of UK citizens. We understand that there are many in European countries, as well as in the UK, who are looking at this issue with great concern.

I want to get back to the process of scrutinising HESA. As the noble Baroness, Lady Brinton, said, this established a legal basis for the Secretary of State for Health and Social Care to fund and give effect to future reciprocal healthcare schemes through its provisions for data sharing and making regulations. It is important to cast our minds back to that debate. This is an implementation Bill; it does not concern the status of the arrangements. In addition, the Government are committed to the effective implementation of the citizens’ rights agreement and the healthcare protections that it provides.

Questions have arisen as a result of my letter, including those raised by the noble Baroness, Lady Brinton, last week. I have been asked why there is no mention of reciprocal healthcare in the Bill. This is because individuals within the scope of the withdrawal agreement are entitled to reciprocal healthcare cover from their competent country for as long as they remain so. The rights of EU citizens, EEA, EFTA and Swiss nationals and their family members who reside in the UK before the implementation period, are brought into UK law through Clauses 5 and 6 of the Bill.

I was also asked about Clause 30. This is limited to implementing parts of the agreement on social security co-ordination and to including reciprocal healthcare and EHIC, so it cannot operate in the way in which the noble Baroness was concerned that it might.

Finally, I was asked whether the consequential powers could be used to revert HESA to the original form—with global scope—that it came to this House in. It cannot. The consequential power does not allow for substantive changes to legislation. It will allow the Government to make only smaller, technical amendments for good housekeeping to ensure that legislation is consistent and functions well. It could not be used in the underhand manner that I think the noble Baroness, Lady Thornton, thinks we intend. This would be much too substantial a use of the power; it would not be considered an appropriate use of it.

NHS Pensions: Taxation

Debate between Baroness Altmann and Baroness Blackwood of North Oxford

Tuesday 9th July 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

I can confirm that it has been made absolutely clear that NHS clinicians have been impacted by these reforms, and front-line care has been impacted. This is unacceptable and that is why we are bringing forward the review to find a solution as quickly as possible. The noble Baroness is right to raise the issue and we are determined to resolve it.

[Baroness Altmann (Con)]

My Lords, I am sure the Minister agrees that this was an unintended consequence of changes to the tax system. The reality is that the cliff edge of the taper is forcing consultants to pay tens of thousands of pounds for doing one small extra shift, sometimes voluntarily. Could she look at offering financial advice to each individual consultant who may be affected? They will not all face this tax charge, but they are all frightened that they might, so they are not undertaking the extra shifts we need them to undertake. Can she also note to her departmental colleagues that high-paid people potentially affected by the taper in other areas of the public sector received some assistance and mitigating measures from their departments, whereas it has been almost impossible for consultants to plan ahead? We are now seeing the problems occurring belatedly.

[Baroness Blackwood of North Oxford]

My noble friend speaks with particular expertise on this issue. As the whole House will appreciate, NHS consultants are often asked to take on additional shifts at short notice and they face peculiar challenges when calculating the consequences for their pensions. This is one of the reasons why the BMA has put up its calculator. However, the pension rules we are discussing today mean that some who take on extra work may find they have inadvertently incurred a substantial tax charge in moving into the taper. This is why we have brought in the consultation. It is obviously important that those facing pension charges should seek advice. NHS England is considering this issue closely at its most senior levels and working with the department to better understand the impact on clinicians, but also on NHS performance, and we are determined to resolve the situation to get it right.