Reciprocal and Cross-Border Healthcare (Amendment etc.) (EU Exit) Regulations 2020

Baroness Jolly Excerpts

Monday 16th November 2020 Lords Chamber

[Baroness Jolly (LD) [V]]

My Lords, these regulations are quite technical in nature but relate to a very important issue for many. I am grateful to my noble friends Lady Ludford, Lord Greaves and Lord Willis of Knaresborough, and to my friend the noble Lord, Lord Bourne of Aberystwyth, for their comments, questions and common sense.

Reciprocal healthcare has been and always will be of vital importance to those who travel between and live across European nations, in particular workers and students, as has already been mentioned. It ensures that health coverage is available as individuals undertake activities that are beneficial across our societies. However, it is extremely important that individuals are informed about their healthcare rights abroad, whether they need to be supplemented with insurance and whether they are covered by direct payment or a reimbursement system.

Could the Minister confirm the arrangements on the island of Ireland? He will be aware that, at present, residents in both the Republic and Northern Ireland have been treated freely on either side of the border. I do not mean “freely” in the financial sense, but in the sense that the border does not exist: ambulances travel from north to south without let or hindrance, and treatment for a single condition can be delivered in both the north and the south. I wonder whether the Minister could clarify whether the financial arrangements will have to change or be renegotiated—and will they be ready with effect from 1 January 2021?

I sit on one of the House of Lords Select Committees that has been looking at various issues relating to the situation in Northern Ireland with effect from 1 January next year. With a lot of despair, we have found that some departments have been very slow in working with the Assembly in the north. They are feeling abandoned by departments and anxious about whether things will be ready for 1 January. Could the Minister confirm that, as far as health is concerned, all arrangements will be completely wrapped up by the time 1 January comes?

Concerns have been raised that those with existing and underlying health conditions may not be covered when they travel to the EU. Can the Minister confirm whether any reciprocal coverage will be available, for those with a learning disability in particular? It is concerning if coverage is not complete for some individuals, as it will add extra pressure to an already stretched NHS resource, as well as having an impact on these individuals. Of course, a comprehensive deal with the EU, securing reciprocal coverage just as we have at the moment, would resolve any uncertainty there is. Can the Minister assure the House that the Government are still committed to negotiating such a deal? Can he confirm that agreeing a reciprocal healthcare scheme is a priority in these negotiations, as it is in the interest of both parties?

The withdrawal agreement agreed in October 2019 and ratified in January 2020, and separate agreements with other EEA states and Switzerland, made some provisions relating to this. First, the existing arrangements continue until the end of the transition period on 31 December this year. Can the Minister clarify who will retain rights after the transition period? What conversations have the Government had with the insurance sector, which I am sure is waiting for new business with bated breath? As was suggested by the noble Lord, Lord Bourne of Aberystwyth, this issue is important. I am concerned that there will be some less-than-ideal arrangements and wonder what assurance the public have that insurance offerings are reasonable and do not take advantage of the situation.

There are some provisions for health at the 23rd hour. UK and EU nationals in a cross-border situation over 31 December 2020—part-way through a holiday, maybe—can continue to use the EHIC to access needs-arising treatment, until they leave the country by travelling to another EU member state or returning to the UK.

People visiting the UK or EU for planned medical treatment under the S2 route can commence or complete their treatment if authorisation was requested on or before 31 December. If a UK national has paid social security contributions in a member state in the past but is not living in the EU on 31 December 2020, the rights that flow from those contributions, such as benefits, pensions and reciprocal healthcare rights, will be protected. This means that someone who has previously worked in an EU EFTA member state can apply for a UK S1 as well as EHIC S2 once they reach state pension age, on the same terms as now. So, we have a clearer picture of what the future arrangements of the EU on healthcare will be.

Many noble Lords have outlined how they have used their EHICs. My noble friend Lord Greaves has clearly had far more exciting experiences than I have in the Alps. I have managed to spend the last 50 years travelling happily around the EU without any problems at all and my EHIC has stayed happily in my wallet. These Benches regret that we are in this position, but we have to put our trust in the Government to arrange as good a reciprocal deal or series of bilateral arrangements as soon as possible. Will this be sorted by the end of the transition period? Can the Minister confirm that we will not be disappointed?