Brexit: Health and Welfare

Baroness Thomas of Winchester Excerpts

Thursday 29th March 2018 Lords Chamber

[Baroness Thomas of Winchester (LD)]

My Lords, I too salute my noble friend for securing this timely debate. Last year, seven of us spoke on this subject, when the emphasis was on the effect of Brexit on disabled people. We are now talking about the effect of Brexit on the health and welfare of everyone in the UK, but many of the same arguments are valid. Of course, “welfare” means many things: it means well-being, but it also means aid and benefits. Therefore, I will touch on a future without the European Social Fund, where negotiations concern reciprocal social security benefits, the blue badge scheme and the European health insurance card, which we currently all have. First, however, I will say something about EU health workers—as absolutely every speaker in this debate has so far.

Since the previous debate, I have spent much of my time in either a hotel or a hospital, where I have witnessed at first hand the extent to which both sectors rely heavily on workers from the EU, several of whom are now my friends. I have found EU workers outstanding in their work ethic, courtesy and willingness to go the extra mile. We are a rapidly ageing population, so our health and care needs will inevitably ramp up. I wish I was confident that all government departments had factored that into their future plans. Disabled people will also live longer with more complex conditions, so the UK needs as many good health and care workers as it can possibly take. Yet, not surprisingly, the numbers from Europe are dropping fast. Many of these invaluable people sense that the climate has changed and feel they are no longer welcome. I find this perception shocking and deeply shaming, and try to counter it whenever I can. Luckily for us, many other EU workers are not going down this route—perhaps because they are settled, with children at school.

Many younger disabled people who need full-time personal assistants—they prefer that term to “care workers”—are really worried about a potential shortage. What is not generally known is that emergency PA cover is often found from EU countries. One of Muscular Dystrophy UK’s trailblazers said:

“When I need someone at the last minute as an emergency, they often fly in from elsewhere in Europe”.


I was going to cite a whole lot of figures but I do not think there is any point as noble Lords have already done that. However, the independent Migration Advisory Committee, which was commissioned by the Government to advise on the new border policy, is not due to report until the autumn, so there will be uncertainty for many months to come. That makes planning for the future extremely difficult for everyone—we do not know what the status of these invaluable workers from the European Union will be. The King’s Fund has also speculated on how restrictive the future policy will be, and whether the set-up will focus on high-skilled labour or will target specific shortages.

While talking about the importance of EU workers in both the health and hospitality sectors, I should like to put in a word for those doing low-skilled but vital jobs, such as cleaners—thousands of whom are not British. I fear that Brexiteers who were critical about freedom of movement rather implied—as I think the noble Lord, Lord Balfe, said—that only high-skilled migrants would be welcome. This is very short-sighted when we know that many crucial but low-skilled jobs are difficult to fill with British-born workers—I think the noble Baroness, Lady Warwick, mentioned this too. Are the Government taking any initiative to make sure that we hang on to our EU workers in the health, care and hospitality sectors? Many younger disabled people have had their care packages slashed already because of cuts. In the future this could be because of the chronic shortage of labour, not just the expense.

Last year I spoke about the long-standing provision in EU law to co-ordinate social security schemes for people moving within the EU and the EEA. Can the Minister tell us where the negotiations are with regard to this reciprocity? Similarly, with the blue badge disabled parking scheme, will there be reciprocal arrangements with EU member states after the UK leaves the EU? As we have heard, around 27 million people in the UK currently hold a European health insurance card, yet we do not know what is going to happen to that. Will any rights we hang on to be portable?

A different matter entirely is the question of the European structural funds, of which the European Social Fund is an important part. Very basically, the structural funds aim to level the playing field between regions in the EU by helping fund projects in less developed regions, largely through local authorities. Two areas in the UK which have received a lot of funding are west Wales and the West Country. The European Social Fund promotes the EU’s employment objectives by providing financial assistance for vocational training, retraining and job creation schemes. It partners thousands of small projects run by neighbourhood charities and not-for-profit organisations to help disadvantaged people find work; for example, projects which try to improve the employability of people with disabilities. Although the Government have said that they will guarantee funding for existing projects even after we have left the EU, will new projects under this heading get funding? We know that the Government are going to replace the structural funds with the UK shared prosperity fund but we have no details. The Government say that it will be,

“cheap to administer, low in bureaucracy and targeted where it is needed most”,

but we have absolutely no idea how it will work.

Others have mentioned, at length, the European Medicines Agency, which is moving—perhaps it has moved already—to the Netherlands. We know that the Prime Minister is keen that we should have some sort of membership of the agency, for which we should pay, but we do not know what the other member states think of this plan. We certainly do not want to have to set up a parallel body. The risk is that the UK not playing any part at all in EMA processes might result in the UK being behind the EU in the queue for approval of new treatments for all kinds of rare diseases. For boys with Duchenne muscular dystrophy, who have only a certain number of days on which they can walk, this will be tragic. In any case, as a result of Brexit, the influence the UK will have on the EMA will be significantly diminished compared with the role which the Medicines and Healthcare products Regulatory Agency currently plays within the EMA. Negotiations should try to secure the quickest access to treatments for UK patients.

Others have mentioned clinical trials. Currently clinical trials must comply with the clinical trials directive, soon to be replaced by the clinical trials regulation. This much more satisfactory new regulation will apply from 2018, facilitating large pan-European trials. Should the UK no longer be governed by the clinical trials regulation, UK involvement in these trials may become more difficult and costly. We need to adopt the new regulation to ensure harmonisation and the continuation of UK participation in Europe-wide trials.