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

Baroness Ludford Excerpts

Monday 16th November 2020 Lords Chamber

[Baroness Ludford (LD)]

My Lords, I thank the Minister for his introduction. The removal of free movement rights in the recent Immigration Act is a matter of great regret to millions of British people, who knew their value. It will also become a matter of regret to many more Brits once they realise that their dreams of working in Germany or retiring to Spain without hassle or paperwork have been torn from them. The triumphant tweet from the Home Secretary celebrating the end of freedom of movement was a tasteless mistake.

The loss of the European health insurance card will be understood and felt immediately by any British person wanting to travel within the EEA next year. If the promise of the vaccines is borne out and travel opportunities open up, people will want to spread their wings. But they will get a nasty shock from the travel insurers, as the price of a policy will be whacked up to account for the loss of free emergency healthcare under the EHIC. In the other place, it was mentioned that some 30,000 people on dialysis can currently travel throughout Europe and receive their dialysis free of charge thanks to the EHIC. This is not covered by commercial travel insurers and in future it will cost them up to £1,000 a week. The Minister in the other place talked about a recently launched directory of specialist insurers covering serious medical conditions. Well, maybe—but the premiums are likely to be eye-watering.

Brits are also losing the ability to go to another EEA country for, say, an operation when the NHS waiting list is too long. Can the Minister tell me how many procedures have been done under the cross-border healthcare directive since it was implemented in 2013? It is perhaps appropriate that the amendment to domestic legislation entails deletion of references to “EU rights” because, very sadly, rights are being torn from British people in the healthcare sector as in so many others.

The only brighter news is that, thanks to the withdrawal agreement, some people will retain rights after the end of the transition period. First, UK nationals living and working in the EEA on 31 December 2020 will continue to be entitled to healthcare funded by their member state of residence and get an EHIC issued by that state. Can the Minster clarify whether that EHIC will grant that UK national free emergency healthcare wherever they travel in the EEA or only in their member state of residence? Will those British nationals get free NHS care when they visit here?

Secondly, British pensioners resident in the EEA on 31 December 2020 who hold a so-called S1 form will continue to be entitled to UK-funded healthcare, including a UK-issued EHIC. Will that EHIC be usable throughout the EEA, and will the S1 form mean they will get free NHS care in this country? EEA nationals resident in the UK on 31 December 2020 will continue to be entitled to access the NHS, which I assume means free of charge. They will also get a UK-issued EHIC, which will surely make their British friends very jealous indeed.

Lastly, a British national who has previously worked in an EEA country can get a UK-issued EHIC plus planned treatment in an EEA country under the S2 scheme. They can also apply for an S1 form—this debate has a horrible amount of jargon—issued by the UK once they reach state pension age, on the same terms as now. Is there a specified minimum length of time that they would need to have worked in an EEA country, or could it be for as little as, say, a week? Again, there will be some jealousy from their British friends that a British national, by virtue of having worked for I do not know how long in an EEA country, will be able to get a new EHIC.

I welcome the agreement with Ireland that the Minister referred to. I was not sure whether the agreement had been finalised, but it is of course good news.

As the clock ticks down to 31 December, we know that even if a deal is reached with the EU, it will be a skinny one. How confident is the Minister that it will include any provision to continue reciprocal healthcare, including the EHIC? Discussion about rules of origin or customs arrangements might seem arcane to many people, but losing access to free healthcare if ill on holiday will hit home to most Brits. The Minister said that no impact assessment has been done because the instrument makes only “technical” amendments. British holidaymakers might disagree when they get their bill from their travel insurer. A Government celebrating “getting Brexit done” through gleeful tweets about the loss of rights might find themselves not so popular if they tweeted about the EHIC. They might think that the loss of free movement is popular, as many people have yet to discover that free movement is a two-way benefit, but the loss of the EHIC card will not go down well at all. I hope the Minister will be able to give us good news about continued arrangements.