Brexit: Reciprocal Healthcare (European Union Committee Report)

Baroness Pinnock Excerpts

Tuesday 3rd July 2018 Lords Chamber

[Baroness Pinnock (LD)]

My Lords, it has been a real privilege to be part of this important investigation and I thank the noble Lord, Lord Jay, for his consummate skill in leading us and guiding the committee through to such clear recommendations.

It is no surprise that many noble Lords have focused on reciprocal healthcare as it affects the island of Ireland. The most striking testimonies I heard as a member of the committee were from healthcare professionals from Ireland. Our witnesses came from both Eire and Northern Ireland and they spoke as one, with passion and very deep concern as to the future of healthcare in their countries. As a direct consequence of the Good Friday agreement, the common travel agreement and the EU’s positive support, health provision for the communities on both sides of the border has been significantly improved. We were told of the situation, before all these arrangements came into play, of ambulances stopping at the border to transfer patients. That is a thing of the past and it needs to remain a thing of the past.

We have heard from the noble Lord, Lord Ribeiro, about the joint commissioning of healthcare. Like him, I was very taken by the example we were given about children who suffered from hearing difficulties and the arrangements that were made for ear, nose and throat operations as a consequence. Children were waiting up to four years in the north for their first appointment. Following the EU funding which enabled more ENT surgeons to be employed, those surgeons spent some of their time in the south and some in the north. What a wonderful example of the Good Friday peace agreement it is that children are cared for and get the operations they need in a more timely way. We are putting that at risk. The Royal College of Physicians of Edinburgh warned that Brexit could result in “substantial disruption” of health services. We also heard a witness statement, which I found moving, saying that patients’ lives had been saved because of free movement across the border and free access to both jurisdictions’ healthcare.

Unfortunately, I am sorry to say, the Government’s response to the committee’s report is far from convincing or reassuring. While the Government are clearly committed to retaining the enormous benefits to the healthcare of the people of Ireland there are no hard and fast proposals, let alone plans, to provide any comfort that they are determined to find a solution that retains—and continues—the significant cross-border joint commissioning of healthcare, even if doing so means that one of the famous red lines has to be erased. The Minister has given us a good and full response. However, can he give us any assurance that the priority for health provision in Ireland will be the health and well-being of all its people, regardless of other conflicting political demands?

The second aspect on which I wish to focus is that of the EHIC arrangements. Millions of UK residents take advantage of the insurance that EHIC provides when they take a holiday in an EU member state. The card provides peace of mind to holidaymakers and travellers that they will be able to access healthcare, wherever they are in the EU, if they have an accident or become ill. The Government continue to try to reassure us that they want the EHIC provisions to remain. However, doubts persist, certainly in my mind, because we are constantly reminded that nothing is agreed until everything is agreed. The committee investigated the potential consequences of the loss of the EHIC arrangements. The travel insurance industry told us quite clearly that the only replacement will be higher travel insurance costs. One figure we heard—it was a guesstimate—was that insurance may rise by up to 20% without EHIC. As the report clearly states, for some people with long-term health conditions, insurance costs may well become prohibitive.

In the Government’s response to the report, they state that they will seek continued participation in the EHIC scheme as a non-member state. However, they say:

“The exact nature of these arrangements is a matter that will be discussed during the next phase of negotiations”.


Yet people are already planning holidays for 2019; some retired people take a long period away from the rigours of a UK winter in the warmer and sunnier climes of southern Europe. Their contracts will be signed in the next few months and certainly before the proposed date for Brexit. What are these travellers supposed to do? Should they rely on the continuation of the EHIC arrangement or take out full travel insurance, which will cover the costs of any ill health eventuality? We simply do not know. The Government have a responsibility to provide advice on this matter.

All in all, the Government have acknowledged the soundness of the judgments made on many issues in the report. I am very pleased about that. Unfortunately, they have failed to provide what I would call the copper-bottomed assurances that travellers require, so that they know whether the Government’s Brexit plans will result in higher travel insurance costs and, for the people of Ireland both north and south, whether their cross-border health provision can continue and expand. These are serious questions and they require serious answers. I look forward to the Government’s response today from the Minister and, more significantly, to when clarity is provided—I hope—in the White Paper to be published next week.