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

Baroness Thornton Excerpts

Monday 16th November 2020 Lords Chamber

[Baroness Thornton (Lab)]

I thank the Minister for his introduction. I also thank all noble Lords who have taken part in this debate, raising an unenviable number of questions that the Minister will need to answer. I want to be clear that I understand the situation here. I am a veteran of this debate. I had a look and I have had this debate in one form or another at least four or five times in the last three years. This is the third Minister I have had dealing with it, so I hope noble Lords will pardon me for my sense of déjà vu.

My understanding is that we are all okay for the next six weeks while we are still covered by the transitional agreement, but on 1 January we are okay in terms of healthcare and other provision only if it already exists. If it does not exist and you are not resident in a European Union country—or, presumably, a European Union resident in this country—you will have to make new arrangements.

I remember being in a meeting with one of the noble Lord’s colleagues, probably about two and a half years ago, who assured us that, if necessary, we would have 27 absolutely rock-solid agreements on reciprocal healthcare, and that it would be okay. I have to say that I greet some of this with a certain amount of scepticism because I feel as though I have been led up this particular mountain at least three or four times in the last few years. I would like to know whether my assumption is right: that those of us who do not live in Spain, have not paid into the Spanish system and are not eligible to do so but who might want to retire there next year, will have to make our own arrangements. I suggest to the Minister that the way people will feel about Brexit will be judged partly on how this works, because healthcare and access to healthcare across the European Union is very personal to all of us.

I put on record some of the concerns that have been raised with us by a range of patient groups and healthcare organisations, who feel that the regulations do not go far enough in protecting the rights to healthcare of British citizens who travel in the European Union. As other noble Lords have said, this could leave some people with underlying health conditions not completely covered. The noble Baroness, Lady Ludford, used an example from Kidney Care UK that 30,000 people on dialysis can currently travel through Europe and receive their dialysis free of charge because of EHIC, even though dialysis for life-sustaining treatment for kidney failure is not covered by travel insurance; without reciprocal healthcare arrangements, it may cost up to £1,000 per week. I would like the Minister to answer the question of what will happen to people who receive dialysis after 1 January. How many more thousands of people with pre-existing health conditions will not be able to get insurance and could be put in the same situation if the Government fail to reach a deal?

If they fail to reach a deal in the next two weeks, will there be 27 agreements in existence? Are they there and ready to run? I would really like to know. The Brexit Health Alliance—a group of organisations that want to ensure that the views of healthcare users and providers are reflected in the Brexit negotiations, including the Academy of Medical Royal Colleges, NHS Providers, the Richmond Group of Charities and the Association of the British Pharmaceutical Industry—says:

“The current arrangements involve minimal bureaucracy for patients and healthcare providers, underpinned by well-established systems for reimbursement between member states. The NHS will face unwelcome increased resourcing burdens, if it is required to handle new, more complex administrative and funding procedures when providing care to EU citizens in future.”


The British Medical Association says that failure to reach a deal would,

“lead to significant disruption to … individuals’ healthcare arrangements, an increase in costs of insurance, and uncertainty regarding accessing healthcare abroad. Moreover, the NHS would face a drastic increase in demand for services, which could dramatically increase its costs and place greater pressure on doctors and clinical staff.”

I said those words to the Minister’s predecessor about two years ago. I said if we do not sort this out, there will be increased pressures on the NHS. Two years later, having increased pressures on the NHS is even more serious than it was.

Those organisations have been completely consistent in what they have been saying to the Government about this issue for the last three to four years and here we are now, weeks from possibly falling off a cliff. It is very important that the Minister not only answers some of the very relevant questions he has been asked by other noble Lords but seeks to reassure us that we are not all going to find ourselves faced with huge costs and, possibly, not being able to travel at all in Europe because we have failed to reach an agreement.