Healthcare (International Arrangements) Bill

Henry Smith Excerpts

Wednesday 14th November 2018 Commons Chamber

[The Minister for Health (Stephen Barclay)]

I beg to move, That the Bill be now read a Second time.

This is a short Bill, with six clauses, to enable continuity of healthcare for British nationals and EU citizens after Britain leaves the European Union. It is clearly in the interests of the British public to ensure reciprocal healthcare arrangements continue when we leave the EU, whether that happens through an agreement with the EU itself or through individual agreements with EU member states. By enabling us to implement those arrangements, the Bill will help us to help nearly 200,000 British pensioners living in EU countries to continue to access the medical treatment that they need, and it will mean that the hundreds of thousands of British citizens who require medical treatment each year during holidays in Europe can still be covered for medical assistance when they need it.

The Bill will help to ensure that UK nationals who live and work in EU countries can continue to access healthcare on the same basis as local people. It will mean that EU citizens can be covered for reciprocal healthcare here, so that the UK continues to be a place tourists want to visit and vital workers, such as our NHS workforce, want to live in. The Bill will also mean that we can continue to recover healthcare costs from Europe as we do now.

[Henry Smith (Crawley) (Con)]

A few years ago, I presented a private Member’s Bill on the recovery of costs under the European health insurance card scheme. More than half of NHS trusts did not record the treating of foreign nationals at all so that they could claim back on those reciprocal arrangements. Can I get an assurance that, under the new arrangements, the NHS will be properly refunded for the care it provides to those from other countries?

[Stephen Barclay]

My hon. Friend makes an important point. Perhaps I should declare that, when I was a Back Bencher, I tabled a number of parliamentary questions on that very issue, relating to my hospitals and to claiming. We pay out around tenfold what we recover. I will come on to that point, but part of the Bill relates to the NHS’s increased focus on the issue, which he is correct to raise.

Reciprocal healthcare agreements benefit people in all regions and nations of the United Kingdom. The Department of Health and Social Care currently funds and arranges EU reciprocal healthcare for people from England, Scotland, Wales and Northern Ireland. The Bill will allow us to continue doing that, if agreed with the EU. We have been working for some time now with the devolved Administrations and will of course continue to do so to ensure that we legislate for reciprocal healthcare in a way that fully respects the devolution settlements.

We can all agree that access to healthcare is essential both for British nationals living in European countries and for EU citizens living in the UK. The Bill will also allow us to strengthen existing reciprocal healthcare agreements with non-EU countries and explore new arrangements. As the Prime Minister said last night, the negotiations for our departure are now in the endgame and we are working to reach an agreement. As Members would expect, we are continuing to make the necessary preparations for all scenarios. It is in everyone’s interests to secure a good deal, but it is the job of a responsible Government to prepare for all scenarios, including in the event that we reach March 2019 without agreeing a deal.

In the event of no deal, the powers in the Bill will help to implement deals with EU countries that will seek to provide continuity of care for UK nationals and avoid a cliff edge. The powers will enable the UK to act swiftly to protect existing healthcare cover for British nationals in the EU, the European economic area and Switzerland, whether deals are made with the EU or individual member states. That is in the interests of everyone and, most importantly, will benefit millions of UK nationals who live, study, work or travel in mainland Europe.

British people who have paid their taxes in the UK their whole working lives and have retired to Spain, France or other EU countries should not have to worry about healthcare and how much it is going to cost them. Similarly, the millions of British people who travel to mainland Europe each year should be able to do so with the peace of mind that the European health insurance card scheme brings. These schemes are popular across the UK. There are currently 27 million EHIC cards in circulation in the UK, with 5 million issued each year. Reciprocal healthcare arrangements enable UK nationals to access healthcare whether they live in, work in or visit EU countries.

The current arrangements involve EU member states reimbursing one another for healthcare costs. We support UK nationals in the EU by spending approximately £630 million a year on healthcare for British expats and tourists. At present, we recover £66 million each year from EU member states under the same rules, but that amount is increasing as the NHS gets better at identifying EU visitors and ensuring that the UK is reimbursed for care provided, which speaks to the point that my hon. Friend raised. It is a net spend because many more British pensioners and tourists go to Europe than the other way around.

It is clearly in the interests of the British public to ensure that reciprocal healthcare arrangements similar to those currently in place continue when we leave the EU. The Bill does not affect the UK’s ability to negotiate or enter into international agreements, and the details of any new reciprocal healthcare arrangements will remain subject to negotiation and parliamentary scrutiny.

Until now, the majority of UK-EU reciprocal healthcare has been enabled by EU regulations. Once we leave the European Union, the EU reciprocal healthcare arrangements will no longer apply in the UK in their current form and we will need new legislation to provide for future arrangements. With a deal, the withdrawal agreement will enable the continuation of existing reciprocal healthcare rules during the implementation period, and afterwards for people covered by that withdrawal agreement, but it is not a long-term arrangement for the British public as a whole, does not provide for the event of the withdrawal agreement not being concluded and does not cover healthcare arrangements with countries worldwide.

The UK already has important agreements in place with Australia, New Zealand and many of our Crown dependencies and overseas territories and the Bill will help us to strengthen those, should we wish to, or seek new arrangements with other countries. The Bill underscores the Government’s commitment to reaching a robust reciprocal healthcare agreement with the EU.

This is important and necessary legislation, introduced so that the British public can look to the future with confidence that they will get the healthcare they need, when they need it. I commend the Bill to the House.