Healthcare (International Arrangements) Bill

Debate between Lady Hermon and Stephen Hammond

3rd reading: House of Commons & Report stage: House of Commons
Monday 21st January 2019 Commons Chamber

[The Minister for Health (Stephen Hammond)]

It is a great pleasure to bring the Bill to its Report stage tonight. Before I address new clause 1 and amendment 1, it might help the House if I set out with clarity what the Bill actually does. It provides the powers to fund and arrange payments for healthcare for UK residents, or indeed former residents, outside the UK as well as to share the necessary data to facilitate this. In a deal scenario, the Bill’s powers would support the Government’s attempts and motivation to implement a future relationship with the EU from 2021 and bilateral arrangements with individual member states, should the EU agreement fall short. In a no-deal scenario, the powers would ensure that the UK was prepared for any outcome. This could include implementing any negotiated reciprocal healthcare arrangements, which might differ from the current EU arrangements, or making unilateral arrangements for UK nationals in order to assist with accessing healthcare abroad in exceptional circumstances.

I am grateful to the hon. Member for Ellesmere Port and Neston (Justin Madders) for tabling new clause 1, because it gives me the opportunity to reiterate what I said in Committee about the important issue of financial reporting and facilitating parliamentary scrutiny. I note that, in Committee, the hon. Member for Burnley (Julie Cooper) tabled exactly the same provision as new clause 1, and that it was defeated. I said at the time that I recognised the new clause as a device that Oppositions always used. That does not make it any less relevant, but I explained that the Government were committed to openness when it came to the managing of public money. Expenditure by the Department of Health and Social Care relating to EU reciprocal healthcare arrangements is currently published in this place in the form of annual resource accounts, and will continue to be so. However, given that we do not know the provisions and administrative processes of future reciprocal agreements, the Government are once again unable to accept the proposal. As now, the Department’s future expenditure on reciprocal healthcare would be subject to the existing Government reporting requirements.

However, the hon. Gentleman’s new clause asks the Government to place a statutory duty on future Administrations to collect and report on data, which we have not yet agreed to exchange with other countries. This cannot be appropriate. The frequency and detailed content of a financial report should and could be determined only when reciprocal healthcare agreements have been reached. Currently, the UK and other EU member states are able to collect data and report both nationally and at EU level, as provided for in the relevant EU regulations. Spending on EU healthcare is reported as part of the Department of Health and Social Care annual report and accounts laid before this place.

My Department is currently working to ensure that UK nationals can continue to access healthcare in the EU in exactly the same way as they do now, either through an agreement at EU level or through agreements with the relevant member states. In either case, we will have to agree how eligibility is evidenced, the way in which and frequency with which that information is exchanged and, of course, the reimbursement mechanisms that will govern the new agreements.

[Lady Hermon (North Down) (Ind)]

I have listened closely to what the Minister has said. It would be helpful if he could offer some reassurance to Irish citizens living in Northern Ireland who, under the terms of the Good Friday/Belfast agreement, are entitled to regard themselves as Irish citizens, British citizens or indeed both. I presume that their rights will continue unchanged in Northern Ireland after Brexit. Am I right?

[Stephen Hammond]

The hon. Lady is completely correct. We explored that in Committee, and discussed the purposes of the common travel area. Indeed, there was an explicit debate in Committee on the arrangements for Northern Ireland. I am happy to confirm that to her.

Each of the agreements that we are seeking to strike could differ from country to country. Such agreements will have to take into account the operational possibilities and limitations of each contracting party, to ensure the smooth operation of reciprocal healthcare arrangements. This should include how NHS trusts in the UK can evidence eligibility for the treatment of non-UK citizens in the most efficient and least burdensome manner. Only when these technical details are known will the Government be able to speak confidently to the specific measures that we can report on for each country. Regardless of the specifics of any arrangements entered into, and as with all departmental expenditure, reciprocal healthcare costs are and will continue to be authorised by the Treasury supply process and to be included in the Department’s annual estimates, as well as being included in the annual resource accounts, which are audited by the Comptroller and Auditor General. I said in Committee that I hoped that the hon. Member for Ellesmere Port and Neston would be satisfied by that commitment to transparency, and I give that commitment again tonight. With that, I hope that he will feel able to withdraw new clause 1.

Turning to amendment 1, the hon. Member for Ellesmere Port and Neston again raised the important issue of appropriate levels of parliamentary scrutiny. The Government clearly recognise the importance of such scrutiny for this Bill and for secondary legislation made under it. The hallmarks of an effective and responsible parliamentary system are the processes by which we draft, consider and test legislation, and the appropriate parliamentary procedure for the scrutiny of regulations made under this Bill is the negative resolution procedure. The exception to that is where provision within regulations is needed to make consequential changes to amend, repeal or revoke primary legislation. Consequently, the Government are once again resisting that amendment.

As I have said previously, the powers in this Bill provide the Government with both the flexibility and the capacity to implement detailed and complex arrangements concerning healthcare access abroad. The remit of our regulation-making powers is tightly focused. They can be used only to give effect to healthcare agreements or arrange, provide for or fund healthcare abroad. Therefore, the subject matter to which the regulations relate is narrow. I say again that when regulations amend, repeal or revoke primary legislation, they will of course be subject to the affirmative resolution procedure, which is the appropriate level of scrutiny for such powers. However, where statutory instruments do not make changes to primary legislation, and deal with procedural, administrative or technical provisions, they should be subject to the negative resolution procedure, and that is reflected in our approach to this Bill.

We have been clear about our intentions for reciprocal healthcare in the context of exiting the EU. In the short term, our policy is to maintain the current system of reciprocal healthcare with the EU on a transitional basis until the end of 2020. That would happen automatically if there is an implementation period, and it is something that we are seeking to agree individually with member states in the event of no deal.

Government Policy on the Proceedings of the House

Debate between Lady Hermon and Stephen Hammond

Tuesday 10th October 2017 Commons Chamber

[Stephen Hammond (Wimbledon) (Con)]

I am grateful to you, Mr Speaker, for the opportunity to make a short contribution to this debate. Like perhaps a number of Members, I was somewhat surprised to find us debating this issue today, when there are so many other things we should be debating, but you are absolutely right, Sir. As the shadow Leader of the House said, you are entrusted with grave responsibilities, and it is only right, when a Member of this House makes what is effectively a substantive complaint against the Government—essentially, that they disrespect this House—that you should call them to this House. I am grateful for that, because it allows those of us on the Government Benches to set out arguments that, as you will see, more or less demolish the proposition that has been put.

My right hon. Friend the Member for Forest of Dean (Mr Harper) quite rightly said that we need to look at the words of the motion, which says:

“That this House has considered the Government’s policy in relation to the proceedings of this House.”

There seem to me to be two ways one can tackle the motion. The first is to look, as he did, forensically at the debates in question, which the right hon. Member for Orkney and Shetland (Mr Carmichael) referred to yesterday. Anyone listening to my right hon. Friend’s speech would conclude that the Government clearly did not disrespect this House in any way.

There is another way of looking at this, which is to say, “What would be the basis for the charge?” There seem to me to be four things that the right hon. Member for Orkney and Shetland could complain about. The first is, “Are the Government allocating enough days to Opposition debates?” Is he saying that the Government are not taking part? Is his charge that failure to vote is in some way a slight or a breach of convention? Or is he just saying that the Government are ignoring the Opposition motions?

The shadow Leader of the House complained in her speech about the number of times she has to ask for days. The reality is that the number of days allocated to Opposition day debates has not changed since their introduction in 1998. Governments of all hues— Labour, coalition and Conservative—have observed the number of allocated days. Indeed, in the period 2010 to 2017, when the Opposition were entitled to 140 days, they were actually given 141 days. They were also given 24 more days in unallocated business that there was space for, so they cannot really claim that Opposition business is not being allocated the right number of days.

If the charge is about participation, then a number of colleagues from across the House have pointed out that they are participating, particularly on this side of the House. As my right hon. Friend the Leader of the House said, on the day in question the Government fielded some of their most senior members. There were 11 speeches from the Opposition Benches and 10 from the Government’s, and in the second debate I think the figures were eight and 17. In both cases we had almost exactly the same number of speeches, so the charge of non-participation, which seems to be the thrust behind some of the contributions today, does not stack up. If this was the only time made available to debate such matters, that would be serious. It is not, of course. Tuition fees have been debated during ministerial statements and urgent questions, and in Westminster Hall. The subjects have been thoroughly debated by this House, and the charge of non-participation seems to me to be very difficult to prove.

The Government, as the Leader of the House said, take their responsibilities very seriously. If the Opposition really believe there is a need for more scrutiny, there is a way to secure more scrutiny and force the Government to defend their case, and that is by debating and voting on programme motions. The Opposition have chosen to debate only 15% of programme motions in the last seven years. If they really want more time, the Opposition could force the Government to come through the Lobby more often on programme motions, but they have chosen not to do so.

The third charge is that, somehow, by not voting the Government snubbed the House. On the two days that we are talking about, my right hon. Friend the Member for Forest of Dean and others have made the point that snubbing the Opposition was certainly not the reason for the Government’s not voting. It is absolutely true that no Government have ever been bound by convention or the rules of the House to vote on any motion, especially Opposition motions. As my right hon. Friend has said, it is clear that Government—the Leader of the House is, I believe, following this tradition—should consider each motion and debate as it comes. There is no reason why the Government should be committed to voting on any motion, and my right hon. Friend the Leader of the House was right to resist the temptations offered by the Scottish National party to commit herself to that.

[Lady Hermon]

I am not suggesting that the Government snubbed this House, but the fact that they did not vote on lifting the pay cap left uncertainty for thousands and thousands of nurses and doctors throughout the United Kingdom. [Interruption.] If I may, I will continue. At the end of that debate when the Government did not vote, after the DUP had indicated that it would not be supporting them, there was no point of order to clarify the situation. I have scores of constituents in Northern Ireland, where we have no devolved Assembly. We need a lead from this House, and we did not get one. The problem is not the snub but the ambiguity, because this is not an academic point of argument; it affects people’s lives.

[Stephen Hammond]

The charge of ambiguity is a serious one, but it does not hold up. The Government Front-Bench team answered that question when they responded to the motion, so I do not think that that charge can really be levelled against the Government.

In the short time that I have left, let me make the point that as a Government Back Bencher, I have experienced the frustration of sitting here with my colleagues until all hours of the night, only to find that no vote takes place. On the question of votes, it is for individual Members to make their minds up, as my right hon. Friend the Member for New Forest West (Sir Desmond Swayne) said. We are elected here as individuals, and we can follow our wits, if we choose to do so. We are often urged to do so, and many people choose to do so, but it is for us to make that decision. Equally, it is for the Government to choose, motion by motion, when they should vote.

Finally, Opposition days can be used to raise matters of national importance, but all too often—not necessarily in this case—they are used for narrow party political posturing rather than a discussion of real quality. If a motion is about a matter of national importance, it is often phrased in a way that the Government find provocative or difficult to support. Many Governments have taken the view that they need to note what an Opposition day motion says, but ever since 1978, when the Conservative Opposition twice defeated the then Labour Government, it has become an established custom of this House that Opposition days are nothing more than advisory, and that they are not actionable. Although the Government should take note of the motions and continue to debate the issues raised in them—I have no doubt that that will happen under my right hon. Friend the Leader of the House—they are advisory and the Government are not bound by them in any way.

This has been an interesting debate, but what today has shown—my right hon. Friend the Member for Forest of Dean pointed this out—is that, in the case of the two debates mentioned by the right hon. Member for Orkney and Shetland, the charge does not stand. If we look behind the four possible arguments for saying that the Government are not listening on Opposition days, it is very difficult to contend that his proposition stands, so I hope Members will vote to defeat it this evening.