Healthcare (International Arrangements) Bill

Lord Bethell Excerpts

2nd reading (Hansard): House of Lords
Tuesday 5th February 2019 Lords Chamber

[Lord Bethell (Con)]

My Lords, I thank the Minister for her excellent introduction and her absolutely excellent maiden speech. I have known her since before she was an MP, followed her progress with absolute awe and grown to respect particularly her expertise in health technology—an area which is a huge opportunity for the country but will also need a lot of scrutiny from the kind of expertise found in this House. I look forward to many engagements on that subject.

On this legislation, I thank the members of the Home Affairs Sub-Committee of the EU Select Committee—the noble Lord, Lord Jay of Ewelme, and his fellows—for their excellent report. What I found striking was the great concern it expressed about the potential loss of existing reciprocal healthcare rights, the dangers of the cost to the NHS and the potential administrative burden, and the large amount of coverage that the report received in the press. It was a brisk reminder of how an overlooked area of policy and machinery of government which is precious to a lot of people needed to be focused on as we approach Brexit.

I was grateful to the noble Lord, Lord Thurlow, for his reminder of the costs of this area of government—it was an important point. I was grateful also to the noble Lord, Lord Lansley, for reminding us that, if we are to take away freedom of movement, we should perhaps get rid of such reciprocal rights—there is a sort of logic to that. I am here to reject both those arguments and to make an appeal in the opposite direction. I want to try just for a moment to extend the debate outside the Chamber, beyond Brexit and Henry VIII powers, to offer a little reminder of how many of the public might regard this as not only a healthcare issue but as one that touches on a subject that is very important to most of them; that is, travel.

Travel has changed dramatically in the public mind. It is not felt to be a luxury any more, as it was when I was a child. It is felt more to be a right and a form of expression; it is a part of one’s education, and it is critical to business. We can all wonder about the sense of entitlement among the modern generation, but I for one celebrate the benefits of travel. It satisfies the yearning to improve oneself personally and, among the business community, enables one to reach exciting new markets. In the context of this debate, we have not really talked much about the benefits of travel both to the country and to individuals. Underpinning that yearning for travel is a desire for frictionless, risk-free and affordable travel. The reciprocal rights that we are talking about are there to provide that kind of cover.

I do not think that there will be a massive change in the country’s mindset in respect of travel just because of Brexit and 29 March; if anything, quite the opposite. There has been a huge boom. Last year, Britons undertook 73 million trips overseas, representing an increase of 4% on the year before—that is a hell of a lot. That growth has gone on at a very steady rate for many years. That growth will go on into the future and we should think in policy terms about its implications. The range of destinations that people are travelling to is only getting wider.

People are also relocating in later life. We have heard a lot about the 190,000 people who have already moved to Tuscany, Provence and the costas, but that number is also edging up. We have to accept that we face the possibility of making provision for an ever larger number of people.

Some 27 million Britons already have an EHIC—the noble Lord, Lord Foulkes, showed us his; I thank him for that. We in my family have six of them; I do not have mine with me. I was staggered when I heard that the figure was 27 million. That is an unbelievable number. For a public policy to be quite so successful and to get through to nearly half the country like that is a huge achievement. There will be public policy professionals who are incredibly envious of that sort of penetration. There were 250,000 claims against those cards last year. Again, that is a daunting number—much higher than I could have imagined.

My appeal today is for us to try to think about this policy not just in terms of the daunting prospect of Brexit, the constitutional implications of the Bill and the cost, but through the lens of the macro changes that we see in society about people’s yearning to go overseas, to take their business and their families with them and to see other lands. We should think about future-proofing this overlooked part of our healthcare provision and accepting that we may need to extend those arrangements in terms not only of their geographical reach but of the sophistication of how we manage them. We should communicate a clear statement to British people and the outside world that nothing that happens around Brexit is about turning our backs on the world or closing the doors. Rather, we should show through our reciprocal healthcare arrangements that we will guarantee fair and reasonable treatment for people who visit Britain and support our own citizens who might run into difficulties when they travel abroad.