European Qualifications (Health and Social Care Professions) (EFTA States) (Amendment etc.) (EU Exit) Regulations 2020

Lord Bethell Excerpts

Monday 16th November 2020 Lords Chamber

Moved by

[Lord Bethell]

That the draft Regulations laid before the House on 17 September be approved.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)]

My Lords, these regulations relate to the recognition of professional healthcare qualifications in the UK and social work qualifications in England. They are part of the Government’s preparations for the end of the transition period. As noble Lords will be aware, the Government have signed agreements with the EU, the three EEA EFTA states and Switzerland in relation to the UK’s withdrawal from the EU. These agreements include provisions that protect the rights of EEA EFTA state professionals with qualifications covered by the directive, and Swiss nationals living and working in the UK, and vice versa.

 European healthcare professionals have played, and will continue to play, an important role in the delivery of health and care services in the UK. We have been clear throughout the EU exit process how valued these professionals are and how we would like them to remain in the UK. It is for that reason that the previous SI, which we are amending today, maintains automatic recognition of relevant European healthcare qualifications for a limited time after the end of the transition period. It is also why a number of health professions, including doctors, nurses and social workers, are on the shortage occupation list.

These regulations specifically implement the agreements that we have signed with Switzerland and the EEA EFTA states, and as such affect a very small number of professionals. For example, on 30 June 2020 there were 80 doctors and 32 nurses and health visitors among a total of 134 Swiss healthcare professionals working in the UK. This legislation also makes some minor amendments to the provision for EEA EFTA-qualified professionals, of which there were 230 working in the UK on 30 June this year.

While the number of professionals impacted is very small, it is important that there is legislation in place to protect the rights of these healthcare workers wishing to come and play a part in the UK healthcare workforce. On 14 September 2020, the House considered legislation brought forward by the Department for Business, Energy and Industrial Strategy which set out arrangements for the recognition of professional qualifications from Switzerland and the EEA EFTA states. These regulations now cover a similar area. They implement the Swiss citizens’ rights agreement and the EEA EFTA separation agreement, in relation to the recognition of professional qualifications for healthcare in the UK, and social work in England.

Regarding the current framework, I will remind noble Lords of the background to the recognition of professional qualifications, or RPQ. The current system for this recognition is derived from EU law. It allows UK professionals to have their qualifications recognised in the EEA and Switzerland, and vice versa, with minimal barriers. There are seven professions where standards are harmonised under the relevant EU directive. This means that qualifications must comply with minimum agreed standards. Five of these harmonised professions are health professions: doctors, nurses, midwives, pharmacists and dentists. The recognition arrangements under the directive have supported the movement of European health and care professionals to the UK. Between 1997 and 2019, more than 77,000 EEA and Swiss qualifications in the professions of doctors, nurses, midwives, dentists and pharmacists have been recognised in the UK. At the end of the transition period, the EU directive will cease to apply to the UK and the mutual recognition of professional qualifications will end.

Last year, in preparation for the UK leaving the EU, Parliament passed regulations to amend the domestic law that implements the current EU system for RPQ. This included regulations in relation to recognition arrangements for health and care professional qualifications, namely SI 2019/593. These regulations, which come into force at the end of the transition period, include provisions which, first, ensure that healthcare qualifications which are currently recognised continue to be recognised automatically, for up to two years after the end of the transition period. Secondly, they protect previous recognition decisions. Thirdly, they allow applications for recognition submitted before the end of the transition period to be concluded. Fourthly, they remove the provision for healthcare professionals to deliver temporary and occasional services in the UK once such current registration comes to an end.

Since the passing of the previous regulations, the Government have secured agreements with Switzerland—the Swiss citizens’ rights agreement—and the EEA EFTA separation agreement. These agreements go further than the arrangements set out in the regulations that were passed last year. Therefore, the regulations before the House today amend the previous SI to implement the terms of the Swiss and EFTA agreements.

 I will explain the main changes. First, they provide a four-year period of continuation of the automatic recognition system for Swiss nationals. Secondly, they allow Swiss healthcare professionals to continue to provide temporary and occasional services under certain conditions. Thirdly, these regulations will require UK regulators to co-operate with their EEA EFTA state and Swiss counterparts to ensure that EEA EFTA state EU-qualified professionals and Swiss nationals whose professional qualifications are recognised are treated on the same basis as UK nationals. These arrangements will be reciprocated by the EEA EFTA states and Switzerland respectively.

These regulations also make a minor amendment to ensure that the frameworks for RPQ will function as intended after the transition period. This makes sure that GP qualifications obtained before the reference date specified in the mutual recognition of professional qualifications directive are recognised in the same way as specialist medical qualifications obtained before that date, and are not eligible for automatic recognition.

UK regulators of healthcare professions have been consulted on an informal basis throughout the development of RPQ EU exit legislation, including these regulations. The devolved Governments were consulted regularly throughout the process. They are supportive of our approach and consent has been given by the Scottish Parliament to take this legislation forward.

These regulations are necessary to implement the Swiss citizens’ rights agreement and the EEA EFTA separation agreement, in respect of the recognition of professional qualifications. These agreements were signed after the passing of previous EU exit legislation on this matter. These regulations enable health and social care professionals and businesses to prepare for the end of the transition period. I commend them to the House.

--- Later in debate ---

[Lord Bethell (Con)]

My Lords, I am enormously grateful for the searching questions of the noble Baronesses. They have covered an enormous amount of ground, and I am not sure whether I can cover it all in my remarks. I will endeavour to write to them on some of their specific questions.

The noble Baroness, Lady Walmsley, asked a large number of pertinent, relevant and searching questions on dentists. We are extremely conscious of the provision of dentists during Covid, the ongoing commitment to improving Britain’s dentistry and the significant contribution of those from overseas to the dentistry practice. Provisions such as this SI and many others like it are there to ensure that dentists from overseas continue to be welcome in the UK and that we can meet the needs of the British public. I would be happy to write to the noble Baroness with some detailed answers to her questions.

The noble Baroness, Lady Jolly, rightly referred to the challenge of recruitment in health and social care, which we take extremely seriously. We have put in place an enormous marketing campaign to build the substantial and important NHS brand. We are recruiting more than ever before, and rather than reducing numbers, Covid has led to an increase in people stepping forward.

As I said in my opening remarks, we remain committed to workers from overseas. They make an invaluable contribution to health and social care, and nothing that we are doing through these provisions, the immigration Bill or any of our other provisions in any way diminishes that enormous contribution. As reciprocal arrangements will be subject to negotiated outcomes, I cannot make the commitments that the noble Baroness requested. However, I assure her that the regulations put in place in these statutory instruments and the others like it ensure that registration is possible and is part of our commitment to those who come to Britain from overseas to work.

I emphasise that the changes contained in these regulations are essential to ensuring that the UK meets its commitments, not only to overseas workers in general, but also, specifically, under the Swiss citizens’ rights agreement and the EEA-EFTA separation agreement. In response to the noble Baroness, Lady Thornton, that is part of a general commitment to those who come to Britain from overseas to work in health and social care. The UK Government are committed to protecting citizens who benefit from rights under the Swiss and EEFA agreements, many of whom make valuable contributions to the UK workforce. These regulations maintain existing rights for EEA, EFTA and EU-qualified workers and Swiss nationals beyond the end of the transition period and ensure that the UK’s existing EU exit regulatory frameworks for RPQ will function effectively at the end of the transition period.

I am enormously grateful for the support shown by many noble Lords for these measures, and I commend these draft regulations to the House.

Motion agreed.