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

Lord Bourne of Aberystwyth Excerpts

Monday 16th November 2020 Lords Chamber

[Lord Bourne of Aberystwyth (Con) [V]]

My Lords, it is a great pleasure to follow the noble Lord, Lord Greaves, who, typically, has come up with some very important questions. I thank the Minister for setting out the terms of the regulations and their implications. I can see that, on one level, these are technical points, but in reality they are going to make a substantial difference to the lives of many millions of Britons. It is that that concerns me at the moment.

I accept that we are obviously moving out of the EU: that is a given. What is not clear is whether we are going to have an agreement at the end of the transition period, which is only some six weeks away. I can see that the six weeks of remaining rights relating to travel are not, in the great scheme of things, that significant, given that very few people will be travelling at the moment. But given the great news that we have had on the vaccines—and I pay tribute to the people who have worked on them, particularly the children of Turkish immigrants in Germany working for BioNTech, who made a massive breakthrough—the likelihood of increased travel, certainly towards the end of next year and thereafter, is very much in play, and we all welcome that.

Having heard the Minister setting out the position, I find it somewhat obscure, involving a rather confused set of rights and obligations. It is confused in the sense that there is any number of different combinations of obligations and rights according to how one looks at this; it is a positive Rubik’s cube of different obligations and rights, and is anything but simple.

What is clear—and it is good news—is that UK nationals living and working in the EU will be entitled to member-state-funded healthcare. That is good news. What is less clear—this was a point touched on also by the noble Baroness, Lady Ludford—is whether, if they return to the UK, they will be entitled to free healthcare here. Perhaps it is very much the case that that is so, but I would be grateful if the Minister could confirm it so that we all know, because it has not been set out very clearly. There are rights for EU citizens in the UK on a similar basis, and I certainly welcome that.

It is also clear that UK citizens who go on holiday or visit an EU member state for a business trip from the beginning of next year, in the absence of a comprehensive agreement, will no longer be able to use their health insurance card or a comparable card, and so will have to take out insurance to ensure proper cover in the absence of that EU-UK agreement, or in the absence at least of bilateral agreements with each of the other states—I think it would be 26 states in this instance, because Ireland is separately catered for. That is anything but simple, if we are going to have 26 separate agreements with different states. I hope we reach a position where there is cover with all of them, but it would be good to know that it is going to be the same cover; otherwise, the insurance position of, for example, young travellers or students on Interrail travelling overseas, having to get different insurance for different countries, will be anything but straightforward and anything but just technical.

I ask the Minister also about whether there has been proper publicity and promotion of the information that will be very much in play at the beginning of next year. If we have no agreement, then there is a need for insurance to ensure proper cover. I am not sure that people appreciate that, and I do not think there has been a sustained publicity campaign about this. I appreciate that we are still hoping for an agreement, but I think that some contingency arrangements should be put in place to ensure that people are aware of the position that will apply at the beginning of next year. The consequences otherwise could be horrendous. It is not simply the cost of insurance, which people will not welcome; it is the cost of what happens if you do not have insurance that is really serious. I would be grateful if my noble friend the Minister could say something on that.

I too am concerned about the position for people with deep-seated medical issues. The noble Baroness, Lady Ludford, mentioned dialysis, and it is a point well made. What is being done to cater for people in this category, who have been previously able to travel without massive insurance costs because of reciprocal rights being applicable? Are we doing anything in that regard? I appreciate the timescales here but, given that we have known these timescales for some time, it would be good to hear that some contingencies are being put into place in relation to these situations.

The last point I wish to raise is in relation to the healthcare that we provide throughout the United Kingdom—not just within England. The UK was, of course, a member state and was subject to reciprocal arrangements for reimbursement of costs that are applied by the healthcare systems of the four nations in relation to travellers from the EU. Are we liaising with the devolved nations to ensure that we have some sort of common approach to the recovery of any costs? It seems to me that there is a recipe here for red tape and bureaucracy beyond what is needed. It would be good to hear that we are on top of this and looking at how we go about seeking reimbursement of these costs. As I say, that is something that I hope does not need to happen, but it may need to happen.

I thank the Minister for confirming that the devolution arrangements are working well with the devolved nations and that that is happening on a very good basis. I am pleased to hear that; it is certainly music to my ears. It would be good to hear that we are on top of that reimbursement issue.

With those thoughts, I rest the case. There are obviously some concerns, but I thank the Minister for setting out the position as clearly as he did.