European Union (Withdrawal) Bill

Lord Davies of Stamford Excerpts

Committee: 2nd sitting (Hansard): House of Lords
Monday 26th February 2018 Lords Chamber

[Lord Stephen (LD)]

My Lords, while I strongly support all that has been said about the continuation of the EHIC scheme, I want to speak to Amendment 353 in my name and thank my noble friend Lady Jolly and the noble Lord, Lord Warner, for adding their names to it.

The amendment would require the UK Government to make arrangements for an independent evaluation of the impact of the European Union withdrawal legislation and of Brexit on the health and social care sectors across England, Scotland, Wales and Northern Ireland. It is intended to be a simple, common-sense amendment. In the Brexit debate, a lot of attention is on trade and the economy, or, today, on the customs union, but our care services and our NHS will also be affected in a major way by our withdrawal from the EU. There will be many impacts on care and support for children and young people, for people with disabilities, for people with long-term conditions and for those with additional support needs. Not all these impacts are yet known or understood. It is clear, however, that many are likely to be negative. That is certainly the risk and it is why we must be vigilant and aware.

So the purpose of the amendment is to say, “Let’s be concerned about these issues; let’s give them a higher priority than at present, and let’s monitor the situation very closely, because if we get it wrong, NHS services and the care of thousands of vulnerable people could be badly affected”. The proposal is to review such issues not more than one year after Brexit takes place to see what has happened, to understand the impact and to allow the Government, local authorities and the NHS to take appropriate action. The intention is to involve in this independent process the devolved Governments, the staff of the NHS and our care services, charities, voluntary organisations and others.

The amendment was inspired by Camphill Scotland, which has many EU staff and volunteers living and working in its outstanding care communities. Camphill also operates in England, Wales, Northern Ireland and right across the EU, and now around the globe, but its very first community was on the Camphill estate in Milltimber, near Aberdeen in Scotland.

More than 50 charitable and voluntary organisations support the amendment. These organisations do not care about the politics of Brexit; they care about the vulnerable children, disadvantaged adults, older people and those with mental health problems or long-term illnesses to whom they give support.

I believe that the amendment will be strongly welcomed also by many people in the NHS, not all of whom were entirely convinced by the message on the side of the “Boris bus” during the campaign. Staff from right across the EU work in our NHS and in our care services. More than 10% of our doctors in the UK are from EU countries and, in total, more than 60,000 staff from the EU work in our British NHS, with many thousands more in the charitable and voluntary sectors. If Brexit means that we lose only some of these people, we could still have big problems. If it becomes more difficult to recruit new staff from EU countries, this could become a major crisis for our hospitals, our care homes, our special needs schools and many other vital services.

I ask the Government and the Minister to respond positively to the amendment. It is the sort of amendment that makes sense and can so easily be agreed to, with little to lose and a great deal to gain.

[Lord Davies of Stamford (Lab)]

My Lords, I have put my name to Amendment 205, which has already been very ably explained by the noble Earl, Lord Clancarty. First, I want to say a word or two in support of the noble Baroness, Lady Finlay, who made a most impressive speech. I hope that, for once, the Government will listen to her; they certainly ought to because she has a very special position of respect in the medical world. The medical profession in this country has been, at least up to now, one of the leading professions in the world, and she has a great deal of experience behind her and behind the words she set forth just now.

On that matter, as the noble Baroness said, the decision to leave the EMA was completely gratuitous. There was no reason for it at all. It was going to be perfectly possible to carry on with full membership while we left the European Union. A lot of us did not want us to leave the European Union—your Lordships know that I am among them—but there is no point in throwing away the whole loaf if you can keep even 5% of the bread. In this case, there would have been no difficulty at all in our remaining part of the EMA. The Government have given no explanation for this extraordinary move, which is a threat, a potential threat at least, to the advance of medical science and a certain threat to the position of the British pharmaceutical industry and to the willingness of companies to set up pharmaceutical operations and research and development operations in this country in the future—indeed, to the willingness of British pharmaceutical majors to remain as committed to this country as they have been up to now. It has really quite devastating industrial as well as medical effects.

The only reason we have ever heard for doing this is that we could not stay in the EMA because it involves some contact with the CJEU. That is quite extraordinary when this is a matter involving the health of the nation and involving one of the major industries in this country, of which we are all very proud. We do not have all that much in the way of successful manufacturing these days, but we undoubtedly do extraordinarily well in the pharmaceutical area, or have done up to now, and this industry is now to be handicapped for no better reason than one of theological fanaticism. It is incomprehensible to most of the world, either inside or outside this country. I hope that the Government will weigh very carefully the words of the noble Baroness and the representations that I know they have received from many branches of the medical profession and of the pharmaceutical industry, and for once just take account, soberly, carefully, thoughtfully and calmly of the values involved that are being thrown away and threatened by this extraordinary decision. I give an undertaking that I shall not gloat in any way if the Government do a U-turn on this: I shall congratulate them, sincerely and openly and I hope that they can find the moral courage to do what is right in this case.

I turn to Amendment 205, which was very ably set out by the noble Earl, Lord Clancarty. I shall not repeat what he said, but I want to talk about one section of the population that will be particularly affected by the abolition of the health insurance card in the European Union, and that is older people. Perhaps I should declare an interest here because I am certainly an older person, but I may be lucky because I have not so far been refused health insurance by anybody or charged exorbitant sums and probably, if I did have to pay a premium on my insurance policy to travel aboard, I would be able to afford to do so. A lot of people in this country, probably the majority, would not.

We all know that healthcare costs can be enormous, particularly in areas such as North America. One American friend of mine, who can actually afford to pay, was recently given a bill for more than $35,000 after a two-day stay in the Houston Medical Center. It involved a number of diagnostic tests, admittedly, as well as the board and lodging in the centre, but it gives an impression of the kind of costs that one can incur. There are countries in the world where you can get first-class medical care much cheaper than you can in Europe, let alone America, such as India, but not many. Countries tend to have medical care which is not up to the standards of North America, Japan or the European Union, or the costs are quite exorbitant, or in many cases both. Switzerland is another example, like the United States, where it is both.

For people who are older or have some particular medical record which makes them a bad insurance risk, underwriters will want to charge a very strong premium for insuring them at all. It is already quite difficult for them to travel outside the European Union. Many of us know people, friends of ours, who for that reason will not now travel outside the European Union. They will not even go and visit their family in the United States or Canada. They hope their family will come and visit them here, of course, but they simply cannot take the risk of falling seriously ill outside the European Union.

If the Government have their way and we go down this road that they have set out for us, the effect will not be just that people cannot go outside the European Union; they will not be able to go to Calais, Amsterdam, Berlin, Dublin, Copenhagen or Stockholm. That is the most terrible restriction of the horizons of a very large number of people. People may not have much time to travel when they are younger. They have business and professional commitments and a lot of strains on their budget because they are bringing up children and so forth. A lot of people look forward to being able to travel when they have retired, and the Government are saying to them, “When we have got this Bill through, you guys will not be able to travel at all—ha ha! You will be stuck here in this country”, which of course will be wonderful because we will have had Brexit and paradise on earth will result. That is a terrible—indeed, devastating—piece of news for a very large number of deserving people in this country. Once again, I hope the Government will have second thoughts.

[Lord Wigley (PC)]

My Lords, I will speak to Amendment 353 in the name of the noble Lord, Lord Stephen. I thought I had appended my name to it but clearly it had not quite arrived. I also support the comments made on the other linked amendments. I particularly identify with the comments of the noble Baroness a moment ago about Great Ormond Street Hospital, whose brilliant services we as a family had to avail ourselves of some decades ago. I cannot speak too highly of it and I hope that the points that were so well made are noted.

This group of amendments touches on one of the most sensitive areas of public policy: health and social care. There is a widespread unease in Wales—as there is, no doubt, throughout the rest of the UK—about the potential impact of Brexit on these vital services. On one level, one might not expect changes in our trading relationships to impact this sector as severely as, say, manufacturing or agriculture, but in fact there are already discernible effects on that key component of healthcare: the availability of a skilled workforce with adequate resources. A totally unnecessary uncertainty has been created, both for the existing NHS workforce, many of whom have come to the UK from EU countries, and with regard to recruiting potential new staff from those countries.

First, I have heard from those involved in healthcare—in Wales and in England, as it happens—about skilled staff employed in the NHS now actively seeking similar posts in other EU countries, just in case they feel forced to leave at a later date, perhaps for professional or social reasons. They fear that others will do likewise and that the available jobs will then dry up and they will need to move quickly to look for them. Secondly, I heard from a very authoritative source that EU-based specialist staff are currently holding back from applying for jobs in the UK because of the uncertainty caused by Brexit. Incidentally, this is not impacting just hospital services but university medical research and manufacturing companies in the healthcare sector.

The potential reduction in the number of key workers available to the NHS needs to be very carefully monitored. If we are to go for a soft Brexit in which we will agree the free movement of those coming for specific jobs and guarantee no dilution of their employment rights, that is all well and good; we might not need the amendment. But at this stage we just do not know what sort of Brexit awaits us. If it is a hard Brexit, with no agreement, we most certainly do need the review mechanism contained in this group of amendments, and we need it for a purpose because in a no-deal scenario we may need to make alternative plans to import key workers from other parts of the world—if we can find them—and to do so quickly. For these reasons I support the amendment.

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[Lord Callanan]

The important progress was announced in the agreement reached in December in the first phase of the negotiations. Reciprocal healthcare benefits were guaranteed for existing UK residents in the EU and for existing EU residents here. The next phase is what happens in the future.

[Lord Davies of Stamford]

The points I raised related not to the important matter of residents, whether continental residents living here or British residents living on the continent, but to travellers—people who may want to travel for a short period for tourism, family reasons or what have you. Has any progress been made on that front? If not, are the Government proposing to make any progress and, if so, what progress?

[Lord Callanan]

That will be for the next phase of the negotiations. We have guaranteed the right of existing residents from the EU in the UK and for UK residents in the EU. The next phase of the negotiations is for people who will travel there in future.