Brexit: Reciprocal Healthcare (European Union Committee Report)

Lord Kirkhope of Harrogate Excerpts

Tuesday 3rd July 2018 Lords Chamber

[Lord Kirkhope of Harrogate (Con)]

My Lords, I will first say what a great privilege and pleasure it has been for me to serve on this sub-committee under the chairmanship of the noble Lord, Lord Jay, and to debate and discuss this matter with some excellent witnesses from a broad range of backgrounds. My only knowledge and expertise in the health field is that I was a member of what was then called Northern Regional Health Authority back in the 1980s. In doing that job, I learned an enormous amount about the excellence of those who work in our health service, both then and, I know, since.

I have also seen the great changes that have taken place since the 1980s, in terms not only of healthcare but of international relations between our health professionals and those in particular in the EU. I shall not go over the ground so excellently covered by my noble friend Lord Ribeiro, but we have reached a point where the National Health Service in this country is highly dependent on those who come to us from other European countries. Whether or not that is a direct point on freedom of movement is a matter which no doubt the Government will want to consider—but, in all my experience and from my connections still in the health service, I am aware of the considerable problems that we are already starting to experience with either potential members of staff who are not confident in making applications because of the lack of clarity as to their future positions if they come over here to work or with those who have worked in the health service and have become unhappy about their future prospects for remaining in that service.

I agree with the points made by the noble Lord, Lord Jay, about the Government’s reaction to this report. I pay tribute not only to my noble friend the Minister but to his department for seeming to have reacted to our report in a better way than have, sadly, one or two other departments to what we suggested in other reports in other fields. It has been a positive reaction. However, of course, good intentions are one thing—there are plenty of those in evidence in the Government’s response—but delivery in a way that deals with the issues that we have raised is entirely another matter. Not being the major issue in the eyes of the Government, and in the forefront of the media, may or may not be a good thing. It may a good thing in the sense that we hope that negotiations are taking place which will secure the future reciprocity of healthcare satisfactorily—or it is possible that, because there is not the pressure or publicity so far, the Government have not yet have negotiated these things or set about them properly. I hope that the former is the case and not the latter.

I will raise one or two points about current relationships and how we need to improve things in a post-Brexit situation. We are talking as if there is a free healthcare arrangement for everybody around Europe wherever they may be at any time, but, more recently, we have had arrangements of cross-charging between the EU states and ourselves. From the evidence that we heard, we learned that the performance of the National Health Service in collecting moneys from the EU for the treatment of EU citizens has been, to say the least, extremely patchy. I am not convinced that, institutionally, the health service has equipped itself properly to deal with that matter. My noble friend Lord Balfe spoke about Belgian administration and paperwork. It seems that we are almost at an opposite extreme in some parts of the health service, where no one appears to be able to take responsibility for making the charges that they ought to make against other EU countries. As a result of that, the health service has been denied resources that it ought to have had and which it desperately needs. In the event of Brexit proceeding in the way planned, but with some safeguards in this field, to what extent will my noble friend’s department prioritise the ongoing collection of the moneys that the health service is entitled to have from our European friends?

Following on from that, there is an issue regarding educating the public. It is amazing that, even now, with the very close co-operation and arrangements that are in place, a considerable number of people in this country who travel in Europe are unaware of their safeguards, protections and entitlements in respect of health. The result is that there are quite a number of insurers which, in my opinion, take advantage of that situation. There are also many people who pay money to get insured in areas where, to be honest, they do not need to have that insurance. What concerns me is that if, post Brexit, we do not educate people clearly as to what they will then have to protect themselves from by insuring, it will result in considerable extra expense for British people—and, I would guess, probably also for EU citizens in reverse. It would benefit only the insurance companies, which may well take advantage of that situation.

Finally, I will comment that we have really achieved an enormous amount over the last few years. Like my noble friend Lord Balfe, I had the honour of serving in the European Parliament for a considerable time. I never intended to be there for 17 years, and the time flew. Throughout it, what impressed me most about our NHS, which we are so proud of, as we should be, was that many of the developments and innovations that came into our health service have been shared with our European friends. That has been recognised in the European Parliament, and no doubt here also. Nevertheless, it has been a big issue. The British component—leadership in so many fields of innovation, including in the health field—is something which our European neighbours would be loath to lose. Similarly, we should be loath to lose those connections. That is why I hope that, in response to this excellent report, the Government will at least determine themselves to conclude negotiations that do no damage to the people of our country, or indeed any European citizen, in the field of health.