Healthcare (International Arrangements) Bill

Paul Masterton Excerpts

Wednesday 14th November 2018 Commons Chamber

[Paul Masterton (East Renfrewshire) (Con)]

It is, as always, a pleasure to follow my hon. Friend the Member for Totnes (Dr Wollaston). She speaks with incredible knowledge and expertise in this area, which I will not even attempt to match.

It is nice, on a day of significant Brexit chattering and uncertainty, to be talking about something to do with Brexit which generally seems pretty consensual. The Bill is, of course, necessary to ensure the smooth transition from our current relationship with the EU to our future relationship. The Government have been very clear about their willingness to consider the continuation of the UK’s participation in reciprocal healthcare. As we have already heard today, there are 32 participating countries in that framework, the other EU member states and all four nations in the European Free Trade Association. It is a mechanism to provide for the co-ordination—not, of course, the alignment—of separate national health systems, which means that provision under the scheme can differ from country to country.

There are four main routes for EU and EEA citizens to access healthcare in member states other than those in which they are ordinarily resident: the European health insurance card—EHIC—the S1 system for state pensioners, the S2 system for planned treatment, and the patients’ rights directive. UK nationals living, working, studying or visiting EU or EEA countries and Switzerland will have continued access to healthcare after 29 March 2019. That is a vital commitment.

The Government’s position is to seek a wider agreement with the EU that covers state pensioners retiring to the EU, with continued participation in the EHIC scheme and co-operation on planned medical treatment. The Bill would allow for the implementation of such an agreement. My hon. Friend the Member for North Thanet (Sir Roger Gale) when talking about ex-pats summed up clearly why that is such an important issue for individuals who have lived here and paid their taxes here and moved abroad; they need to know this system will continue to be available to them.

There were approximately 27 million active UK EHIC cards in circulation in September 2017, including the one in my pocket. Of the 53 million visits made to the EU from the UK each year, and the 25 million visits from the EU to the UK, only around 1% result in an EHIC claim. I am glad this Bill establishes the basis for a new arrangement allowing the scheme to continue after 2020, subject, of course, to an agreement with the EU. There are 250,000 medical treatments each year and when abroad, regardless of how well we know the country in question, it can be quite frightening to find ourselves in need of medical treatment; there is enough to be thinking about without not knowing what our access to healthcare will be.

I had experience of that myself in Portugal on my stag-do. I will not go into the story as to why we ended up in a Portuguese hospital, but it involved a roof and a shoe—we will go no further. It is good to know with some confidence that we are going to be able to access healthcare; we should always make sure we are covered by insurance and so forth, but having that extra bit of comfort is extremely important. It would be hugely damaging for us as a country going forward post Brexit not to have that level of assurance for our citizens.

The Minister set out in detail what the Bill will do, so I will not run through that, but he confirmed why this is a necessary agreement, particularly because the European Union (Withdrawal) Act 2018 does not provide all the powers and mechanisms needed to do this. The Bill provides the Secretary of State with the powers that are necessary to arrange for the provision of healthcare overseas, and, crucially to fund that, which is important. This is needed regardless of whether we are in a deal or no-deal situation. It is also important to note that, as the Minister said, we have arrangements with other countries, and making sure we have the power not only to continue what we have at the moment but to add to or improve arrangements with other countries is significant.

Fundamentally, this Bill means that UK nationals residing in another state may obtain treatment as a resident of that country. The range of medical services in some EU countries may be less than under the NHS, and in some cases patients might need to make a contribution towards the costs of their care, but through this Bill we can ensure access to healthcare at reduced cost, and in most cases for free.

I want to pick up briefly on the points about devolution made by the Labour shadow Minister and the SNP spokesperson. They were fair comments. While this is a reserved mechanism, the provision of these services is devolved and it is the devolved Administrations that have to provide structure and fund the services for EU nationals who rely on them, so it is not a massive step to ensure that they are appropriately involved. I would be interested to hear about how we are working with the devolved Administrations and the healthcare providers in the devolved nations to ensure seamless continuity of this going forward.