Draft Social Security Coordination (Reciprocal Healthcare) (Amendment etc) (EU Exit) Regulations 2019 Draft National Health Service (Cross-Border Healthcare and Miscellaneous Amendments etc.) (EU Exit) Regulations 2019 Draft Health Services (Cross-Border Health Care and Miscellaneous Amendments) (Northern Ireland) (EU Exit) Regulations 2019

Paula Sherriff Excerpts

Monday 25th March 2019 General Committees

[Paula Sherriff (Dewsbury) (Lab)]

It is a pleasure, Sir David, to be here discussing the draft regulations. The Opposition have started our speeches on Brexit SIs with a caveat, and I shall do so again this evening, so I apologise for any repetition.

We are now just four days away from Brexit day, as I am sure everyone is well aware. It is deeply concerning that we are still planning for a no-deal scenario when we are so close to the deadline. Once again, we are in Committee to discuss a statutory instrument that would make provision for the regulatory framework after Brexit in the event that we crash out without a deal. On each similar occasion, I and my Labour Front-Bench colleagues have spelled out our objections to the Government’s approach to secondary legislation.

The volume and flow of EU exit secondary legislation is deeply concerning for accountability and proper scrutiny. The Government have assured the Opposition that no policy decisions are being taken. However, establishing a regulatory framework, for example, inevitably involves matters of judgment and raises questions about resourcing and capacity. Secondary legislation should be used for technical, non-partisan, non-controversial changes, because of the limited accountability that it allows. Instead, the Government continue to push through contentious legislation with high policy content via such vehicles. As legislators, we have to get things right. The regulations could represent real and substantive changes to the statute book and they need proper in-depth scrutiny. In the light of that, the Opposition would once again like to put on record our deepest concerns that the process for these regulations is not as accessible and transparent as it should be.

With that out of the way, as always I have some concerns and questions about the statutory instruments. I understand that the three SIs set out provisions for an “orderly wind-down” of UK reciprocal healthcare arrangements with the EU and European economic area in the case of no deal, and that they allow for treatment that is in progress or that was authorised before exit day to be completed on either side of the channel, and—so far as possible acting unilaterally—for reimbursement for those treatments. I also understand that the Department of Health and Social Care regards the regulations as a temporary provision, which, until the Healthcare (International Arrangements) Bill comes into effect, will allow the current system, including the European healthcare insurance card and S1 form, to be continued until 31 December 2020 with individual countries. The Minister has alluded to that.

The transitional elements allow for all ongoing treatment to continue for a maximum period of one year following exit, and for pre-authorised treatments. Similarly, dedicated regulations deal with the special situation in Northern Ireland, where such arrangements are more frequent owing to the land border with the Republic of Ireland. I know that the Department of Health and Social Care regards the regulations as a temporary provision, but an article in The Guardian this week showed that British nationals in Europe feel that the healthcare plans for pensioners are “sick” and “uncaring”. They feel that they are being thrown under a bus and abandoned. They do not think that the one-year undertaking is at all adequate. The Minister will need to deal with the fact that the measure does not reassure many of our fellow citizens living abroad who access healthcare abroad.

As to the Northern Ireland regulations, people need clear guidance to avert harm in the event of no deal. Health services in Northern Ireland and the Republic of Ireland, working separately, often do not have sufficient demand to provide cost-effective, highly specialised medical services. More than €40 million has been invested in cross-border health and social care initiatives via Co-operation and Working Together, a partnership between the health and social care services in Northern Ireland and the Republic of Ireland. Cross-border service arrangements have been established and are currently providing high-quality, safe care for patients, in a range of areas including primary care, cancer services, and paediatric cardiac surgery. Those vital health services must not be destabilised during, or after, the Brexit process, regardless of the outcome.

It is also vital that patient access to key health services is not jeopardised during the Brexit process. Can the Minister provide assurances on that? Will he also agree to an equality impact assessment to ascertain the number of Brits who may lose access to treatment for long-term conditions if his desire for a deal is not realised? It would also be good to understand what the cost would be of any of those Brits having to return home for treatment, as clearly there might be financial implications.

Lastly, on the Social Security Coordination (Reciprocal Healthcare) (Amendment etc.) (EU Exit) Regulations 2019, we are talking about the European health insurance card. Some 27 million of our fellow citizens hold the EHIC and some 190,000 UK pensioners living elsewhere in the EU are registered with the S1 scheme. One week away from Brexit, the NHS England website is still encouraging people to apply for the EHIC, even though it might not be valid in one week’s time, and it is very difficult to see what other advice is available. There is no advice about taking out additional insurance, and no advice whatsoever for those with long-term conditions. That is completely inadequate and it will not do when we are so close to what might be an exit without a deal.

Can the Minister tell me how people will know what to do? How will they go about finding out? When will the NHS website be updated? What will happen to those people, who already feel abandoned, if in just over a week’s time we leave the European Union without a deal and they find that they cannot access clear advice on how to keep themselves and their families safe?