Oral Answers to Questions
Debate between Stephen Hammond and Barry Sheerman(5 years, 4 months ago)
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Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
The Minister for Health (Stephen Hammond)
The NHS is responsible for ensuring adequate resources and a high-quality workforce that can deliver a comprehensive health service for all people, including vulnerable older people. That is clearly happening. We are supporting that through investing an extra £33.9 billion in the NHS.
Mr Sheerman
I have also just heard the news that we have a new Prime Minister. I am thinking of the man who stands outside with a sign saying that the end of the world is nigh.
The fact of the matter is that the end of life for many of my constituents is tough, because the people in the care sector who support them are poorly paid, poorly resourced and poorly trained. Surely we should go for well-managed, highly trained, highly skilled people in the NHS for every age?
Stephen Hammond
The hon. Gentleman is right, which is why we have ensured that we are putting more money into the NHS and more money into primary care, with £4.5 billion in real terms on primary medical care and community health services. It is why we commissioned Baroness Dido Harding to produce the “Interim NHS People Plan”, which she has done, and why we are working on ensuring that we have the health service workers to provide excellent care for all people in the community.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
Stephen Hammond
The hon. Gentleman will know that the Government have produced an interim people plan setting out the course and the trajectory that will mean more doctors and nurses being trained. He will also know that we have opened new medical schools this year, and that more doctors are now being trained.
Oral Answers to Questions
Debate between Stephen Hammond and Barry Sheerman(5 years, 6 months ago)
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Stephen Hammond
My right hon. Friend is absolutely correct that the Secretary of State’s announcement has gone down extremely well. He will know that there are now more nurses in training than ever before—over 50,000—and he will know that London, in particular, will get its share of those nurses. He should be reassured that we are creating routes into nursing via nurse training, nursing recruitment and, indeed, nursing associates, and their recruitment into valuable roles across the health service will benefit his constituents.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
Does the Minister know that when I went to a restaurant the other night with my wife there was a hum and a buzz coming mainly from the young women there? I asked, “Who are all these young women?” The maître d’ said, “They are all young Spanish nurses who are going home. This is their last evening in Britain.” Nursing associates will not fill that gap; these are young people coming in at the classroom assistant level of qualification. We need more nurses now, and we want to stop this haemorrhaging of nurses who are going back to the rest of Europe.
Stephen Hammond
The hon. Gentleman will know that nursing and nursing associate training places are being increased; that more funding is going in to increase nurse training places by 25% every year, from last September; and that we are announcing an expansion of nursing associates. He will see tomorrow, when new figures are announced, that more nurses are working in the NHS than this time last year.
Healthcare (International Arrangements) Bill (Changed to Healthcare (European Economic Area and Switzerland Arrangements) Bill)
Debate between Stephen Hammond and Barry SheermanTuesday 26th March 2019
(5 years, 8 months ago)
Commons ChamberRead Full debate Healthcare (European Economic Area and Switzerland Arrangements) Act 2019 View all Healthcare (European Economic Area and Switzerland Arrangements) Act 2019 Debates Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: HL Bill 166-I Marshalled list for Third Reading (PDF) - (18 Mar 2019)
Stephen Hammond
I thank the right hon. Gentleman for his words about why I was unable to go to St Helier Hospital. He knows that, as a Minister, it would have been inappropriate, but as a constituency Member of Parliament, I have no doubt that I will be visiting there again soon. I do not accept his criticism. That was never the point of the Bill. We made that argument consistently both in this House and in the Lords. But we have listened carefully to what has been said about the scope of the Bill and I am about to address that now.
As we prepare for our imminent exit from the EU, the global scope of this Bill has been the source of much discussion in here, outside this House and in the other place. I am pleased that the noble lords did not fundamentally disagree with the idea of reciprocal healthcare arrangements outside the EU. However, it was strongly felt that this was not the time to provide for it. Although the Government would have welcomed that opportunity to provide for it, they have recognised that through this group of amendments their lordships voted to restrict the scope of the Bill to making provision only for EU/EEA countries and Switzerland.
The Government believe it is disappointing to lose at this particular time the opportunity to be able to help UK nationals to obtain healthcare when they visit countries outside the EU, such as when they are travelling, studying or working abroad, or if they want to give birth or obtain treatment. It remains the Government’s view that international arrangements on these issues could promote more life options for our citizens outside the EU, offer greater personalisation of care and assist further in the fostering of international healthcare co-operation. However, it must be our foremost priority to ensure that the Bill receives Royal Assent and is in place so we can respond to the different scenarios without delay and assist, as appropriate, the people who rely on these vital healthcare arrangements.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
The Minister and I have form on this, in that we were in a Statutory Instrument Committee only yesterday when I was trying to get over to him the need to be very clear to our constituents that, when we leave the EU, the EHIC—the European health insurance card—will disappear and when our constituents go to anywhere in Europe the full bank of healthcare will disappear. Yesterday, the Minister suggested people should take out private insurance instead. Is it not his job as a Minister to tell his constituents and my constituents the truth about this?
Stephen Hammond
It absolutely is my job to tell my constituents and the whole of the country the truth, and I did that yesterday in Committee and will do it again now. If the hon. Gentleman votes for the withdrawal agreement and it passes, the EHIC will remain in place, as I said yesterday. As I also said yesterday it has always been the Government’s advice that people should purchase travel insurance. None of that has changed and that is exactly what I said yesterday and it is exactly what I am saying today.
Stephen Hammond
My hon. Friend is right. I made that point yesterday; I made it when I was speaking at the Dispatch Box on Report; and I am happy to make that commitment again today.
It must be our foremost priority to ensure that the Bill receives Royal Assent and is in place so that we can respond to different scenarios. We take this decision with regard for the people who currently rely on the EU reciprocal healthcare arrangements and, only with that in mind, we are choosing not to disagree with the Lords amendments.
Stephen Hammond
One last time because the hon. Gentleman and I had form on this yesterday.
Mr Sheerman
This is an important issue. If the Minister wants me to make a series of points of order, I will because this is so important. Yesterday in a Committee Room, none of us could understand this. At one point, the Minister said, “This is transitional. This will only cover the transition until we are out of the EU. After we have left the EU, EHIC won’t apply.” That is what he said yesterday. I am still not sure whether EHIC will apply only in the transition period, or will go on forever. He has not been clear about this.
Stephen Hammond
I have been clear. One can say these things as many times as one likes, but if someone won’t hear, they won’t hear. I will say one more time to the hon. Gentleman—I am happy to take his interventions if he is going to move on to other points—that, as I made clear yesterday, if the withdrawal Bill passes, the current arrangements for reciprocal healthcare will continue throughout the implementation period. During that implementation period, it is the express intention of the Government and the EU to secure continuing reciprocal healthcare arrangements.
Stephen Hammond
The hon. Gentleman chunters that there is no guarantee. I have given him the guarantee that it is the express intention of both the UK and the EU to ensure reciprocal healthcare arrangements for our citizens post EU exit. I have set out clearly that, in the event of the withdrawal Bill passing and the implementation period starting, EHIC will continue and I think—
Mr Sheerman
On a point of order, Mr Deputy Speaker. The Minister and I were in an SI Committee yesterday and you will know how pressurised they are. Four SIs were all blended together, so it was very difficult to separate them and do our job of scrutinising the legislation going through this place, which is our prime responsibility. What we could not get from the Minister was absolute clarity, speaking out to the public and saying that actually the likelihood of keeping EHIC after we leave the EU is on a wing and a prayer—there is no certainty at all.
Stephen Hammond
The hon. Gentleman put that on the record yesterday. I answered the question yesterday. I did so with clarity, in a way that I think almost any member of the public could have understood, and I hope that with that we can move on.
The next amendment I wish to discuss is Lords amendment 3. Their lordships have amended clause 2 to limit the regulation-making powers at clause 2(1). Clause 2(2) was intended to be an illustrative list setting out examples of the type of provision that may be included in regulations made under clause 2(1). It is not, on its own, a delegated power. The effect of amendment 3 is to make the list at clause 2(2) exhaustive. Regulations made under clause 2(1) can now only provide for those things on the list at clause 2(2). The intention of the Government has always been to be prudent and transparent in the use of the Bill’s delegated powers and the list was included to be helpful by demonstrating the types of provision that the regulation-making powers at clause 2(1) could include.
Mr Sheerman
On a point of order, Mr Deputy Speaker. I like the Minister—he is a nice man—but he is reading a brief that for most of my constituents and his is absolute gobbledegook—brackets, references here and sub-clauses there. Surely his job as a Minister is to tell this House in plain English what the dangers are to their future travel—their holidays and business in Europe?
Stephen Hammond
Much of what we discuss in this House is clearly of a technical nature, and sometimes its language is impenetrable to others who are watching. However, as the hon. Members for Burnley (Julie Cooper) and for Ellesmere Port and Neston (Justin Madders) will know, the House has had a chance to look at this in a fairly exhaustive way. They will know exactly what I am referring to, and I am sure that they will wish to refer to it in their speeches.
Using “for example” to introduce an illustrative list of things that can be done under a regulation-making power can be found in a number of other pieces of legislation. Section 11(2) of the Automated and Electric Vehicles Act 2018 states:
“Regulations under subsection (1) may, for example”.
Section 48G(2) of the Banking Act 2009 says:
“An order may, for example”.
Using “for example” is not unknown. However, we acknowledge the concerns raised about the breadth of the delegated powers in the Bill, and the Government have taken considerable steps to address those concerns via a number of Government amendments that were accepted in the other place, which I will come to shortly. In addition, we are choosing not to disagree to this amendment, to give further reassurance that the delegated powers in the Bill are no wider than necessary.
Mr Sheerman
The Minister knows that I have also been on another, similar Statutory Instrument Committee, which looked at the use of the green card that gives our constituents the assurance when they travel to Europe that if they are hit by an uninsured driver they will be covered by the insurance industry. That will be lost when we leave the European Union. I used that example yesterday, but the Minister did not come back on it. That is a right and privilege that our constituents expect, and now they are going to lose a similar one relating to healthcare. Is it not clear that these are both examples of the real damage that leaving the European Union will do to us?
Stephen Hammond
The hon. Gentleman has confused various clauses of the Bill, but I will not trouble to explain that. I simply say that the green card is clearly an issue for another Department. I also say again, as I said to him yesterday, that citizens are not going to lose the benefits they enjoy under the EHIC if the withdrawal agreement is passed and the implementation period starts. I would guide him by saying that the easiest way to ensure that all the good burghers of Huddersfield whom he so ably represents can continue to enjoy those rights is to vote for the withdrawal agreement.
As I was saying, the Government have taken considerable steps to address these concerns via a series of Government amendments that were accepted in the other place. In addition, we are choosing not to disagree to this amendment, to give further reassurance that the delegated powers in the Bill are no wider than necessary. Our primary concern, as I have said, is to ensure that the Bill is in place so we have the legal mechanism to support people who rely on these vital healthcare arrangements, as may be necessary.
I would now like to turn to the Government amendments in this group. The Government have also sought to restrict the regulation-making powers in clause 2(1). Amendments 4, 5, and 6 will ensure that, if we confer or delegate functions, this will only be to public authorities. The Government have listened closely to the concerns that the regulations could be used to confer functions on “anyone, anywhere”. The hon. Member for Ellesmere Port and Neston argued in Committee that this wide-ranging scope was unacceptable. As I said to him, there has never been an intention to confer functions on private bodies in order to implement reciprocal healthcare arrangements, but, given the concerns that have been raised, we were prepared to make this restriction clear through these amendments to clause 2.
The Government have also brought forward amendment 7. Arguably the most persistent criticism in both Houses has concerned the Bill’s delegated powers. The Delegated Powers and Regulatory Reform Committee and the Constitution Committee both raised particular concerns about the breadth of the powers. The powers in the Bill were sought to provide options in the event of no deal to mitigate the detrimental effects of a sudden change in healthcare overseas for UK nationals living in the EU. In particular, the regulation-making powers in clause 2 (1)(a) and 2(1)(b) provide a means for dealing with situations where there is no bilateral or multilateral agreement in place.
The Government listened carefully to the concerns raised by parliamentarians across both Houses about the scope of the Bill’s regulation-making powers and concluded that the powers used to establish unilateral healthcare arrangements outside of reciprocal healthcare agreements should be sunset for a period of five years following the UK’s exit from the EU. During the five years before the sunset, we will have the ability to use regulations under clause 2(1) as appropriate. These powers can be used to support UK nationals in the EU in different EU exit scenarios. After the sunset, making use of the regulation-making powers under clause 2(1) would be limited to clause 2(1)(c) only. This provides the Government with a mechanism to give effect to future complex healthcare agreements with the EU, individual EEA member states and/or Switzerland.
Mr Sheerman
Will the Minister give a crystal clear guarantee to all those people who are related to our constituents and who live across Europe and have perhaps retired there that, if they have a long-term health need, the benefits they enjoy under the EHIC at the moment will continue? I do not want to hear anything about the difference between transitional and long term; can he assure those people that they will continue to get those health benefits in the long term?
Stephen Hammond
If the hon. Gentleman votes for the withdrawal agreement, he will be able to give them that reassurance.
I want to turn now to Government amendment 11. The matter of financial reporting and parliamentary scrutiny has also been a matter of legitimate concern to this House and the other place, and amendment 11 speaks to this concern. As I explained in Committee, the Government are firmly committed to transparency in the use of public money. We have made this commitment plain in the Bill with a duty on the Secretary of State to lay a report before Parliament each year. This report will outline all payments made during the preceding financial year in respect of healthcare arrangements implemented by the Bill. I believe that this amendment directly addresses the concerns raised by hon. Members in Committee, particularly those raised by the hon. Member for Burnley. The nature and implementation of future reciprocal healthcare agreements is a matter for future negotiations. However, we envisage that through this reporting mechanism we would also be able to provide Parliament with further information on the operation of future agreements. For example, we anticipate that this report would include details of both expenditure and income to reflect the reciprocal nature of the agreements.
Before I speak to Government amendment 12, I am pleased to report that we have secured legislative consent motions from both the Scottish and Welsh Governments, in addition to having positive and productive engagement with colleagues in the Northern Ireland Department of Health and the Northern Ireland Office. I want to put on record my thanks to all of them. We have amended the Bill to reflect the outcome of our productive discussions, and the Secretary of State must now consult the relevant devolved authority before making regulations under clause 2(1) that contain any provision that is within the legislative competence of a devolved legislature. To underpin and facilitate this consultation, we have developed and agreed a memorandum of understanding with the devolved Administrations. The MOU sets out a practical and mutually beneficial working relationship that will ensure that the devolved Administrations continue to play a vital role in delivering reciprocal healthcare for the benefit of all UK nationals. We believe that this practical and pragmatic agreement allows us to move forward in a collaborative way with all our colleagues in the devolved Administrations.
Mr Sheerman
The Minister will remember that, in our previous encounter on this matter in Committee, we asked him how far he had spread his discussions about the impact of this Bill in Northern Ireland. He was very honest and said that he had spoken mainly to officials and civil servants, and not to the politicians who represent the constituents there. Has he changed his mind about that, because that seems like a strangely narrow sort of consultation?
Stephen Hammond
I do not think that it was narrow in the slightest. We have discussed matters with the Welsh and Scottish Governments and, given the situation in Northern Ireland, which the hon. Gentleman well knows, with the Northern Ireland civil service, the Northern Ireland Department of Health and the Northern Ireland Office here. I think that that is exactly what I said yesterday, and I am happy to repeat it.
Turning to amendment 15 and transparency, we have also amended the Bill to allow for further parliamentary scrutiny of the list of persons who can lawfully process data as a part of implementing new reciprocal healthcare arrangements under the Bill.
Mr Sheerman
The Minister is being generous in giving way. He will be aware that even Henry VIII in his full pomp would not have got away with stealing the right to health cover of British citizens travelling on holiday to Europe or visiting on business without full democratic scrutiny of the decision. Henry VIII would have been pleased to have had that privilege. This Government have been smuggling the decision through, both in Committee and here in this empty Chamber, and they are stealing the rights of British people.
Stephen Hammond
Given that I just said that we have accepted the amendment that would remove the powers, that argument is hardly powerful. I also suspect that the Opposition spokesperson and the other members of the Committee will be surprised to hear that they had not fulfilled their role when they sat through the hours of scrutiny in Committee.
In conclusion, I offer my thanks to hon. Members from across the House and to the Lords for its constructive work in scrutinising and improving this Bill. We share a common goal in wanting to ensure that we can continue to benefit from the current reciprocal healthcare schemes and benefit from similar arrangements in the future. This Bill is an important and necessary piece of legislation that seeks to ensure that the Government are ready and able to respond to different EU-exit scenarios and that we are in a position to support, as appropriate, people who rely on current EU reciprocal healthcare arrangements. For that reason, it is critical that we take those steps and that the Bill can become law.
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
Debate between Stephen Hammond and Barry Sheerman(5 years, 8 months ago)
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Stephen Hammond
It is a great pleasure to serve under your chairmanship, Sir David. I am grateful to the Committee for agreeing to discuss these regulations together, which seems logical to me. I welcome the hon. Member for Dewsbury, who is debating with me. I want to put on record at the start that the hon. Member for Ellesmere Port and Neston (Justin Madders), who is no longer on the Labour Front Bench, conducted himself in a helpful and constructive way in this particular part of our discussions about EU exit, which is about reciprocal healthcare and the good of all our constituents.
I would also like to put on record my thanks to the Scottish Government and the Welsh Assembly, and the Labour Government there, for their help with the Healthcare (International Arrangements) Bill, on which we have had legislative consent motions. That is a record, because it is the only piece of EU exit legislation to which we have a legislative consent motion. It will mean, hopefully, that some of the things that we are discussing tonight will be easier to implement when that Bill comes through, either tomorrow or some other time.
Mr Sheerman
Before the Minister gets into full flow, I would like to say that I have been to lots of these Committees—I do not know if someone up there loves me or the Whips have a grudge—but I have never come across one that is such a rag-bag of things. As a Member of Parliament, I am supposed to give parliamentary scrutiny to this whole rag-bag of very important pieces of delegated legislation. Is that just because the Minister is in a hurry? This disaster of Brexit is coming and we are throwing everything at it. Up until now, we have had one statutory instrument, debated it in some detail and, by and large, felt that we have led some accountability. This looks like a total mess. How can we do our job properly with this large number of documents in front of us?
Stephen Hammond
The hon. Gentleman has been in the House much longer than I have. He will know that it is not unusual to have statutory instruments grouped together. In fact, last week a number of SIs from the Department for Environment, Food and Rural Affairs were grouped together and discussed on the Floor of the House, and then voted on individually.
The rationale for this evening’s grouping is simple: they are all to do with reciprocal healthcare, ensuring that our citizens—in either a deal or, particularly, a no-deal situation—have the potential to have the rights that they currently enjoy, which is the Government’s aim. That is why I have asked for them to be grouped together. I am grateful to the Committee for allowing that. Had the hon. Gentleman chosen to do so, we could have discussed them individually. If he allows me the time to progress with my speech, I hope he will see the logic of why we have grouped them this evening.
Stephen Hammond
If the hon. Lady will allow me, I will tackle that in my speech. I will set out the arrangements that are in place with the Northern Ireland Executive, and if she is then not happy I will try to answer any questions at the end.
Mr Sheerman
I have to explain this accountability and scrutiny work I am doing to my constituents, so before the Minister sets sail—I wish him a really nice journey, with no problems—will he be putting the SIs into layman’s language, carefully going through them and saying what they really mean in the sort of language his constituents, along with mine and yours, Sir David, could understand?
Stephen Hammond
The hon. Gentleman can only test that and prove whether he has done his work on accountability after he has heard what I have to say, so I hope he will allow me to say it. I read this speech last week and it went back for re-writing, so I hope that it is now in the sort of language that both he and I and, importantly, our constituents will be able to understand.
Stephen Hammond
Here we go.
The Government are introducing these three statutory instruments under section 8 of the European Union (Withdrawal) Act 2018, to correct deficiencies in retained EU law relating to reciprocal and cross-border healthcare, and to ensure that the law is operable on exit day. When the UK leaves the EU, that Act will automatically retain the relevant EU legislation and the domestic implementing legislation in UK law. In a no-deal scenario, however, if we did not legislate further, the regulations would be incoherent and unworkable without reciprocity from member states. There would be a lack of clarity about patients’ rights to UK-funded healthcare in EU and European Free Trade Association countries.
Current EU reciprocal healthcare arrangements enable people to access healthcare when they live, study, work or travel in EU and EFTA countries, and in the UK. They give people retiring abroad more security, they support tourism and business, and they facilitate healthcare co-operation. The Government intend to continue those reciprocal and cross-border healthcare arrangements, as they are now, in any exit scenario until at least December 2020.
In a deal scenario, the in principle agreement we have reached with the EU under the withdrawal agreement is that during the implementation period—until 31 December 2020—all reciprocal and cross-border healthcare entitlements will continue. There will be no changes to healthcare for UK pensioners, workers, students, tourists and other visitors, and the European health insurance card scheme and planned treatment will continue. That would all be legislated for in the European Union (Withdrawal Agreement) Bill. The Government want to secure a wider reciprocal healthcare agreement with EU and EFTA states following the end of the implementation period, which will support a broad range of people. We will negotiate that with our European partners during phase 2 of the talks on our future relationship.
In a no-deal scenario, our proposal to all EU and EFTA countries is to maintain the current reciprocal healthcare arrangements for at least a transitional period lasting until December 2020, to ensure that UK nationals can continue to access affordable healthcare when in the EU.
Mr Sheerman
When we get our EHIC card and go across to anywhere in Europe, we are sure that if we need medical attention it is covered by those reciprocal agreements. Is the Minister saying that for a short transitional period the continuity of that process will be maintained but that it will all end when we leave the European Union?
Stephen Hammond
No, that is not at all what I am saying. I am sure that the hon. Gentleman was listening carefully. I was saying that in a deal scenario all current arrangements will continue and in a no-deal scenario we are seeking to put in place interim arrangements. In both scenarios we seek to have an arrangement that will continue reciprocal healthcare after the implementation period. Were he to vote for the withdrawal agreement, the EHIC card he was talking about would continue to be used, certainly until December 2020 and possibly much later depending upon what we negotiate. These regulations seek to ensure that UK law is consistent, so that the arrangements that are in place in a potential no-deal scenario can allow reciprocal healthcare arrangements to continue.
Mr Sheerman
When I discussed the subject with a junior Transport Minister, who is a good colleague of the Minister’s, he said that the green card—which ensures that UK drivers who are hit by an uninsured driver when driving in Europe, whether they are in their own car which they have taken to the EU or one they have hired there, are insured—will disappear as we leave the European Union and it will no longer work. He was very final about that. The hon. Gentleman is now saying that he is not sure if that is final. It is the end of a reciprocal relationship and after 2020 everyone will be uninsured when they travel abroad.
Stephen Hammond
The hon. Gentleman is putting words into my mouth that I did not say. What I said was that in a deal scenario all reciprocal arrangements will continue as per now until 31 December 2020. As I have pointed out, during that period clearly the Government will seek to negotiate an EU and EFTA states-wide continuing reciprocal arrangement. Everything we have now will immediately go into that transitional period when we negotiate. If there were a no-deal scenario, we would have to put in place interim arrangements to ensure that the current arrangements pertain. Again, during the transitional period it is the Government’s intention to seek to negotiate an EU and EFTA states-wide continuing reciprocal healthcare arrangement. However, we might also have to do that on a bilateral basis with individual states. There is no intention or expectation from the Government—or from the EU or EFTA states—that 31 December 2020 is a break point. I hope that I have satisfied the hon. Gentleman on that point.
Stephen Hammond
I am not going to respond to the chuntering from the floor, other than to note very clearly what—
Stephen Hammond
The Government want to secure a wider reciprocal healthcare agreement with EU and EFTA states following the end of the implementation period, which supports a broad range of people. That is what I have just explained. In a no-deal scenario, our proposal to all EU and EFTA countries is to maintain the current reciprocal healthcare arrangements for at least a transitional period to ensure that UK nationals can continue to access affordable healthcare when they are in the EU.
The statutory instruments we consider today will support us to do that with the countries we are able to negotiate those agreements with. However, our proposal depends on reciprocity from other European countries and we are in advanced discussions with member states to ensure continuity. In the event that an agreement cannot be reached, healthcare cover for those nationals may change.
We have approached and are in discussion with other member states and are prioritising those that are the major pensioner, worker and tourist destinations. The UK and Irish Governments are committed to continuing access to healthcare arrangements within the common travel area and both Governments are taking legislative steps to ensure we can implement the arrangements in time for exit day.
The Government welcome the action by EU member states who have prepared their own legislation for a no-deal scenario, including, but not limited to, Spain, France, Portugal, and Belgium. Depending on the decisions by other member states, it is important to acknowledge that access to healthcare could change.
Mr Sheerman
Did I hear the Minister right? Forgive me for another intervention, Sir David. Did the Minister say that he thanks those other European states, because they are negotiating this? It is not final, is it? As I said earlier, this is a “coming home on a wing and a prayer” policy. Our constituents should know the position, surely. We are Members of Parliament; we are paid to come here and represent our constituents. The Minister is telling me that this legislation will mean that after 2020 they will not be insured for their healthcare when they travel abroad. That is what he is saying, because there is no certainty in what he says.
Stephen Hammond
The hon. Gentleman is completely wrong: that is not what I am saying. I will say this once again for him. If the withdrawal agreement is signed—I urge him to vote for it, because that would provide certainty for his constituents—the current arrangements will continue, and it is the Government’s intention, during the transitional period, the implementation period, to negotiate an EU and EFTA states continuing arrangement. In a no-deal scenario, we will have to put in place interim arrangements, and that is what we are discussing now. It would still be the intention—it is a very clear expectation of the Government and is very clear from the stated ambitions and comments of the EU—that reciprocal healthcare would be the subject of a negotiation, either on an EU-wide basis or by individual member states.
I accept that there is some element of uncertainty, but I hope that I can now reassure the hon. Gentleman. Each of the 27 EU member states is a country with universal healthcare, and in general people have good options for obtaining healthcare, provided that they take the appropriate steps. Depending on the country, it will be possible to access healthcare through legal residency, current or previous employment, or by joining a social insurance scheme. Less frequently, people may need to purchase private insurance. It is always the advice when people travel overseas, including to Europe, that they should purchase appropriate travel insurance. People have always been encouraged to do that. However, I appreciate that it can be difficult for some people with long-term conditions, and it is important that people make the best decisions for their circumstances when choosing to travel.
As is the case now, UK nationals who return to live permanently in the UK will be able to access NHS care. UK nationals who currently have their healthcare funded by the UK and are resident in the EU on exit day can use NHS services in England without charge when they temporarily visit England. We recognise that that might mean change, and in some circumstances additional expense, for UK nationals living abroad. It is to avoid that that we are bringing forward these statutory instruments.
I would like to reassure the Committee that the Government have issued advice, via Government and NHS websites, to UK nationals living in and travelling to EU and EFTA states and to EU citizens living in the UK. The advice to UK nationals explains how the UK is working to maintain reciprocal healthcare arrangements, but that their continuation depends on decisions by member states. It also sets out what options people might have to access healthcare under local laws in the country that they live in if we do not have bilateral arrangements in place, and what people can do to prepare.
Mr Sheerman
The Minister has lifted the lid on this. It is horrific news for our constituents—for people who live in Huddersfield and Dewsbury and all the constituents we represent. It is, in stark terms, the end of the assurance that people can travel around Europe. We all had our little card and we knew that we did not have to go out and get private health insurance; we would be covered. We had that peace of mind. What the Minister is saying today, in plain language, is that that peace of mind will end. He has just read that out. It will end unless by luck, some wing and a prayer policy that arrives from this incompetent Government actually delivers something that they cannot promise and cannot deliver.
Stephen Hammond
The hon. Gentleman is a noble exponent of the art of opposition, but he is sensationalising and misunderstanding what I say. I have not said that the arrangements are not going to continue; what I have said is that in a no-deal scenario there may be some circumstances where people have to consider different arrangements from what they have already. It is the Government’s intention, in both a deal and a no-deal scenario, that these arrangements should continue, and that is what we will put in place this afternoon, if we ever get there.
Stephen Hammond
It is correct only in the unlikely circumstance of a no-deal scenario, and only in that there may not be interim arrangements put in place immediately after exit in a no-deal scenario. That is why I am setting out what the possibility might be, but I stressed that this is not what the Government hope for. Neither is it something that the Government expect or that is the Government’s ambition. What I have said is that, in the unlikely circumstance of a no-deal scenario, there may be some changes that some people need to make.
Mr Sheerman
On a point of order, Sir David. I know this Minister to be a very honest man, but I think he is in danger of misleading the Committee, only in this sense—that he keeps saying “only if we crash out without a deal”. I am sorry, but as I read the documents and listen to him when he reads from them, that does not appear to be the case. It seems to me that, whatever happens when we leave the EU, the security of being insured as people travel around Europe will disappear, whether we crash out or whether we achieve a deal.
The Chair
As a Member of 40 years’ standing, the hon. Gentleman knows perfectly well that no one can be accused of misleading anyone, so I am sure that he did not mean to say that. And as far as the point of order is concerned, it was not a point of order; it was a point of exasperation.
Stephen Hammond
What I am telling the hon. Lady about the specific statutory instrument, the Health Services (Cross-Border Health Care and Miscellaneous Amendments) (Northern Ireland) (EU Exit) Regulations 2019, is that consent was sought from the Northern Ireland civil service, and was provided by the permanent secretary for the Department of Health for Northern Ireland. The Northern Ireland civil service may make decisions in the public interest under the Northern Ireland (Executive Formation and Exercise of Functions) Act 2018. Again, following decisions by UK Government Ministers, in the interest of securing legal certainty in Northern Ireland, the UK Government will progress the necessary secondary legislation in close consultation. As I have said, consent was sought from the Northern Ireland civil service, and was granted.
Stephen Hammond
It is not a constitutional point. I will not take the hon. Gentleman’s intervention.
The Chair
Order. We can have only one person on their feet at a time. Is it the case that the Minister is not giving way?
Stephen Hammond
I have given way on a number of occasions. I am bound to say to the hon. Member for Huddersfield that I have been clear about the legal position and the legal certainty. I have given clarity that the Northern Ireland civil service and the Northern Ireland Department of Health are clear and are consenting to what we are doing.
Stephen Hammond
Then the hon. Gentleman does not need to ask me, because I have just answered his question.
In addition, I am pleased to report that we have the legislative consent motions for our Healthcare (International Arrangements) Bill. To underpin and facilitate the consultation, we have developed and agreed a memorandum of understanding with the devolved Administrations, which sets out a practical and mutually beneficial working relationship. That will ensure that the devolved Administrations will continue to play a vital role in delivering reciprocal healthcare for the benefit of all United Kingdom nationals.
Mr Sheerman
The Minister is a little grudging, but it is an important issue. He has gone through all the people whom he has consulted in Northern Ireland, and they all sounded like bureaucrats and civil servants to me. I did not hear him once say that he had confronted the facts of what is happening, through the statutory instruments, to our parliamentary colleagues or that he had put it to them. For all these years, their constituents have felt that they could go all over Europe and carry with them an extension or a bubble of the national health service that delivered the NHS promise, even though they were travelling. Did they get the picture? Were they told in blunt terms that that will no longer exist for their constituents? For people who are travelling, it is the old Tory dream of privatising the health service.
Stephen Hammond
I was going to say that I can see why the Speaker regards the hon. Gentleman as a national treasure, but after his final remarks, it is difficult to agree.
In closing, I make it clear that the instruments make miscellaneous amendments to EU references in retained EU law—for example, by removing references to EU concepts. Moreover, together with the Healthcare (International Arrangements) Bill, the instruments are necessary to ensure that the UK Government are ready to deal with reciprocal and cross-border healthcare in any EU exit scenario. They provide us with an efficient and effective mechanism to ensure that there will be no interruption to people’s healthcare in a no-deal scenario.
I thank members of the Committee for their valuable contributions.
Mr Sheerman
I do not want to speak for more than half an hour, but I must make the point about this bundling. I have been on many Delegated Legislation Committees and have become quite an expert on statutory instruments.
Stephen Hammond
If the hon. Gentleman and the hon. Member for Walthamstow did not want the statutory instruments to be bundled, they could have said so at the beginning of the Committee. The Government did nothing other than seek the permission of the Committee to bundle them. Should the Committee have wished, I would have been perfectly happy to unbundle them.
Stephen Hammond
I recognise the concerns of the hon. Gentleman and the hon. Lady and I will address their points, but the Government asked the Committee to agree, and the Committee agreed to the bundling of the statutory instruments.
Mr Sheerman
I take that point. There has been honest confusion, because when the Minister introduced the statutory instruments, I did not realise that, because they had all been bundled, I could not have a responsible view and single out the statutory instrument relating to Northern Ireland. I would not want to vote against that, but I want to vote against the others. I did not realise that was what would happen; I thought we would vote on each one.
Oral Answers to Questions
Debate between Stephen Hammond and Barry Sheerman(10 years, 4 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Stephen Hammond
It is only fair for me to recognise the extraordinary efforts of my hon. Friend in ensuring that high-speed rail comes to Deal. I also recognise the extraordinary efforts of my hon. Friend the Member for Hastings and Rye (Amber Rudd), who is making the same case. HS2 will make an important contribution to securing prosperity across the country. It will generate jobs and rebalance the economy, and our estimates suggest that there will be more than £70 billion of benefits, including £53 billion of benefits to business.