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Glenys Thornton on a Brexit-related Bill with huge implications for UK citizens’ healthcare

The Healthcare (International Arrangements) Bill begins its Lords Committee stage today. Small in size but wide in scope, the range of amendments tabled – from peers on all sides – reveals great concern about where this legislation could lead.

It is essential to ensure continuity for the UK citizens with EHIC cards that they can access free healthcare when living in or travelling within the EU and Switzerland, and for EU citizens doing the same here. Yet here we are, weeks away from Brexit and this vital issue remains unresolved. 

A deal would see reciprocal healthcare carry on for the two year transition period. Crashing out however, would have grave implications for thousands of UK pensioners living with long-term conditions in Spain, Cyprus and elsewhere in the EU who could find themselves paying for health care. Or alternatively, put considerable extra stress on the NHS as people return to the UK for treatment.

Some of our more important amendments, address just these issues. If we crash out, it seems unlikely that the necessary deals with 27 countries to provide reciprocity will be in place. One government Minister has admitted as much and recommended getting health insurance.

The government must do two things. First, publicise the changes and provide guidance to the public on the likely impact on their lives. Second, put a six month arrangement in place to reimburse our citizens for any healthcare costs incurred that would previously have been covered, until new agreements come into effect. We will be fighting hard for this basic protection for our citizens, wherever they live in the EU. 

There are also worrying concerns about the bill opening the door to healthcare negotiations across the rest of the world, via trade and foreign affairs discussions. While the new Health Minister in the Lords believes this is forward looking, almost everyone else in the Lords thinks it more urgent to sort out post-Brexit arrangements with the EU and not slip in new policy. And the legislation has now been subject to highly critical reports from both our Constitution and Delegated Powers and Regulatory Reform (DPRR) committees.

The former has said the Bill should be limited to UK/EU reciprocity and EHIC matters, while the latter committee has raised concerns about powers conferred on the Secretary of State. It is rare to see the DPPR report that “Clause 2 has breath-taking scope. Indeed, the scope of the regulations could hardly be wider”, and add for good measure that these “can delegate functions to anyone anywhere”. Labour’s amendments will seek to reduce the scope of the bill in line with such concerns.

We will also be questioning other matters in the bill, including a loosely worded clause about the necessary use of patient data. The question arises about data protection for NHS patients who access health care in the EU provided by the private sector. We are raising this with the NHS Data Guardian. There are also very serious issues regarding arrangements between Northern Ireland and the Republic, not to mention the complete absence of any reference to costs and accountability. 

Baroness Glenys Thornton is Shadow Health Minister in the House of Lords. She tweets @glenysthornton 

Published 19th February 2019

Sick notes

Glenys Thornton on a Brexit-related Bill with huge implications for UK citizens’ healthcare

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Angela Smith speech in the House of Lords, Wednesday 13th February 2019

Two weeks ago, having reflected on her crushing defeat, the Prime Minister vowed to renegotiate and come back to Parliament with, apparently, a better deal. 

And, as we edge ever closer to 29 March – with just 44 days to go – we were eagerly awaiting details of the progress made to date. Perhaps we should’ve known better than to expect anything of substance from the Prime Minister when her statement was suddenly brought forward to yesterday afternoon.

But, ever the optimist, I hoped to hear the results of her mission to obtain legally binding changes to the withdrawal agreement. If not that, perhaps Mrs May would genuinely seek to build a cross-party consensus behind a different, more detailed political declaration. And yet, on both counts, we were disappointed.

For the past week we have waited with baited breath to see the Government’s motion for today’s debate. But it seems to have been drafted to rub salt into already weeping wounds. All it says “that this House takes note of the ongoing discussions with the European Union under Article 50 of the Treaty on European Union.” 

A debate that could have been had at any point in the past two years. The Government's motion says nothing. It does nothing. And therefore, it means nothing.

Whilst MPs hang around waiting for that Meaningful Vote – all the Government wants to offer is a meaningless debate. So the purpose of my motion is to provide some meaningful structure for our deliberations today.

For the benefit of the House I’ll speak to both motions and although it may be a vain hope, I would welcome Government support.

Each and every time I make a proposal, I do so after consultation and discussion with colleagues across the House, seeking not to be controversial, but constructive. 

We want to find a way forward that can command broad support in YLH and allow the Government to return to Brussels with something new to say. Something I’m sure Mr Barnier would appreciate. We want to rule out the catastrophe of crashing out on 29 March, and ensure sufficient time for proper consideration of the legislation needed to deliver Brexit. And surely we’ll also want to ensure that the Constitutional Reform and Governance Act is not simply torn up and tossed aside.

The Government’s motion, taken alone, is inadequate. It asks us to take note of the ongoing discussions – but what discussions? According to media reports, EU officials were once again bewildered that the Prime Minister arrived for urgent meetings in Brussels without anything new to discuss with those she had requested to meet.

And despite having received a constructive proposition from the Leader of the Opposition, Mrs May refuses to provide Parliament with an opportunity to vote on that proposal, as she stubbornly clings to her now discredited red lines.

Rather than listening to the Prime Minister’s plea for more time yesterday, perhaps it would have been more fruitful for noble Lords to gather in a Brussels hotel bar. Hopefully Mr Robbins was able to enjoy as many different Belgian beers as the Government has timetables for the next meaningful vote.

Even as ONS data shows that economic growth is slowing, with manufacturing now performing as badly as it did at the onset of the financial crash, the Government continues to talk up a no-deal exit. And all we hear from ministers is that the only way to prevent crashing out is to support the Prime Minister’s Deal – even though she has herself already rejected part of it, the backstop.

Many colleagues will have heard the Noble Lord, Lord Kerslake interviewed on the Today programme last Friday. He laid out what we all know to be true:

  • If the Government sought to rule out a no-deal exit at the end of March, both Parliament and the EU27 would gladly facilitate this shift;
  • Civil servants and local government are being forced to allocate limited resources to an outcome that would actively harm citizens, businesses and communities; and,
  • Even if the Prime Minister were to secure the changes she seeks, it is simply no longer possible for the Government to ensure an orderly exit from the EU on 29 March.

And in that same programme, the Shadow Chancellor again laid out the terms of Labour’s proposals for an alternative deal:

  • A permanent and comprehensive customs union with the EU;
  • Close alignment with the Single Market, underpinned by shared institutions and obligations;
  • Dynamic alignment on a range of rights and protections;
  • Concrete commitments on future participation in EU agencies and funding programmes; and,
  • Greater clarity on future participation in EU security mechanisms and arrangements, including the European Arrest Warrant.

All of this is based on comments made on all sides of both chambers and is an arrangement the Government should allow Parliament the opportunity to fully consider – and vote on.

My motion today is intended to assist the Government. It recalls that this House, by substantial majorities, emphatically ruled out a no-deal exit, and called on the Government to act accordingly.

This reflects the mood of the elected House, where MPs have twice voted against the principle of crashing out without an agreement. It asks the Prime Minister to take all steps necessary to ensure that we do not leave without a deal on 29 March, which could include seeking an extension to the Article 50 negotiating period.

Such an extension would allow time to develop the political declaration in vital areas such as security cooperation, and to pass the legislation needed to give effect to the final withdrawal agreement.

We all understand that an extension requires the approval of the EU27. But faced with the choice of a limited extension or a no-deal Brexit, there is only one sensible option for both sides.

So can the Government finally stop dragging its feet, commit to asking for more time, and therefore rule out the most disastrous of all outcomes? Doing so would reassure:

  • Citizens, that their basic rights will not be in jeopardy as a result of an unprecedented political gamble;
  • Businesses, that the Government will secure the right deal, rather than any deal; and,
  • Communities, that vital public services – and entire sectors of the economy – will not grind to a halt on 30 March, in some kind of Trump-esque shutdown.

This is not project fear. It is project reality.

The motion in my name also asks the Government to facilitate a further ‘meaningful vote’ for MPs by the end of February and, as required under the EU (Withdrawal) Act, to table a ‘take note’ motion in YLH. How timely this issue has become.

MPs will have the opportunity to vote on various amendments to a non-binding motion tomorrow evening. A motion only promised a fortnight ago to allow government whips to pick off potential rebels.

Over the weekend, in an attempt to prevent a rebellion this week, the Communities Secretary committed to an extra vote by 27 February, confirmed by the Prime Minister yesterday. However, the nature of this vote will be dependent on the progress, or otherwise, of the negotiations. It could, as will be the case tomorrow should there be a vote, be completely non-binding.

The Prime Minister is so obviously trying to run down the clock and force a decision between her deal and no-deal. We had confirmation of that Hobson’s choice last night courtesy of ITV. It is only by securing a binding vote for MPs that they can apply the brakes before we career over a cliff-edge.

In addition to our motion in this House, the Labour Party has tabled an amendment in the Commons to require either a meaningful vote – in the case of a new deal being struck – or a further statement and amendable motion on 27 February.

We all know the Prime Minister likes to get her own way. But running down the clock is a high-risk strategy. So the Government should accept that amendment and grant a meaningful vote before the end of February.

I would prefer not to divide the House on my motion. I’m not the only one who has struggled to understand why the Government has not simply accepted the previous two, given that they recognised the supremacy of the Commons and reflected the stated intentions of the Prime Minister.

The Government says it wants to avoid a no-deal outcome. The Government says it wants to engage Parliament. The Government says it wants to swiftly secure MPs’ approval for a withdrawal agreement. This motion does nothing to undermine those aims. It reinforces them.

So at the third time of asking, will the Government accept this common-sense motion, take all the necessary steps in relation to Article 50, and ensure that MPs are able to engage in both a meaningful and a timely manner?

-Ends-

Speech in the House of Lords moving motion on the Government’s Brexit deal

Angela Smith speech in the House of Lords, Wednesday 13th February 2019

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Ray Collins on major problems with the government’s agenda for overseas aid programmes

Today in the House of Lords, I will press Ministers on the Prosperity Fund. Part of the government’s international development programme, the fund’s primary objective is to promote economic growth that contributes to poverty reduction – a noble aim which we can all get behind. A secondary objective however, is to promote international business opportunities, including for UK companies.

The Prosperity Fund has a considerable budget – £1.22bn for the 2015-22 period. 97% of this spend is expected to be reported as Official Development Assistance and count towards the 0.7% GDP target for overseas aid. Legally therefore, only 3% of the budget can be spent on promoting business – but the government is yet to provide assurances.

The Fund is also overseen by the National Security Council, raising questions over aid intentions. But while developmental projects should be prioritising the world poorest, major programmes are being planned in upper Middle Income Countries (MICs) – for example, Brazil, China, Indonesia and South Africa. Is this the most efficient way of spending our aid budget? The Fund not only fails to target Less Developed Countries, it is also not targeting the poorest and most marginalised in MICs, and so it is not adhering to the Leave No One Behind agenda in the UN’s Sustainable Development Goals.

There have been a series of inquiries into the Fund, including one by the Independent Commission for Aid Impact (ICAI) that suggested its initial proposals promoted UK business more strongly than economic growth. It also raised questions over the lack of transparency. And despite the government enshrining in the law the need for UK aid to take more of a focus on gender, the ICAI made clear that this has not been sufficiently applied with this fund.

Another inquiry has been carried out in the Commons by the Development Select Committee. Its damning verdict concludes that the Fund focuses too hard on trade, has lost sight of the primary task of poverty reduction, and is a step towards the return of tied aid. Ministers have since failed to commit to any improvements.

Oxfam has also been highly critical, finding that 50% of projects implemented in China were explicitly promoting UK expertise and technology or collaborations with UK entities. Again, the government has refused to make meaningful changes.

The Prosperity Fund is not the only UK aid programme with these problems. The Conflict, Stability and Security Fund has been widely criticised for securitising aid and neglecting human rights, despite a proportion being earmarked for aid. Only last year, the ICAI asked the same questions now asked of the Prosperity Fund: does it really help the world’s poorest and most vulnerable? They also noted inadequate results management practices and limited data to evidence value for money, along with inconsistencies in programme quality.

In addition, the Joint Committee on the National Security Strategy has accused the Security Fund of failing to provide enough information about objectives, operations and accomplishments; and the National Audit Office called out the lack of accountability.

Whether the Prosperity Fund, the Security Fund, or the government’s wider development strategy, Ministers must answer for this blatant misdirection of the aid budget. Only Labour will ensure that the UK’s aid budget is once again efficiently spent, on reducing both poverty and inequality.

Lord Ray Collins of Highbury is Shadow International Development Minister in the House of Lords. He tweets @Lord_Collins

Published 7th February 2019

The language of priorities

Ray Collins on major problems with the government’s agenda for overseas aid programmes

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