Sick notes

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

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