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Benefits (Reciprocity)

Volume 480: debated on Thursday 9 November 1950

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asked the Minister of Health what reciprocal arrangements have been made during 1950 with other countries whereby British citizens may receive Health Service benefits without payment when abroad.

Arrangements providing for varying degrees of reciprocity have been or are being made with the following places outside the United Kingdom—Isle of Man, States of Jersey and Guernsey, Belgium, France, Luxemburg, the Netherlands.

As there are comparatively few countries on that list, can the right hon. Gentleman say what the reason is for the small number? Is it generally the time taken to work out the arrangements, or is it that the other countries are unable to offer facilities? Will he press this as hard as he can, especially in view of the fact that it affects many merchant seamen who are away from this country for nine months each year and who pay their contributions but cannot get the benefits?

We are trying to do this, but other nations have not got our advanced facilities.

Will the right hon. Gentleman use his bargaining power by threatening not to treat foreigners in this country or, alternatively, asking foreign countries to subscribe a lump sum for the services which their people receive here?

If we are to have reasonable arrangements with other countries it is better to start off in an atmosphere of conciliation rather than of threats.

If the right hon. Gentleman cannot control other countries, as obviously he cannot, will he arrange for a refund to British nationals, to be paid to them from National Health Service funds when they return to this country, for the cost of treatment incurred abroad?

That is an absurd suggestion. It is suggested that a patient shall make arrangements with a doctor, a surgeon, a hospital, a dentist or anybody else in another country and present the bill for us to pay although we have no say as to whether the charges are reasonable or not. I am certain that the hon. and gallant Gentleman did not reflect upon his suggestion.


asked the Minister of Health if he will now make regulations under the National Health Service (Amendment) Act, 1949, whereby foreign residents visiting this country will have to pay a charge for using the Service.

I am keeping this under review, but am not at present satisfied that there is enough evidence of abuses to justify action.

In view of the fact that the Minister said, in answer to an earlier Question, that most other countries do not have the facilities which we have here and that, therefore, reciprocal agreements cannot be made, how long is this one-way traffic in benefits to continue; and why does the right hon. Gentleman not use the powers which he took in the 1949 amending Act?

It was made perfectly clear that the powers were being taken only to deal with abuse if it arose. I can assure the House that if I tried to take or use power to deal with the very small number of cases that might exist, the expense of administration would be far more than the gain to the Health Service.

Can the right hon. Gentleman tell the House what was the expense last year so far as foreign nationals were concerned?

No, because if I was able to say what the cost would be I would have the administrative machinery that I suggested. We can only make a guess, and our guess is that it is a very small proportion indeed. My right hon. Friend the Home Secretary prevents the entry into this country of people who come only to use the Health Service.