asked Her Majesty's Government:

My Lords, following consultations and as part of the implementation of the National Health Service review, the Government have decided that from 1st April 1991 providers of hospital care in Great Britain will be reimbursed for the actual cost of the treatment of EC nationals as in-patients or at out-patient clinics. That is facilitated by the new contractual system.

My Lords, I thank the Minister for that encouraging answer. Is she aware that it has been discouraging for staff at some of our expert units, such as liver units, when they have not seen the rewards of their work and that they need every encouragement and money to support their much needed units?

My Lords, although the cost of treating patients from European Community member states is met by the health authorities and any moneys received in respect of that treatment from those states is retained in central funds and the health authorities are not therefore currently reimbursed for the treatment that they provide for overseas visitors, perhaps I may remind noble Lords that neither are they charged for treatment provided overseas for UK nationals from their catchment areas.

My Lords, perhaps I may say how much we on this side of the House welcome the Minister's announcement. Will she tell us roughly the size of the sum involved and why it has taken all this time to move away from a system that was disadvantageous to the district health authorities?

My Lords, as I said in my original response, those arrangements have been the subject of consultation which has had to take place with the territorial health departments as well as with the National Health Service. The service will be consulted further on the detailed working arrangements. Because of the current system, the number of treatments and the costs of treatment are not known precisely, so exact figures are difficult to provide. Our best estimate is that about £9 million per annum will be required in all.

My Lords, does the Minister agree that it is excellent that we have some of the best specialising services which we can offer to other EC countries and that they want to come to us?

Yes, my Lords. We are fortunate in that other countries wish to refer their patients to this country for specialised treatment. I should add that not only does that happen under special arrangements and on the National Health Service, but that referrals are sometimes made for specific payment.

My Lords, will the Minister advise the House what proportion of EC nationals treated in the National Health Service come here specifically for that treatment and what proportion receive treatment under the NHS because they are here for other reasons; for example, if they are on holiday or on business?

My Lords, as I said earlier, it is difficult to give precise figures because of the nature of the current system. Clearly, that is particularly true of accident and emergency cases, which form part of the system. With the further costs of ward admissions, out-patient clinics and general practitioners, it is estimated that on balance the cost of treatment received by UK nationals overseas is slightly higher than the cost of treatment of EC nationals treated over here, so the balance is in our favour.