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Health: Reciprocal Agreements

Volume 716: debated on Monday 25 January 2010


Asked By

To ask Her Majesty’s Government why they are rescinding the reciprocal health agreements with Guernsey, the Isle of Man and Jersey with effect from 1 April.

My Lords, the Government ended their agreement with the Channel Islands on 31 March 2009 and are ending their agreement with the Isle of Man on 1 April 2010 as they do not represent value for money for the UK taxpayer and travel insurance is widely available. Tourists will continue to receive free accident and emergency treatment. However, they will now be expected to have insurance to cover the cost of further emergency and other treatment.

My Lords, I thank the Minister for that rather unsatisfactory explanation. I have two points. First, why was the arrangement not renegotiated, rather than unilaterally stopped? Secondly, does the Minister agree that this is very ageist? A large number of very old people travel to and from the Crown dependencies, particularly the Isle of Man. I declare an interest here: I am one of them, and I cannot get personal health insurance. If I were to leave and then had to have an air ambulance back, it would cost in excess of £4,000.

My Lords, the agreement had a six-month notice clause on either side; in fact, we provided a one-year notice of the termination. It is not value for money for the UK taxpayer, and it is not the role of the UK taxpayer to provide travel insurance to citizens. We have a series of bilateral agreements, where they make sense, and we have some obligations under the European Union. We do not have a specific obligation to old UK residents wanting to go to the Isle of Man.

My Lords, I declare an interest as a Manxman. Can the Minister clarify an anomaly? Neither the Isle of Man nor Switzerland is a member of the EU, but on 7 January the Minister of State, Gillian Merron, told MPs that, unlike visitors from the Isle of Man, those from Switzerland would still be “entitled, free of charge”, to all NHS hospital treatment and care. Is this act of charity because so many tourists from Switzerland are destitute bankers?

That is a lovely idea, but in practice it is more complex. An enormous amount of European Union regulations extend to the European Economic Area, which is Switzerland, Norway, Lichtenstein, Iceland and the whole of the EU. The agreements we have with the countries of that area are under EU regulations 1408/71, and the general heading of the co-ordination of social security, which have the effect of looking after workers, pensioners and tourists as described. They are part of our European obligations. We do not have those responsibilities with the Isle of Man because it chose not to be a full member of the EU; it is a Protocol 3 member—a Crown dependency—and it only enjoys a customs union.

My Lords, I declare an interest as the bishop with responsibility for the Church of England in the Channel Island Bailiwicks, and also as somebody financially affected, both personally and with regard to my diocese, by the Government’s decision which is the target of the noble Lord’s Question.

The Government have mentioned that they have a range of bilateral agreements, and some with places a great deal further away that the Channel Island Bailiwicks. Are they considering making that kind of bilateral agreement with the Bailiwicks of Jersey and Guernsey? It should be remembered that moves such as that which is the target of this Question cause considerable, further damage to any sense the people of those islands—subjects of Her Majesty—have that Her Majesty’s Government really understand their needs and position.

My Lords, the relationship with the Channel Islands is a special one. That and the relationship with the other two Crown dependencies depend on their being sovereign territories. As a generality, they do not come under the UK Government, but under the Crown. The bilateral agreements that we have elsewhere are judged to be of value. None that we have outside the EAA involves the movement of funds. These agreements were terminated because we were paying money to these various communities. We were paying £2.8 million this year to the Isle of Man, £3.8 million to Jersey and £0.5 million to Guernsey. We did not feel that that was good value for money.

My Lords, perhaps my noble friend would comment on the position of British tourists visiting the Channel Islands or the Isle of Man. Is it not a fact that they will now no longer have the sort of health cover that they would have if they visited one of the EU countries? Does this not mean that they have to take out insurance; and, if this were widely known, would this not be damaging to tourism in the Channel Islands and the Isle of Man? Surely the time has come to renegotiate the matter.

My Lords, the position as described is accurate. British tourists will need to take out insurance to go to the Isle of Man. However, we recommend that, wherever British tourists are travelling, they take out insurance. It is not as straightforward getting healthcare across the world as might be described. It is important, as a generality, that British tourists take out healthcare insurance because of the variations in service. In the EU, we have an arrangement.

My Lords, does the Minister recognise that while it may be fair enough for one of Her Majesty's Governments—the one over there—to renegotiate these agreements with others of Her Majesty's elected Governments in these dependencies, it is not fair for them simply to bully them in the way that they are doing? Will they now negotiate these things properly with the dependencies?

My Lords, there was no bullying. These agreements were not perpetual, but had proper termination clauses. The proper termination period was given. No new information came forward from other parties. We think that the way we have behaved is entirely reasonable.