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Brexit: Health Policy

Volume 787: debated on Wednesday 6 December 2017


Asked by

To ask Her Majesty’s Government what are their priorities concerning health policy in the Brexit negotiations.

As the UK leaves the European Union, the Government are committed to safeguarding the success of the health and care sectors as well as the UK as a whole. Our priority is to make sure that, whatever the outcome of the negotiations, British citizens will continue to receive world-class healthcare. We are undertaking detailed planning for all scenarios.

Given the concerns expressed by the British Medical Association and others about such issues as recruitment and retention in the NHS, research, mutual recognition of qualifications, the market in pharmaceuticals and medicines and so on, do the Government agree that a full impact assessment of the effect of Brexit on this sector would be a very good idea? Since I understand some progress has been made on mutual rights between British and European Union citizens, will the Minister say whether that means that all British citizens will be able to enjoy entitlement to the European health insurance card in future?

I can reassure the noble Baroness that we are meeting a range of stakeholders. Indeed, I met the BMA, which she specifically mentioned, yesterday to talk about the impact of Brexit on the workforce and other issues. I assure her that we have had extensive discussions with the NHS, doctors’ groups, nurses, industry and so on, so that we understand the consequences of a range of options and so that we make sure that ultimately patients’ health and interests are protected. The noble Baroness asked about mutual benefits. I think she was talking about reciprocal healthcare with the EHIC. We have made good progress so far in the withdrawal discussions. For example, we will continue to cover the healthcare costs of pensioners who are permanently resident abroad, and anyone abroad at the point of exit will be able to use their EHIC. That was all that the first-wave mandate allowed us to do, but as we get to the second phase, we will be able to talk about what the future looks like.

Is not the real reason behind these negotiations the protection of democracy, which is best conducted at the nation state level where the Government are directly accountable to the people and the people are accountable for the Government, which is a million miles away from the type of government we have from a bunch of bureaucrats in Brussels?

My noble friend gives a wonderful exposition of the values of democracy, which I wholeheartedly endorse. I should point out that the UK Government are implementing the wishes of the British people, as expressed through the referendum, and that this position was supported by the manifestos of parties that gained 80% of the vote at the most recent general election.

My Lords, EU workers comprise some 5.6% of the healthcare workforce overall, including 10% of our doctors and 7% of our nurses. Most of these workers, who are not trained in the UK, are able to come and work here through the EU mutual recognition of professional qualifications directive. Can the Minister reassure the House that these reciprocal arrangements are afforded to EU and UK health professionals in perpetuity?

The noble Baroness is right about the important role that EU workers play in the NHS, and I pay tribute again to the work that they do. We value them and want them to stay. We are in a position with the stock of EU workers here—and, equally, UK workers in other health systems—to recognise those qualifications. Clearly we will have to agree to continue doing that as part of the future negotiations. It has to be said that some concerns have been expressed by bodies such as the GMC about how that operates. We are working with them to make sure we get that right.

My Lords, could the Minister remind us what the effect of Brexit has been on the location of the European Medicines Agency?

My Lords, the life sciences sector deal has been published today. From the point of view of the pharmaceutical and medical devices industries, one of the important and immediate objectives of the negotiations is to secure agreement to mutual recognition for things such as batch product testing and release, so that at the very least, through the transitional deal, they will not be required to move elsewhere in Europe for batch product testing and release in March 2019. Could my noble friend reassure the industries that the transition deal will give them that degree of protection for an additional period?

I thank my noble friend for mentioning the sector deal. There are some big announcements in it on investments and creating growth and jobs in the UK, which is a huge endorsement of our leading role as a life sciences hub throughout the world. We have said that we want a continued relationship with EMA. The MHRA, our sovereign regulator, makes a huge contribution, by both approving licences for medicines and issuing safety notices. It is our intention as we move to the next phase of talks that we will have that kind of relationship going forward with the EMA.

My Lords, to follow on from the point made by the noble Lord, Lord Lansley, there is great anxiety in the medical research and clinical worlds about research, medical trials, the regulatory framework and access to drugs, including new drugs. Can the Minister give the House a categorical guarantee today that UK patient access to crucial drugs will be maintained and that this access will not be restricted in any way when the UK leaves the European Union?

The Secretary of State has set out very clearly that patients should not be disadvantaged as a result of the new arrangements, whatever they may be. Clearly, those new arrangements will be a matter for negotiation, but we will make sure that patients are not disadvantaged and that the industry can continue to get its drugs and devices to the UK market as quickly as it does now.

My Lords, how many people from Europe who are in the medical field have already left because of insecurity and not knowing what is happening?

I recognise that there is uncertainty. That is why we have set out our intention of offering a route to settled status for those people working here, and why we want the issues of citizens’ rights to be dealt with as soon as possible in the next phase of talks. The noble Baroness and other noble Lords will be interested to know that, if you compare June 2016 to June 2017, there are more EU workers working in the NHS from one year to the next.

Does my noble friend understand—I am sure he does—that on both sides of the channel we are all concerned about the rights of British people in the EU and EU citizens here to health service treatment free of charge? Of course, the numbers are different. Would it not make it much more equal if we could agree with our friends in Europe that after Brexit we would issue a similar number of cards entitling people to treatment—Brits and EU citizens? If there was a disparity, whichever side needed more cards could buy them from the appropriate Government.

My noble friend is, as ever, a huge source of ideas and advice, for which I am grateful. This point about reciprocal health care is really important, because our reciprocal healthcare arrangements predate membership of the European Union. They worked in the interests of people in both the UK and the European Union and I have every expectation that they will continue in the future.