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Healthcare (European Economic Area and Switzerland Arrangements) Bill

Volume 796: debated on Tuesday 19 March 2019

Third Reading

Clause 1: Power to make healthcare payments

Amendment 1

Moved by

1: Clause 1, page 1, line 3, leave out “a European Economic Area country” and insert “an EEA state”

My Lords, the proposed government amendments in the name of my noble friend Lady Blackwood of North Oxford seek to clarify and remove any potential legal ambiguity in the drafting of the “global scope” amendments made at Report and to clarify the drafting of Clause 2(2) to ensure the other place can consider a legally unambiguous Bill when it returns there from this House.

As noble Lords are aware, the Government resisted the amendments at Report, but I emphasise that these are purely technical amendments and reassure noble Lords that their aim is not to change the policy intention behind the original amendments passed at Report. These technical amendments ensure the other place can review the Bill in a version which is based on government drafting guidance.

The Interpretation Act 1978 uses the definition of an “EEA state”, and this term is used throughout the statute book. Amendments 1, 2, 4, 5, 6 and 7 therefore seek to change the references to “European Economic Area country” to “EEA state” in the Bill.

Turning to Amendment 3, as the phrase “for example” was removed from Clause 2(2) at Report, it is important to ensure the intention behind the amendment is clear from the drafting and avoids the potential for any legal uncertainty. This amendment therefore clarifies that regulations under Clause 2(1) could only include one or more of the types of provision listed in Clause 2(2). The amendment removes any potential argument—even if unlikely—that regulations under Clause 2(1) would have to provide for everything on the list in Clause 2(2), even when it is not applicable or appropriate.

I hope these amendments are clear and will have your Lordships’ support, but it will of course be up to the other place to consider the revised Bill when it returns there. Notwithstanding that, I would like to keep working with noble Lords to ensure we achieve the best possible outcome for this important Bill, which is aimed at providing the Government with the appropriate means to support comprehensive reciprocal healthcare arrangements and the people reliant upon them. I hope that these amendments will be able to command the support of this House. I beg to move.

I thank the Minister for Amendment 3. That was an important matter to clear up, and the way in which it has been done is entirely in accordance with the wishes of those who were concerned about the previous wording. We are most grateful.

My Lords, I thank the Minister for introducing these amendments and explaining their intent. With the exception of Amendment 3, they seek to make the Bill consistent and coherent, its intended scope now being the EEA and Switzerland. I checked on the meaning of Amendment 3; it looks to me like it does the trick, so I thank the Minister for that.

At this stage, given the uncertainties we face over Brexit and what might happen in the next 10 days, surely the Government take the view that right now we have to focus on the challenge before us: the healthcare needs of UK citizens. We need to think about their healthcare arrangements and leave other parts of the world to be considered in due course. That requires a decision by the Secretary of State, and everybody would understand if he felt that the Government had enough on their plates right now.

Indeed, the Secretary of State might have been reading my mind, because at 12:54 today—lo and behold—we received an update in the form of a Written Statement about the continuity of reciprocal healthcare arrangements in the event that we exit the European Union without a deal. I commend this Statement to all noble Lords and hope that they will read. I have one or two questions for the Minister arising out of it. The Statement says,

“We have proposed to EU member states and EFTA states that we should maintain the existing healthcare arrangements in a no-deal scenario until 31 December 2020 with the aim of minimising disruption to UK nationals and EU and EFTA states citizens’ healthcare provision”.

This relates to the passage of the Bill, because the discussions all took place in Committee and on Report.

The Statement went on to say that current arrangements could only continue if there was a deal and an implementation period. Previously, it was said that 27 bilateral agreements would have to be negotiated, so we welcome what the Secretary of State is saying, but I would like the Minister to clarify whether my understanding is correct.

Furthermore, in Committee, Members—including some on these Benches—suggested that UK nationals and others for whom the UK is responsible and who have applied for or are undergoing treatment in the EU prior to and on exit day should be recompensed for up to one year. The then Minister said that this would not be possible because it would place a huge financial and administrative burden on the NHS. She said:

“It would make it less likely that individuals would take the steps they need to, even if they were able to. It would undermine our approach to member states in negotiating reciprocal agreements”.—[Official Report, 19/2/19; col. 2255.]

However, it has to be said—and I welcome it greatly—that this Statement goes some way to meeting that, and suggests that the Government will be prepared to recompense and pay for the treatment of UK residents. I welcome that but seek some clarification from the Minister. The point is that the Secretary of State’s Statement really only reinforces the need for the amendments that this House has put forward and voted on at every stage of this Bill, and that the Government themselves brought forward and voted on at Report. The lengthy Statement addresses the healthcare issues that we face and merely underlines the importance and urgency of sorting this matter out whichever way things go.

My Lords, on behalf of my noble friend Lady Blackwood and myself, I thank all noble Lords who have contributed to the constructive deliberations and review of the Bill during its passage over the past weeks. In that time, it has been the subject of spirited and carefully considered debate, both inside and outside of this Chamber. As we approach the final leg, I would like, in particular, to offer my thanks to the noble and learned Lords, Lord Hope and Lord Judge; the noble Lords, Lord Patel, Lord Kakkar, Lord Lisvane, Lord Foulkes and Lord Marks; the noble Baronesses, Lady Thornton, Lady Jolly, Lady Brinton and Lady Wheeler; and my noble friends Lord Lansley and Lord Dundee, for their considered contributions to this important debate. I am also grateful to my noble friend Lord O’Shaughnessy, who has been an invaluable supporter of this Bill. I also thank my noble friend Lord Young and the Bill team for all their support and hard work. I fully acknowledge the invaluable role played by my noble friend Lady Blackwood in leading on this Bill.

This Bill has been subject to considerable scrutiny and continues to be so, as the noble Baroness, Lady Thornton, has just said. I am grateful to the noble Lords who sought to improve and strengthen this important Bill.

I am pleased to hear that the noble Baroness, Lady Thornton, supports the Statement made by my right honourable friend the Secretary of State for Health in the other place. I can reassure her that, as she will be aware, we have two SIs that will come before the Grand Committee on Thursday, and I look forward to her support for those regulations. As she rightly highlights, our intention is to continue the reciprocal arrangements where we possibly can. In addition, through those SIs we will look at reciprocal healthcare arrangements with member states for urgent treatment where it may have started or is in the process of being started.

I thank the noble and learned Lord, Lord Hope, for his supportive comments. I say to the noble Baroness, Lady Thornton, and other noble Lords that our amendments have significantly reduced the scope of the Bill’s powers and are a response to this House’s clear request for increased opportunities for parliamentary oversight. We have removed the consequential Henry VIII power; limited the ability to confer functions to public bodies only; provided greater parliamentary scrutiny of regulations relating to data processing; provided greater transparency concerning the financial aspects of future reciprocal healthcare policy, in the form of an annual report; placed a statutory duty to consult the devolved Administrations where regulations under Clause 2 make provision within a devolved authority’s legislative competence; and finally, and significantly, sunset two of the three regulation-making powers in Clause 2 so that they can be exercised only for a period of five years after exit day.

Of course, the other place will now need to decide if it agrees with the amendments made in this Chamber. Notwithstanding that, again I extend my offer to keep working with noble Lords to ensure that we have the best possible outcome for the Bill and for the people reliant upon reciprocal healthcare arrangements. I beg to move.

Amendment 1 agreed.

Clause 2: Healthcare and healthcare agreements

Amendments 2 and 3

Moved by

2: Clause 2, page 1, line 8, leave out “a European Economic Area country” and insert “an EEA state”

3: Clause 2, page 1, line 11, after “may” insert “only do one or more of the following things”

Amendments 2 and 3 agreed.

Clause 3: Meaning of “healthcare” and “healthcare agreement”

Amendments 4 to 6

Moved by

4: Clause 3, page 2, line 24, leave out “a country or territory in the European Economic Area” and insert “an EEA state”

5: Clause 3, page 2, line 28, leave out “a European Economic Area country” and insert “an EEA state”

6: Clause 3, page 2, line 32, leave out “a country or territory with which the agreement has been made” and insert “an EEA state or Switzerland”

Amendments 4 to 6 agreed.

In the Title

Amendment 7

Moved by

7: In the Title, line 1, leave out “a European Economic Area country” and insert “an EEA state”

Amendment 7 agreed.


Moved by

My Lords, on a point of clarification, the Minister said—in an impeccable way—exactly what changes have been made by the Government. She also said that the amendments we have put forward have, understandably, to be approved by the other place. However, does not the change of the title to the Healthcare (European Economic Area and Switzerland Arrangements) Bill, which is very welcome, imply that the Government are accepting the amendments that this House has made? That is my understanding; is it also the Minister’s?

Bill passed and returned to the Commons with amendments.