I totally agree that that is part of it. The Government have to consider, given the numbers involved, whether creating that entire administrative system will bring more money back in than is spent on administering it.
It is important to consider exactly how we will expect doctors and other health staff to demand to see someone’s settled status. Will it be based on a foreign sounding name, a skin colour or an accent? Will people have to produce an ID card if they were born here, they grew up here, they have never been anywhere else and their family are 20 generations English? That is the point: there is no ID card here. In other European countries, there is an ID card and it will show that UK citizens
have whatever the equivalent of settled status is. I think doctors and others are anxious about the circumstances in which they should ask for proof of habitual residency.
We see that already in respect of universal credit. I have dealt with a German lady who has been settled here for 30 years and who was refused universal credit on the basis that she was not habitually resident. We are already seeing these things, and we do not want to see them around healthcare.
As we have heard, there are three main groups. The biggest group is the almost 200,000 pensioners using their S1 rights to register somewhere they have never paid tax—and yet they benefit as if they have. It is important that their rights continue, or they may end up having to come back home. They would cost more here than the Government are paying France or Spain to deliver their healthcare. It is important that they are not limited in some way, so that only people who do not have medical health risks are accepted, as happens with insurance. Ordinary pensioners who have exercised those rights would simply not be able to afford comprehensive private health insurance.
A lot of work is being done to protect those who have settled already, but what about the rest of us, who might fancy settling in the south of France or Spain? Will this be achievable by ordinary pensioners in the future?
Approximately 1,300 UK citizens use S2 forms for planned treatment, and the biggest number is the 250,000 claims a year that are made through the EHIC card, which allows people to travel or study all over the EU. As the hon. Member for Burnley (Julie Cooper) said, that includes people with expensive chronic conditions that require treatment such as dialysis three times a week. I defy any Member to find affordable health insurance that would cover such treatment. That is not a risk of healthcare, but planned healthcare, otherwise the trip simply cannot be made.
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As I mentioned earlier, that should not be extrapolated to EU citizens who live here or UK citizens who live and work in Europe. If they already pay full tax and national insurance here, or the equivalent in Europe, they qualify through those payments, and the UK does not currently reimburse those countries.
The withdrawal agreement Bill only covers transition. It does not go beyond that. The problem is the prospect of no deal, which is still hovering over our heads. It is therefore important that the Government negotiate, but recognise that provision may well be on a much more limited basis. Reciprocal healthcare was not designed around a stag weekend in Prague, but to facilitate freedom of movement.
For me, the Bill highlights what we are losing with Brexit. We are losing freedom of movement, which has often been described from the Dispatch Box as something negative, the end of which we should celebrate. It is actually one of the greatest benefits that we as individual citizens have had from being in the European Union, and it works both ways. We all know people who have worked or studied in Europe; those who have met people from Europe and settled there, or those whose partners have settled here. Free movement has been a
great contributor to friendship and love across Europe. The problem is that those rights cannot be exercised unless healthcare can be afforded.
We will not vote against the Lords amendments—they are necessary; the work needs to get done—but it still makes me sad, because all the measure does is highlight what we are losing.