My Lords, I apologise for not having spoken in the debate at Second Reading, but I was unable to be here on the first day. The amendments I am supporting for the most part try to deal with the obstacles put in the way of ordinary people, both young and old, who are on holiday, working or studying abroad. These include the amendments that seek to protect the European health insurance card scheme and Erasmus+, which is the subject of the next group. I have added my name to Amendment 9, moved by the noble Baroness, Lady Thornton, and I have my own Amendment 205 in this group which seeks specifically to retain the EHIC scheme and to which the noble Lords, Lord Judd and Lord Davies of Stamford, have added their names.
To focus on the holidaymaker’s point of view, I am a great believer in the EHIC scheme. Like millions of others across Europe, I carry the card with me when I go abroad, and I certainly would not travel without it. It has been a help to me personally when I had a combination of a flu-like virus and asthma in Germany. It is also clear from the stories I have heard—ranging from needing stitches after a hotel poolside fall to pulled muscles and broken legs on the ski slopes—how extraordinarily helpful the scheme has been to others, and I have even heard about a case of amnesia. All these are situations where immediate medical attention is required. In those circumstances, the last thing people want to worry about when on holiday or on a business trip is having to book the next flight back to the UK or having to claim immediately on their travel insurance. Apart from the fact that treatment is free and comparable to what one would receive at home, the scheme reduces stress. In the case of a concussion that I was told about, it meant that the person could return to the hospital for monitoring without the worry of paperwork or bills. It also gives peace of mind to the many people who have not needed to use the card but carry it nevertheless—something which cannot be overestimated.
Once you have the card, it is a simple and bureaucracy-free system for the holidaymaker. It does not replace travel insurance, but works well in conjunction with it. I realise that my speech is an unashamed advert for a scheme which saves British people thousands of pounds in bills and reduces the claims and costs of travel insurance. The fear of course is that those costs will rise steeply if we lose the scheme. A replacement scheme or schemes might do all this, perhaps through agreements with individual countries, but presently the one card covers all the single market countries, the 31 EEA countries and Switzerland. Clearly, it would not be in our interests to adopt a scheme that is less comprehensive geographically, and retaining the scheme would be the easiest and most convenient option. If we stay in the single market in some form, there should be no problem.
It is worth noting that citizenship itself is not an aspect of the EHIC scheme; rather, it is based on country of legal residence so that British people living in France or Spain, for example, can apply for a card through their health services. It should not be forgotten that the scheme works for the benefit of British people living abroad as well as those from other countries living here. It is a properly co-operative system—a two-way street.
Accusations of health tourism always ignore what we as individual citizens get out of the system. A freedom of information question in 2015 revealed that in 2013-14, the treatment of ill British tourists in other countries of the single market cost more than five times that which European visitors cost the NHS. Perhaps the one improvement we can make here in the UK is to become better at recouping the moneys we are entitled to through the use of the scheme, and last year’s Public Accounts Committee report, NHS Treatment for Overseas Patients, stated that the systems for cost recovery appear to be chaotic. Other countries recoup what is owed to them and there is no external reason why we cannot do so as well. But that does not invalidate a scheme that continues to work tremendously well for the benefit of millions of people throughout Europe, including millions of British citizens both here and abroad.
The process of leaving the EU has thrown light on a lot of the concerns of ordinary people that perhaps were taken for granted. The EHIC scheme is one of those areas. No one voted for higher travel insurance costs and no one voted for less healthcare support while they are on holiday. The Government should pledge to retain this scheme.