HL Deb 03 July 1991 vol 530 cc986-7

3.13 p.m.

The Countess of Mar asked Her Majesty's Government:

Why citizens of the United Kingdom who retire and settle in a European Community country before they reach the statutory retirement age are unable to obtain publicly funded medical treatment anywhere within the European Community, including the United Kingdom, until they reach retirement age.

The Parliamentary Under-Secretary of State, Department of Social Security (Lord Henley)

My Lords, under the NHS Acts my right honourable friend the Secretary of State for Health has no power to pay for the costs of medical treatment abroad. United Kingdom citizens living elsewhere in the Community may, like other EC nationals, receive emergency treatment, the need for which arose during a visit to the United Kingdom free of charge.

The UK does meet the costs of those living elsewhere in the EC if they have reached state retirement age. The costs of UK citizens retiring abroad before that age can be covered for a period of up to two-and-three-quarter years depending on their record of national insurance contributions.

The Countess of Mar

My Lords, I thank the noble Lord for his reply. No doubt he will realise that I already knew the answer. Does he consider it reasonable that, for example, if a French citizen retires in this country, because he is regarded as being domiciled here he is entitled to full National Health Service facilities and yet if a British person is domiciled in France, he is not accepted either by his own system or by the French system? Are there any proposals to negotiate a satisfactory reciprocal arrangement between the British and the Continental systems so that those people can be treated without having to take out private insurance?

Lard Henley

My Lords, basically we are ahead of the field in this matter in that we are unusual because we have a residence-based test rather than a test based on insurance. In the case which the noble Baroness gave—that is, a British person going to France—such a person could join in the voluntary insurance scheme and pay to be part of the insurance-based scheme which exists in France. We have no plans to extend our scheme to people going abroad. Even if my right honourable friend wished to do that, there would be considerable cost implications and there are many other competing priorities.

Lord Stallard

My Lords, the noble Lord said that we are ahead in this field. Will he accept that that remark will not be very well received by retired pensioners in Canada, Australia and New Zealand? It will certainly not be as well received there as it will be by pensioners in France, Spain, the Bahamas, America, Russia, Yugoslavia, Greece and so on. How does he justify being ahead in the field when thousands of British retired people in Commonwealth countries are excluded?

Lord Henley

My Lords, I know well the noble Lord's views on the position of pensioners in Canada and Australia. However, I believe that the noble Lord will accept that that is wide of the Question.

Lord Ennals

My Lords, as regards the European Community, is there not a strong case to be made for having reciprocal arrangements with all those countries within the Community?

Lord Henley

My Lords, I thought I had explained why we cannot go down that road. Some countries have insurance-based schemes and it is possible to enter those schemes through paying voluntary contributions. In some countries—for example, Denmark and Ireland—there are residence-based schemes. Therefore, residents in those countries can make use of he health service. As I said, there are cost implications and there are more serious competing priorities.

The Countess of Mar

My Lords, I appreciate that the UK system is better than the Continental systems. Is the noble Lord aware that unless one is working in France, one cannot join the contribution system? Therefore, those people are left high and dry. If they take out private insurance, by the time they have reached the age of 60 there are pre-existing conditions which are not covered by private insurance, and yet, they are taken back into our system once they become state pensioners when they reach the age of 65. It seems ridiculous that they cannot be covered for the intervening period.

Lord Henley

My Lords, I am not sure that the noble Countess is correct. I understand—and I shall write to the noble Countess if I am wrong—that in France, as in Germany and Italy, one can voluntarily join the scheme whether or not one is working.

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