Treaty of Lisbon (No. 4) — (4th Allotted Day)
Business of the House (Lisbon Treaty) (No. 3)
Frank Dobson (Holborn and St Pancras, Labour)
I confess that I approach this matter from the opposite end of the spectrum to Mr. Hammond. A major part of my job as an MP is to try to promote prosperity and fairness in our society and, as a Labour MP, to protect and enhance the interests of the worst-off people in my constituency and in the country as a whole. In that respect, I welcome our Labour Government's acceptance of the social chapter.
I am extremely concerned about recent developments in the EU, and in particular about the application of fair and open competition in the internal market to health care. The EU treaty as it stands states that on health:
"Community action...shall complement national policies".
It goes on:
"Community action in the field of public health shall fully respect the responsibilities of the Member States for the organisation and delivery of health services and medical care."
The Lisbon treaty updates that, I suppose, and states:
"Union action shall respect the responsibilities of the Member States for the definition of their health policy and for the organisation and delivery of health services and medical care. The responsibilities of the Member States shall include the management of health services and medical care and the allocation of the resources assigned to them."
Appearances would suggest that our national health service is and will remain the exclusive responsibility of the UK Government, but it is not and, under the Lisbon treaty, it will not. All the apparent protection for our sovereignty that was provided in the old and new treaties does not exist. It turns out that some parts of the treaties are more equal than others.
In a recent ECJ decision, now followed up by the European Commission, the neo-liberals who hold powerful positions on the Court and the Commission decided to open everything to do with health care up to internal market forces. My right hon. Friend the Secretary of State referred to the Watts case in 2006, which the British Government lost in the ECJ. The Court found that a patient from this country was entitled to be treated in another European country and that the NHS was obliged to pay the Bill. The patient was not in despair after a protracted wait for treatment in the UK. The patient's daughter was pushing the primary care trust to provide the European care before the GP had even referred the patient to a consultant. The Court's decision was therefore made in worship of the internal market, in blatant contradiction of the treaty protections that I have read out.
Worse was to come. In December last year, the European Commission produced a draft directive in which it asserted that competition would drive down costs in health care. We should ask whether that works in the US. That directive, as drafted—before it was withdrawn—would have meant that the British Government would have no say whatever in setting any limits on the provision. People would be entitled to get treatment in Europe. They would be given a voucher or, after they were treated, what they spent could be repaid. They would also be able to top up any costs with their own money. I cannot see why the Tories did not welcome that, because it is exactly like the patient passport proposition that they put to the country at the last general election, which was so roundly rejected and, we are told, has been abandoned as a policy.
When the ECJ decision was made and when the European Commission produced its latest document, Tories from this country in the European Parliament said that it was absolutely right. I was rather shocked to discover that the Liberal Democrats welcomed it, describing it as health tourism. I want to try to look after the least well off and the least well informed, but the decision of the Court and the proposal from the Commission will clearly give a leg-up to the well off and the well informed, disadvantaging everyone else. The well off will be able to afford to pay in advance and wait to be reimbursed. They will be able to afford to make a top-up payment if they need to, and to meet the cost of travel. Badly off people will not be able to do any of those things. The well off are also likely to be well informed and to know how to work the system.
I cannot possibly support the proposal before us today, and I am very dubious about supporting a treaty that has not done something to set aside the Watts decision. I should warn the House that I think that there are very powerful forces at work behind the proposition, and they are in this country now. Those forces are the US health corporations that are having such a bad time in their own country. They have made such a gratuitous mess of the health care system there that even the most right-wing Republican presidential candidates are calling for wholesale, root-and-branch changes. They want to ensure that every American is covered and to prevent costs from escalating even above the present level which, roughly speaking, is twice as much per head of population as anywhere else in the developed world.
However, the mess in the US is so great that the companies to which I have referred are roaming around Europe and Britain looking for markets. They are promoting the concept of competition in health provision which, if it is applied in the way set out in the European directive, is likely to be greatly to the disadvantage of the worst off and least informed people in this country—exactly the people to whose interests all Labour MPs should give a high priority. I shall therefore find it very difficult to vote for the treaty's ratification unless the Government make some concession to that effect.