My Lords, I am pleased that the second of the statutory instruments in this group is not being moved now, because the issues involved in that one require more consideration than we might have given them today. The Government should think rather more carefully about some of these issues because it is clear that a considerable number of UK citizens living in other EU countries are incredibly concerned about them. They would be even more concerned if they had heard the remarks of the noble Baroness at the beginning of this discussion on these SIs. The idea that they may have to apply for extra insurance policies, social insurance schemes and so on as soon as a week on Saturday illustrates why it is so important that we do not crash out of the EU on Friday of next week. People are also acutely aware of how the Government at the moment appear to be treating rather differently issues such as the voting rights of UK citizens living overseas and the healthcare rights of UK citizens currently living in EU countries.

Tomorrow the Government will support a Private Member’s Bill in the House of Commons to give permanent voting rights in UK elections to all UK citizens living overseas. However, many of them were denied votes in the EU referendum and now find themselves potential victims of that decision in terms of fundamental changes to their existing healthcare rights. The winding down of reciprocal healthcare arrangements was not really examined in the referendum campaign as a potential consequence of that vote.

On Tuesday the Minister of State for Health, Mr Stephen Hammond, sought to allay some of their fears. But the Guardian today reports on the furious reaction of UK nationals who have retired to EU countries. The offer by the Government to cover healthcare costs for up to one year, if they have applied for or are undergoing treatment before exit day, is a terrible one. One of the people quoted in the Guardian article today says that if a person,

“has paid into the system all their lives and retired to an EU country in good faith, with all the reciprocal arrangements in place, they could be left high and dry if they, say, get cancer after 29 March”— next Friday. Tuesday’s Written Statement by the Minister said that pensioners will be eligible to return to the UK and get treatment on the NHS under the contingency plans. But another of the people quoted in the article today asks:

“How can pensioners with cancer, cardiac problems or other major issues be expected to make or even afford repeated visits to the UK for regular vital treatment?”

The present system works well and is cost effective, because healthcare is cheaper in many EU countries than in the UK, so the existing system helps save the NHS money. We are losing a benefit and incurring more expense.

Campaign groups such as Bremain in Spain, British in Italy and Expat Citizen Rights in EU have all raised practical problems with the Government’s plans. They are right to criticise the way in which people who have paid national insurance contributions for many years, and may continue to pay taxes to HMRC, may now be deprived of their rights to reciprocal healthcare arrangements where they now live. They may in practice be unable to return to the UK for treatment they need.

Those of us living here who travel to Europe have come to regard the EHIC as a major advantage, and it has helped to keep travel insurance costs within Europe far lower than for the USA, for example. It is welcome that the cards may remain valid to the end of 2020, as opposed to next Friday, but only where a separate memorandum of understanding is in place with the relevant country. From what we heard a few moments ago, I understand that this is not the case with many countries so far. The basis of the statutory instruments relies heavily on the Government’s ability to agree transitional reciprocal healthcare arrangements with EU member states. Few agreements have already been reached, eight days before some people want us to leave the EU. It is hard to see how the new arrangements proposed can be subject to proper scrutiny—particularly without the relative costs of the new arrangements being assessed—together with what appear to be major drawbacks for UK citizens living in or visiting EU countries in future.

Current EU reciprocal healthcare arrangements allow UK citizens to have access to healthcare when they live, study, work, or travel in the EU, EEA and Switzerland, and vice versa. What they get in future may not be nearly as good, and the costs of the new arrangements are not known. The Government have admitted in these SIs that,

“there is a high level of uncertainty around the precise value of the costs and benefits”.

It is also clear that the Government are relying on powers to be given to the Secretary of State via the Healthcare (International Arrangements) Bill to make any provisions for after 31 December 2020, but we do not know who that Secretary of State will be then, or what it will be possible for them to agree. Does the Minister accept that we cannot give proper scrutiny to legislation when so much is unknown and uncosted? Can she say something about what the costings really are? Does she accept that it is regrettable that the timeframe for consideration of these measures means that there has not really been any proper public consultation about them, particularly with UK citizens living across different EU states?

Like the noble Baroness, Lady Thornton, I also want to know what arrangements the Government will make for advising travellers and expats as to their healthcare coverage status if we leave without a deal next Friday. We have seen little preparation for that so far. How will the date of 31 December 2020, outlined in the SIs as the day when all current arrangements with other member states cease, be revised if the Government succeed next week in securing an extension to the Article 50 process?