My Lords, I thank the noble Baroness, Lady Thornton, and the noble Lord, Lord Rennard, for their valuable contributions to this debate. The effect of these two sets of regulations is to make miscellaneous amendments to EU references in retained EU law relating to reciprocal and cross-border healthcare. I understand the wider points that both noble Lords have made, but am not in a position to comment on those wider points in relation to exit. I am in a position to comment on these SIs. I reassure the House and both noble Lords who have spoken that we are doing everything we possibly can to ensure that we have arrangements in place for reciprocal healthcare with the EU. These regulations ensure continuity of reciprocal healthcare arrangements, where appropriate, for UK citizens living, working or travelling abroad, while removing these arrangements in the longer term, as the noble Lord, Lord Rennard, said.

I turn to specific points raised by noble Lords. The noble Baroness, Lady Thornton, referred to the common travel area. I reassure her that the UK and Ireland are both committed to continuing the reciprocal healthcare arrangements on a bilateral basis after the UK’s withdrawal from the EU. We recognise our unique relationship with Ireland and the importance of the common travel area, and in healthcare, as in other relevant policy areas, we have been working closely with Ireland to ensure that the rights associated with the common travel area continue to be protected, and we have made good progress. Discussions to continue reciprocal healthcare arrangements are under way between the UK and Ireland and, once concluded, these instruments will provide a mechanism to implement the agreement and thereby ensure that there is no interruption to healthcare arrangements between the UK and Ireland for a transition period.

The noble Baroness, Lady Thornton, asked about the impact the legislation arrangements that are in place will have on an all-Ireland basis. The north-south arrangements to provide healthcare services on the island of Ireland are not impacted by the UK’s withdrawal from the EU or by these SIs. These arrangements operate under MoUs, as she correctly identified, and service level agreements between Irish and Northern Irish health authorities will continue to operate after exit day. The UK Government have made a commitment to ensure that these arrangements continue and that new arrangements can be made. The noble Baroness is aware that healthcare is devolved to Northern Ireland, and this statutory instrument has been brought forward in the absence of a Northern Ireland Executive.

I share the concerns raised by the noble Baroness in relation to paediatric heart surgery and cancer. I reassure her that the north-south arrangements to provide services such as paediatric heart surgery are not impacted by the UK’s withdrawal from the EU and the UK Government have made a commitment to ensure that those arrangements continue and that no new arrangements in relation to those areas are put in place.

The noble Baroness, Lady Thornton, asked what guides are available. The website GOV.UK contains “Living in country guides”, which contain country-specific information on the steps that people can take in relation to healthcare, and is regularly updated. However, I take on board the comments the noble Baroness has made and I will feed them back to the department to ensure that any further information is put in these guides.

The noble Baroness, Lady Thornton, and the noble Lord, Lord Rennard, asked about bilateral agreements if there is no deal. I acknowledge that the timescales are challenging. The Secretary of State for Health has written to all Health Ministers in the EU to offer an agreement on a reciprocal basis with other member states that individuals continue to be covered for healthcare under the same terms as now if they retire in, work in or visit the other country. We are currently engaging with member states to see whether these arrangements can be put in place should we exit the EU without a deal. While it would not be appropriate to share details of the negotiations with member states at this stage, I reiterate that our clear focus is to protect healthcare access for people in the EU.

The noble Lord, Lord Rennard, raised the issue of how we inform individuals of their rights in a no-deal scenario. I refer him to the answer I have just given in relation to the website and the guidelines. If they need to be updated with new information, the department will certainly do that.

One of the final issues raised by the noble Lord, Lord Rennard, on which I can comment relates to the costs of spend-on arrangements with the EU. The longer-term costs of reciprocal healthcare arrangements are subject to negotiations between the UK and the EU, as the noble Lord will be aware. Expenditure under the current EU reciprocal healthcare arrangements was approximately £630 million in 2016-17, and we expect future expenditure on EU reciprocal healthcare arrangements to reflect current costs. Our intention is that Parliament will have clear and easy-to-access details of public spending on healthcare arrangements implemented under the Healthcare (International Arrangements) Bill. We have made a government Amendment reflecting the suggestion by the noble Baroness, Lady Thornton, and others to provide Parliament with a regular report on payments made using the powers under the Bill. We anticipate that this report will be a baseline. We intend to go further than reporting on payments, but we cannot provide a statutory obligation to do so at the moment.

I think those are the key questions that I can answer.