Cancellation of Reciprocal Health Agreement

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JERSEY PARLIAMENT

Andrew Mackinlay MP and other MP’s Questions put to the Commons in Westminster about the Cancellation of the Reciprocal Health Agreement.

 
 

Most recent first:

 

Questions from 16th March 2010

 

23
N 		Andrew Mackinlay (Thurrock): To ask the Secretary of State for Health, pursuant to the Answer of 10 March 2010, Official Report, column 350W, on health services: reciprocal arrangements, by what means his Department made the Isle of Man government aware of its position on 9 March 2010.
(322667)
24
N 		Andrew Mackinlay (Thurrock): To ask the Secretary of State for Health, if he will meet the co-chair of the British-Irish Parliamentary Assembly, the right hon. Member for Torfaen, to discuss the contents of his recent letter setting out the terms of the unanimous resolution passed by the Assembly requesting deferment of the decision to revoke the reciprocal health agreement between the UK and the Isle of Man; and if he will make a statement.
(322680)
25
N 		Andrew Mackinlay (Thurrock): To ask the Secretary of State for Health, on what date his officials informed him of the letter from the co-chair of the British-Irish Parliamentary Assembly, the right hon. Member for Torfaen, setting out the terms of the unanimous resolution passed by the Assembly requesting deferment of the decision to revoke the reciprocal health agreement between the UK and the Isle of Man; and if he will make a statement.
(322681)

 

Questions and Answers from 9th March 2010

 

 

14
N

Andrew Mackinlay (Thurrock): To ask the Secretary of State for Health, for what reason no response has yet been sent to (a) the letter from the Department of Health and Social Security of the Isle of Man Government of 7 September 2009 on the negotiation of separate bilateral health agreements between the Isle of Man and Scotland, Wales and Northern Ireland and (b) the requests for a response sent on 15 October and 4 November 2009 and subsequently; when he plans to make a substantive response to the letter; if he will place in the Library a copy of his eventual reponse; and if he will make a statement.

 

Gillian Merron: The development of any agreement between the Isle of Man Government and the devolved government's would at this stage be a matter for their respective governments. The Department made the Isle of Man Government aware of that position on 9 March 2010.

(321495)
15
N

Andrew Mackinlay (Thurrock): To ask the Secretary of State for Justice, if he will examine the matters raised by the Minister for Health and Social Security of the Isle of Man Government in Tynwald Court on 15 December 2009 in respect of the response of the Department of Health to written requests for information made by the Isle of Man Government on 7 September 2009, repeated on 15 October and 4 November 2009; what his duties are in respect of mediation between the administrations of the Crown Dependencies and Government departments; and if he will make a statement.

 

Mr. Wills: The Ministry of Justice is responsible for the relationship between the UK and the Crown Dependencies and provides the main channel of communication between the UK and the Crown Dependencies.

The termination of the bilateral health agreement and the matters raised by the Isle of Man Minister for Health and Social Security about bilateral health agreements are a matter for the Department of Health. There has been close examination of the issues at ministerial and officer level in my department and in the Department of Health. The Isle of Man Chief Minister has discussed the issue with the Secretary of State for Health and with Lord Bach.

The UK has committed to keep the situation under review with the Isle of Man Government in case of any unforeseen impacts after the end of the agreement.

(321493)
16
N

Andrew Mackinlay (Thurrock): To ask the Secretary of State for Justice, what reasons his Department has not replied to the letter from the Isle of Man Government sent in 2009 requesting advice on the Isle of Man's wish to negotiate a bilateral health agreement with the Scottish Executive; and if he will make a statement.

 

Mr. Wills: I am not aware of a letter from the Isle of Man Government requesting advice from the Ministry of Justice (MoJ) on the Isle of Man's wish to negotiate a bilateral health agreement with the Scottish Executive. I understand that the Isle of Man Department for Health and Social Security has been in contact with the Department of Health and with the Scottish Executive in connection with a new health agreement.

The development of any agreement between the Isle of Man and Scotland would, at this stage, be a matter for their respective administrations.

(321494)

 

Questions and Answers for 5th March 2010. 

Health Services: Isle of Man

Andrew Mackinlay: To ask the Secretary of State for Health whether Flybe has been consulted on the implications for carriers of the discontinuance of the reciprocal health agreement between the UK and the Isle of Man; and if he will make a statement. [318456]

Gillian Merron: The Department took the decision to end the reciprocal healthcare agreement between the United Kingdom and the Isle of Man, as it no longer represents value for money to the UK taxpayer. Neither Flybe, nor other carriers, were consulted as part of that process. However, the Department will be targeting the tourist industry as part of a campaign to raise awareness that the agreement with the Isle of Man will be ending.

 

 

Question and Answers 3rd March 2010

 

Health Services: Crown Dependencies

Mr. Stephen O'Brien: To ask the Secretary of State for Health when he expects to publish his Department's review of the discontinuance of reciprocal health arrangements with the Crown Dependencies. [318221]

Gillian Merron: The review of the ending of the reciprocal healthcare agreement with the Isle of Man will take place in the autumn, around six months after the ending of the agreement. We will publish the findings as soon as we are able following completion of that review.

 

Andrew Mackinlay: To ask the Secretary of State for Culture, Media and Sport whether responsibility for providing free emergency health cover and hospital accommodation and treatment for (a) participants and (b) spectators at major international sporting
3 Mar 2010 : Column 1292W
events resides with the host country; if he will clarify the position in relation to (i) participants and visitors to the UK attending the London 2012 Olympic Games and (ii) UK residents who attend, as participants and as visitors, the Isle of Man TT Races; and if he will make a statement. [318457]

Mr. Sutcliffe: UK Sport has advised that for the majority of events supported by UK Sport through its World Class Events programme, athletes are required by their international federations to have their own insurance to allow them to compete. International federations will usually incorporate medical cover requirements in the event contract agreements with which host organisers must comply.

The event organisers are liable for public liability insurance cover in case of any accident/injury as a result of the event set up, as opposed to simply injury/accidents as a result of participants competing.

Visitors to events are always covered in terms of emergency first aid as a matter of best practice. This would be free of charge, but organisers of events would not be liable to cover any required hospital treatment.

With regards to participants and visitors to the UK for the Olympic Games in 2012, it was a requirement of the bid that NHS treatment for the Games Family (including participants, IOC and IPC members, technical officials etc.) would be free. The Department of Health is working to fulfil the bid commitment.

For participants, the larger Olympic and Paralympic teams will bring their own specialist medical teams and will provide any medical care required. The vast majority of medical services will be delivered by LOCOG in the polyclinic in the Olympic Park and in on-site facilities in other Games' venues. LOCOG is working directly with Hospital Trusts to specify the services and facilities needed in the rare event that a participant is admitted to hospital.

For spectators, business as usual arrangements will apply in line with current legislation-treatment given in an NHS accident and emergency department is free to all persons, but treatment after admission as an in-patient will incur a charge unless the person is entitled to it for free.

Finally, with regards to the TT races on the Isle of Man, the reciprocal healthcare agreement between the UK and the Isle of Man is still in effect, but terminates on 31 March 2010. Therefore all competitors must be insured against the risk of personal accident in accordance with the FIM Sporting Code.

The Isle of Man Health Service is not part of the UK NHS and, except for immediately necessary and emergency treatment which does not require admission to hospital, visitors to the Isle of Man (including UK residents) who require treatment will be expected to pay for it.

It is therefore strongly recommended that all visitors to the Isle of Man ensure that they have appropriate insurance in place which will cover any treatment costs and repatriation to the UK by air ambulance if that should prove necessary.

 

Andrew Mackinlay: To ask the Secretary of State for Justice what assessment he has made of the effect on the Sewel Convention of the decision to end on behalf of the whole of the UK the reciprocal health agreement with the Isle of Man with effect from 1 April 2010. [320154]

Mr. Wills: None. The Sewel Convention is not relevant to the UK's decision to end the reciprocal health care agreement with the Isle of Man, as it involves neither a devolved legislature nor any form of legislation.

The Sewel Convention is relevant to the relationship between the UK Parliament and the Scottish Parliament. Similar conventions apply to the relationship between the UK Parliament and the National Assembly for Wales and the Northern Ireland Assembly. The convention provides that the UK Parliament would not normally legislate with regard to devolved matters except with the agreement of the devolved legislature.

 

 Andrew Mackinlay: To ask the Secretary of State for Health whether subordinate legislation is required to give effect to the decision of the UK Government to end the reciprocal health agreement between the UK and the Isle of Man with effect from 1 April 2010; and if he will make a statement. [320155]

Gillian Merron: No subordinate legislation is required to give effect to the decision to end the reciprocal healthcare agreement between the United Kingdom and the Isle of Man. The UK Government agreed a one year notice period with the Isle of Man Government to end the agreement, double the six months notice period contained within the agreement.

Andrew Mackinlay: To ask the Secretary of State for Health if he will negotiate an agreement with the Isle of Man Government to ensure that elderly persons and chronically sick and disabled persons who wish to make visits between the UK and the Isle of Man will continue to be eligible for free emergency hospital admission and treatment in either jurisdiction, providing that they are unable to obtain travel and health insurance at a reasonable cost due to their medical condition. [320188]

Gillian Merron: The UK Government have committed to working with the Isle of Man Government to carry out a review of the ending of the reciprocal healthcare agreement with the Isle of Man. The review will take place around six months after the agreement ends and will address any unforeseen consequences, including access to insurance. Accident and emergency treatment will continue to be free.

Andrew Mackinlay: To ask the Secretary of State for Health (1) with reference to paragraph seven of the Minister of State's letter of 22 January 2010 to the Co-chair of the British-Irish Parliamentary Assembly on the UK's decision to terminate reciprocal health arrangements with the Isle of Man with effect from 1 April 2010, under what arrangements free emergency hospital admission and treatment will continue to be afforded to visitors to the Isle of Man who are visitors to the UK from a country which has a bilateral healthcare agreement with the UK; and if he will make a statement; [320189]

(2) with reference to paragraphs six and seven of the Minister of State's letter of 22 January 2010 to the co-chair of the British-Irish Parliamentary Assembly, under what agreement or authority (a) all UK pensioners visiting the Isle of Man who have lawfully lived in the UK for 10 continuous years will receive free emergency hospital treatment and admission and (b) there will be no variation in such provision following the termination of the reciprocal health arrangement; and if he will make a statement. [320190]

Gillian Merron: Free emergency hospital treatment will continue to be afforded to visitors to the United Kingdom from a country with which the UK has a reciprocal healthcare agreement. This provision does not extend to those visiting the Isle of Man, given that is not part of the UK.

3 Mar 2010 : Column 1213W

The exemption from national health service charges for UK pensioners who have previously lived in the UK for 10 continuous years, under the national heath service (Charges to Overseas Visitors) Regulations 1989, as amended, applies only to UK pensioners visiting the UK. It does not apply to UK pensioners visiting destinations outside of the UK, including the Isle of Man.

Health Services: Isle of Man

Andrew Mackinlay: To ask the Secretary of State for Health (1) what discussions he has had with his counterpart in (a) Scotland, (b) Northern Ireland and (c) Wales on the modalities of and method for (i) recording and (ii) collecting charges from visitors from the Isle of Man who are detained and in receipt of emergency treatment in hospitals in (A) England, (B) Scotland, (C) Wales and (D) Northern Ireland consequent on the cancellation of the reciprocal health agreement between the Isle of Man and each UK health service with effect from 1 April 2010; and if he will make a statement; [319357]

(2) by what means he proposes to identify those visitors from the Isle of Man who are exempt from charges by virtue of (a) being in receipt of a UK state pension and having lived in the UK for 10 continuous years, (b) being a spouse or civil partner visiting the UK with an exempt UK state pensioner and (c) being a child visiting the UK with an exempt UK state pensioner following the cancellation of the reciprocal health agreement; and if he will make a statement; [319358]

(3) by what means it is proposed to (a) identify and (b) collect charges from visitors from the Isle of Man who are hospitalised whilst in the UK following the cancellation of the reciprocal health agreement on 1 April 2010; and if he will make a statement. [319360]

Gillian Merron: Under the national heath service (Charges to Overseas Visitors) Regulations 1989, as amended, trusts have a legal duty to identify and charge those overseas visitors to the United Kingdom who are not exempt from charges, and to make and recover from them charges for their treatment.

1 Mar 2010 : Column 873W

The Department has produced comprehensive guidance for the NHS to use when implementing these regulations, and most trusts have an Overseas Visitors Manager in post to oversee this. Trusts are advised to ask baseline questions to each patient to quickly identify if they have not lived lawfully in the UK for the past 12 months, and if they have not, to then interview them to establish if charges apply. It is a matter for individual trusts how they collect any charges that are due. The Department is contacting every trust informing them of the need to treat residents of the Isle of Man as overseas visitors from 1 April 2010 following the termination of the reciprocal healthcare agreement.

Following discussions with departmental officials, the Devolved Administrations are putting in place their own arrangements in order to inform their organisations of the changing circumstances.

 

Written Answer 1st March 2010 

Health Services: Channel Islands

Andrew Mackinlay: To ask the Secretary of State for Health how many individuals from (a) Guernsey and (b) Jersey have had emergency admission and received treatment from an NHS hospital since the cancellation of the reciprocal health agreement between the Channel Islands and the UK on 1 April 2009; and how many such individuals (i) have been charged the costs of treatment and hospitalisation, (ii) have been billed for costs of treatment and hospitalisation but have yet to make payment, (iii) were exempt from charges by virtue of (A) being in receipt of a UK state pension and having lived in the UK for 10 continuous years, (B) being a spouse or civil partner visiting the UK with an exempt UK state pensioner and (C) being a child visiting the UK with an exempt UK state pensioner; and if he will make a statement. [319359]

Gillian Merron: This information is not held centrally.

Andrew Mackinlay: To ask the Secretary of State for Health by what method costs have been recouped in respect of charges incurred in emergency hospital admission and treatment of visitors to (a) the UK and (b) England from (i) Guernsey and (ii) Jersey since the cancellation of the reciprocal health agreement between the Channel Islands and the UK health services on 1 April 2009; and if he will make a statement. [319361]


1 Mar 2010 : Column 870W

Gillian Merron: This information is not held centrally. It is for individual trusts to decide how charges are recouped in terms of methodology. This will depend on the circumstances of individual cases.

Andrew Mackinlay: To ask the Secretary of State for Health how much has been recouped in charges from visitors from Guernsey and Jersey since the cancellation on 1 April 2009 of the reciprocal health agreements between the Channel Islands and the UK consequent upon their emergency admission and receipt of treatment in UK NHS hospitals; and if he will make a statement. [319696]

Gillian Merron: This information is not recorded centrally.

 

 

Welsh Affairs Debate Commons 26th February 2010
 
Andrew Mackinlay (Thurrock) (Lab): I am very grateful to my right hon. Friend for giving way and I apologise for interrupting. I asked the nice man sitting on his left, who seems to have an advance copy of my right hon. Friend's speech, whether he was going to deal with governance. I got the impression that he was not, and I did not want to be disappointed about not intervening to ask about it.
As an English Member of Parliament I am very interested in governance, and hope that my right hon. Friend will address this issue. Ministers with primarily English portfolios have taken arbitrary decisions without consulting their opposite numbers in Belfast, Edinburgh and Cardiff. As Secretary of State for Wales, will he jealously press the Justice Secretary, who is the custodian of these matters, to ensure that that does not happen?

By way of example, and in conclusion, I refer to the arbitrary decision of the Secretary of State for Health to abrogate and tear up the reciprocal health agreements between the Isle of Man, Guernsey and Jersey, without consulting the Health Ministers in Wales, Edinburgh or Northern Ireland.
Mr. Hain: My hon. Friend has got me on that one. I always admire his energy as a parliamentarian, but this Government have been an enthusiastic devolver of power. We have devolved more powers than any other Government in our history, and of course we respect the rights of Wales, Scotland and Northern, as we do those of the islands that he mentioned.

22nd February 2010.

 

Aviation: Isle of Man

Andrew Mackinlay: To ask the Minister of State, Department for Transport what discussions he has had with air carriers on the consequences for them of the cessation of the bilateral health agreement between the UK and the Isle of Man with effect from 1 April 2010; what obligations there are on air carriers on routes between the UK and the Isle of Man to meet the costs of hospital care and admission consequent upon a passenger falling ill while being carried on such a route; and if he will make a statement. [317584]

 

Paul Clark: Responsibility for the bilateral health agreement with the Isle of Man rests with the Department of Health.

 

In relation to aviation, the Department for Transport has had no discussions with air carriers about the cessation of the bilateral health agreement. There are no obligations on airlines to cover costs of passengers who become ill (unless the airline was in some way negligent).

 

10th February 2010.

 

Health: Bilateral Agreements

 

Question

 

Asked by Lord Laird

 

To ask Her Majesty's Government how much was paid to the Isle of Man, Guernsey, Jersey and the Republic of Ireland by the United Kingdom under reciprocal health agreements in each of the last three years; and how much was paid by them to the United Kingdom. [HL1650]

 

Baroness Thornton: The United Kingdom Government pay an allocation to the Isle of Man, and paid an allocation to the Channel Islands as part of the reciprocal healthcare agreements held with both Crown Dependencies. The allocations are shown in the following table. The UK did not receive any financial income in return.

 

 

Financial allocation provided to Jersey

2007-08

£3,828,000

2006-07

£3,611,000

2005-06

£2,358,000

 

Financial allocation provided to Guernsey

2007-08

£504,000

2006-07

£475,000

2005-06

£626,000

 

Financial allocation provided to the Isle of Man

2008-09

£2,800,000

2007-08

£2,650,000

2006-07

£2,500,000

In contrast to the reciprocal healthcare agreements with Crown Dependencies, the agreement with Ireland is based on European Social Security legislation. Payments made in any one year do not necessarily relate to costs incurred within that year.

 

Within that context, the net payments the UK made to Ireland in each of the last three years are shown in the following table:

 

10th February 2010.

 

Health: Reciprocal Agreements

Question

 

 

 

Asked by Lord Wallace of Tankerness

To ask Her Majesty's Government what was the net surplus or deficit experienced by the National Health Service in the financial years 2007-08 and 2008-09 arising out of the reciprocal health agreements between the United Kingdom and (a) the Isle of Man, (b) Jersey, (c) Guernsey, (d) Azerbaijan, (e) Georgia, (f) Ukraine, (g) Moldova, and (h) Serbia. [HL1888]

 

Baroness Thornton: The net deficit, based on the financial allocation provided under the bilateral healthcare agreement with the Isle of Man for 2007-08 and 2008-09 was £2.65 million and £2.8 million respectively. Over the same period, the net deficit, based on the financial allocation provided under the bilateral healthcare agreement with the Channel Islands was £4.332 million and £6,390,672.

The agreements with Azerbaijan, Georgia, Ukraine, Moldova and Serbia do not involve financial transactions.

 

1st February 2010.

 

Health Services: Isle of Man

 

Colin Challen: To ask the Secretary of State for Health what estimate he has made of the net financial effect on the NHS of the withdrawal of reciprocal health arrangements with the Isle of Man. [314584]

Gillian Merron: It is essential that all bilateral health care agreements represent value for money to the United Kingdom taxpayer. The net financial effect of withdrawing from the bilateral health care agreement with the Isle of Man will be a £2.82 million saving for the national health service.

Andrew Mackinlay: To ask the Secretary of State for Health pursuant to the answer of 20 January 2010, Official Report, columns 366-7W, on health services: Isle of Man, what types of personal data are contained in the dataset; and if he will publish a version of the dataset with personal data removed. [314590]

Gillian Merron: The dataset, originally provided by the Isle of Man Government, contains personal addresses and medical details over a large number of pages. We are therefore not able to publish this information in a redacted form given the disproportionate cost.

 

1st February 2010.

 

Andrew Mackinlay (Thurrock) (Lab): In a period of joined-up Government, will the Secretary of State tell us whether or not the Department of Health consulted her about the decision arbitrarily to tear up the reciprocal health agreement between the Isle of Man and the United Kingdom, given the ramifications it has for the chronically sick and disabled and the elderly who want to travel to and from the island?

Yvette Cooper: I will write to my hon. Friend about that.

 

27th January 2010.

 

Health Services: Reciprocal Arrangements

 

Sir Alan Beith: To ask the Secretary of State for Health what discussions he had with the Isle of Man government before he made his decision to terminate the reciprocal health agreement with the Isle of Man; whether he proposed any alternative financial terms for a continuing health agreement; what the reasons were for his decision; and if he will make a statement. [312835]

Gillian Merron: Ministers took the decision to end the current bilateral health care agreement with the Isle of Man on the basis that it did not represent value for money for the UK taxpayer and the wide availability of travel insurance. Discussions prior to the decision being made were at official level and the UK Government proposed no alternative financial mechanism.

Mr. David Anderson: To ask the Secretary of State for Health on what date the reciprocal agreement for medical cover with (a) the Channel Islands and (b) the Isle of Man was terminated; and if he will make a statement. [313527]

Gillian Merron: The Government ended its agreement with the Channel Islands on 31 March 2009, and is ending its agreement with the Isle of Man on 1 April 2010, as they do not represent value for money for the United Kingdom taxpayer and travel insurance is widely available. Tourists will continue to receive free accident and emergency treatment. However, they will now be expected to have insurance to cover the cost of other treatment.

 

26th January 2010.

 

Health Services: Reciprocal Arrangements

 

Bob Spink: To ask the Secretary of State for Health with which countries the NHS has reciprocal arrangements for health treatment. [313579]

Gillian Merron: The United Kingdom has reciprocal health care obligations under European Union regulations, which coordinate social security including sickness, maternity and equivalent paternity benefits in kind, in the European Economic Area and Switzerland.

In addition, the United Kingdom has bilateral health care agreements with the following:

Anguilla

Armenia

Australia

Azerbaijan

Barbados

Bosnia

British Virgin Islands

Croatia

Falkland Islands

Georgia

Gibraltar

Isle of Man

Kazakhstan

Kyrgyzstan

Macedonia

 

 

29th January 2010.

 

Health Services: Isle of Man

 

Andrew Mackinlay: To ask the Secretary of State for Health (1) for what reasons a UK military pension paid to a resident of the Isle of Man will not be deemed to be a UK state pension for the purpose of qualifying for free emergency admission to hospital when that person visits the UK after the end of the UK-Isle of Man reciprocal health agreement with effect from 1 April 2010; and if he will make a statement; [314205]

(2) if he will ensure that former members of HM Armed Forces resident in the Isle of Man in receipt of military pensions will continue to have free NHS hospital care when visiting the UK when they are subject of an emergency admission to hospital following the end of the reciprocal UK-Isle of Man Health Agreement on 1 April 2010; and if he will make a statement. [314206]

Gillian Merron: The National Health Service Charges to Overseas Visitors Regulations set out a number of exemptions to charging, regardless of where an individual resides.

Those serving in HM UK forces are exempt from all charges for NHS hospital treatment (including elective treatment). Those in receipt of a war pension or war widows pension are also exempt from all hospital treatment charges (including elective treatment). In addition, those in receipt of a UK state pension are exempt from charges for treatment the need for which arises during a visit to the UK.

The Regulations do not exempt other ex-service people on the basis of being in receipt of a military pension,but some specific services are exempt from charge to all persons, e.g. those provided in an accident and emergency Department.

 

25th January 2010.

 

Isle of Man: Health Services

 

Miss McIntosh: To ask the Secretary of State for Foreign and Commonwealth Affairs what recent representations he has received on the ending of the UK's bilateral health arrangement with the Isle of Man. [310631]

Chris Bryant: None. Reciprocal health agreements are the responsibility of the Department of Health.


20th January 2010.

 

Health Services: Isle of Man

 

Andrew Mackinlay: To ask the Secretary of State for Health pursuant to the answer of 6 January 2010, Official Report, column 476W, on health services: Isle of Man, if he will (a) place in the Library and (b)
20 Jan 2010 : Column 367W
provide to the Isle of Man authorities a copy of the dataset used in the calculation of the allocation of funding provided to the Isle of Man under the present bilateral agreement. [311128]

Gillian Merron: The Isle of Man provided the dataset used in the calculation of the allocation of funding provided to the Isle of Man under the current bilateral healthcare agreement with the United Kingdom. As it contains personal data, it cannot be place it in the Library.

Sir Nicholas Winterton: To ask the Secretary of State for Health what financial contribution the Isle of Man government made to the NHS in England under the current reciprocal agreement in 2008-09; what estimate he has made of the cost of the arrangements under the reciprocal agreement with Isle of Man government to the NHS in England in 2008-09. [311305]

Gillian Merron: I refer the hon. Member to the answer I gave my hon. Friend the Member for Thurrock (Andrew Mackinlay) on 6 January 2010, Official Report, column 476W.

 

14th January 2010.

 

Isle of Man

Question

 

Asked by Lord Steel of Aikwood

To ask Her Majesty's Government whether payment of £8.4 million by the Government of the Isle of Man to health authorities in north-west England for patients referred for specialist treatment and the existing reciprocal health agreements between the United Kingdom and other countries outside the European Union were considerations in the decision to end this year the reciprocal health agreement with the Isle of Man; and whether they will reconsider the decision. [HL1065]

Baroness Thornton: All relevant factors were taken into consideration in deciding to terminate the current agreement with the Isle of Man. The decision was made on economic grounds and took account of the payment of £8.4 million for elective treatment commissioned by the Isle of Man, which is partly offset by a financial allocation provided by the United Kingdom Government. The Government are not minded to revisit the decision to end the current agreement.

 

12th January 2010.

 

Andrew Mackinlay (Thurrock) (Lab): I thank the Secretary of State for agreeing to meet the Chief Minister of the Isle of Man about the future of the reciprocal health agreement. Will he get his officials to look particularly at the impact that that decision could have on his and my constituents who are TT enthusiasts-motorcyclists-and the impact that it would have on NHS North West if the Isle of Man took its elective surgery purchases away from there to Edinburgh, Belfast or Dublin?

Andy Burnham: As the Minister of State, my right hon. and learned Friend the Member for North Warwickshire (Mr. O'Brien), mentioned a moment ago, I have agreed to meet the Manx Health Minister to discuss these issues. As a north-west MP, I know that the island has a long-standing relationship with the north-west of England and its health service, and I will commission the work that my hon. Friend mentions on the potential effect of purchasing being switched. I am not minded at present to change our position but I will, of course, listen to what the Minister has to say.

 

12th January 2010.

 

Sir Nicholas Winterton (Macclesfield) (Con): Will the Minister tell the House whether the level of deprivation featured in the decision of the Department of Health to end the reciprocal health agreement with the Government of the Isle of Man? That agreement, which has been in place since 1948, is to be ended on 1 April this year. This is a very serious matter. May I have an answer?

Mr. O'Brien: My right hon. Friend the Secretary of State will be meeting the Manx Minister in due course. We are not minded to change our policy on this. We take the view that our approach is the right one, and we will see what the outcomes are of the discussions with the Isle of Man

 

11th January 2010.

 

Isle of Man: Health Services

 

Andrew Rosindell: To ask the Secretary of State for Justice what plans he has for the termination of the Isle of Man-United Kingdom Reciprocal Health Agreement. [309097]

Mr. Wills: The Ministry of Justice has no such plans, since reciprocal health agreements are the responsibility of the Department of Health, not the Ministry of Justice. I understand however that Department of Health Ministers have given notice of their intention to terminate the agreement with the Isle of Man with effect from 1 April 2010.

 

7th January 2010.

 

Health Services: Reciprocal Arrangements

 

Mike Penning: To ask the Secretary of State for Health (1) how much the NHS (a) was entitled to reclaim and (b) has reclaimed for healthcare carried out on UK citizens in other countries with which the UK has a reciprocal agreement in the last 12 month period for which figures are available; [308380]

(2) how much has been reclaimed by the NHS for healthcare carried out in England in respect of nationals of other countries with which the UK has a reciprocal agreement in the last 12 month period for which figures are available. [308381]

Gillian Merron: The United Kingdom does not claim reimbursement for UK citizens treated in other countries on the basis of bilateral health care agreements, as the costs are incurred in the country that provided the health care, and not in the UK.

Similarly, countries with which the UK has a bilateral health care agreement do not claim reimbursement from the UK for treatment provided in the UK to their citizens, as the costs are incurred in the UK, and not in the citizen's home country.

European regulations provide for the UK to reclaim costs from the European economic area and Switzerland for health care provided to their citizens, and vice versa.

 

6th January 2010.

 

Health Services: Isle of Man

 

Andrew Mackinlay: To ask the Secretary of State for Health pursuant to the answer of 15 November 2009, to question 300313, how much the Isle of Man government has paid for elective health service treatments of each kind provided under the agreement with his Department in each of the last 10 years. [308645]

Gillian Merron: The Isle of Man does not pay for elective treatment under the current reciprocal healthcare agreement. The following table shows elective treatment, commissioned by the Isle of Man, outside of that agreement, over the past six years. The allocation of funding provided by the United Kingdom to the Isle of Man under the current bilateral agreement is also shown.

£

Contracted trust

2009-10

2008-09

2007-08

2006-07

2005-06

2004-05

Aintree

540,000.00

-

-

-

-

-

Alder Hey

612,000.00

605,000.00

491,000.00

501,000.00

884,000.00

626,000.00

Clatterbridge Centre for Oncology

1,044,000.00

1,016,000.00

800,000.00

780,000.00

834,000.00

792,000.00

Leeds Teaching

91,843.00

-

-

-

-

 

Liverpool Heart and Chest

2,184,000.00

2,057,000.00

1,449,000.00

1,110,000.00

1,023,000.00

969,000.00

Liverpool Women's

252,000.00

-

-

-

-

-

Royal Liverpool and Broadgreen

1,692,000.00

1,887,000.00

1,178,000.00

853,000.00

836,000.00

550,000.00

Southport and Ormskirk

83,000.00

92,000.00

98,000.00

109,000.00

146,000.00

-

Walton Centre

444,000.00

389,000.00

367,000.00

350,000.00

251,000.00

238,000.00

Wrightington Wigan and Leigh

516,000.00

-

-

-

-

-

 

 

 

 

 

 

 

Non contracted activity

 

 

 

 

 

 

All trusts

623,157.00

1,919,000.00

1,417,000.00

1,219,000.00

970,000.00

512,000.00

Total spend

8,082,000.00

7,965,000.00

5,800,000.00

4,922,000.00

4,944,000.00

3,687,000.00

Department of Health Reciprocal agreement funding

2,862,000.00

2,787,000.00

2,650,000.00

2,500,000.00

3,000,000.00

3,000,000.00

Net spend (total minus Department of Health funding)

5,220,000.00

5,178,000.00

3,150,000.00

2,422,000.00

1,944,000.00

687,000.00

 

16th December 2009.

 

Written Questions: Government Responses

Andrew Mackinlay: To ask the Secretary of State for Health when he plans to respond to Question 300313, on commissioning of elective health service treatments, tabled on 18 November for answer on 25 November 2009. [307608]


16 Dec 2009 : Column 1325W

Gillian Merron: I refer the right hon. Member to the answer given on 15 December 2009, Official Report, column 1049W.

15th December 2009.

Health Services: Channel Islands

Andrew Mackinlay: To ask the Secretary of State for Justice what recent assessment he has made of the effects on (a) educational institutions and (b) businesses in the Isle of Man of the decision of the National Health Service to terminate its reciprocal agreement with effect from April 2010; and if he will make a statement. [306507]

Mr. Wills: No such assessments took place. The Department of Health ended the bilateral agreement with the Channel Islands (including Jersey and Guernsey) and gave notice on the agreement with the Isle of Man, as it considers that they are out of place considering the wide availability of travel insurance, and there is little robust data to justify the business case and value for money for the national health service.

15th December 2009.

Health Services: Isle of Man

Andrew Mackinlay: To ask the Secretary of State for Health if he will place in the Library details of (a) arrangements, (b) contracts and (c) tariffs relating to the commissioning by the Isle of Man Government of elective health service treatments handled by North West Specialist Commissioning team of the NHS that have been in operation over the past decade; and if he will make a statement. [300313]

Gillian Merron [holding answer 25 November 2009]: A copy of an agreement between NHS North West Specialist Commissioning team and the Isle of Man Government has been placed in the Library. Tariffs used are in line with national policy with regard to payment by result.

14th December 2009.

Health Services: Channel Islands

Andrew Mackinlay: To ask the Secretary of State for Justice what consultation his Department conducted with (a) British Chambers of Commerce, (b) trades unions, (c) the Federation of Small Businesses, (d) the Confederation of British Industry and (e) other organisations with interests in industry, trade, or commerce prior to the decision to cancel the reciprocal agreement between the National Health Service and
the Isle of Man with effect from 1 April 2010; and if he will make a statement. [306506]

Mr. Wills: No such discussions took place. The Department of Health ended the bilateral agreement with the Channel Islands (including Jersey and Guernsey) and gave notice on the agreement with the Isle of Man, as it considers that they are out of place considering the wide availability of travel insurance, and there is little robust data to justify the business case and value for money for the national health service.

10th December 2009.

Crown Dependencies

Andrew Mackinlay: To ask the Secretary of State for Justice on what date the Ministry of Justice issued advice to Government departments to (a) always consult his Department's Crown Dependencies Branch before making any statements on answers to parliamentary questions about Crown Dependencies and (b) where a UK policy initiative requires consultation with Crown Dependencies, to allow sufficient time for their governments to make consultation effective; on what date and in what manner he received notification from the Department of Health prior to its decisions to abrogate the reciprocal NHS arrangements with (i) Guernsey and Jersey with effect from 1 April 2009 and (ii) the Isle of Man from 1 April 2010; and if he will make a statement. [305811]

Mr. Wills: Advice on consultation with the Ministry of Justice regarding the Crown Dependencies was circulated to all Departments in June 2006 and has been available on departmental websites since that time. It is currently being updated and will be re-circulated to all Departments in the new year. Officials in the Department of Health and the Ministry of Justice liaised on the UK Government's decision to withdraw from bilateral health agreements with the Channel Islands and the Isle of Man from February 2008.

8th December 2009.

NHS: Reciprocal Arrangements

Andrew Mackinlay: To ask the Secretary of State for Justice (1) whether he has had discussions with the Secretary of State for Health on the implications for the Isle of Man of the decision to cancel the reciprocal agreement between the NHS and the Isle of Man with effect from 1 April 2010; and if he will make a statement; [305186]

(2) whether he had discussions with the Secretary of State for Health on the implications for (a) Jersey and (b) Guernsey of the cancellation of the reciprocal agreement between each island and the NHS from 1 April 2009 prior to the decision to cancel the agreement; and if he will make a statement. [305187]

Mr. Wills: There were no discussions between Ministry of Justice and Department of Health Ministers. The decision to cancel the agreement was a matter for Department of Health Ministers alone, but prior to the decision being taken discussions took place between officials of both Departments.

8th December 2009

Health Services: Crown Dependencies

Andrew Mackinlay: To ask the Secretary of State for Health (1) what (a) the total monetary value was of elective health treatment purchased from the NHS by the Isle of Man government in each of the last 20 years for which figures are available; and if he will make a statement; [301050]

(2) with which (a) countries, (b) overseas territories and (c) other jurisdictions the National Health Service has reciprocal agreements comparable to the agreement between the NHS and the Isle of Man; and if he will make a statement; [304444]

(3) on what statutory basis he cancelled the reciprocal agreement between the NHS and (a) Jersey and (b) Guernsey in respect of (i) Scotland, (ii) Northern Ireland and (c) Wales; and if he will make a statement; [304549]

(4) what discussions (a) Ministers and (b) officials of his Department had with their counterparts in (i) the Northern Ireland Executive, (ii) the Scottish Executive and (iii) the Welsh Assembly Government on the discontinuance of reciprocal health arrangements between the NHS and (A) Guernsey and (B) Jersey with effect from 1 April 2009; and if he will make a statement; [304529]

(5) what discussions (a) Ministers and (b) officials of his Department have had with their counterparts in the Scottish Executive on the discontinuance of reciprocal health arrangements between the NHS and the Isle of Man with effect from 1 April 2010; and if he will make a statement. [304832]

Gillian Merron [holding answer for PQ301050 25 November 2009]: In addition to the Isle of Man, the United Kingdom Government currently have reciprocal healthcare agreements with Australia, Barbados, British Virgin Islands, Falkland Islands, Gibraltar, Montserrat, New Zealand, Russia, St. Helena, Turks and Caicos Islands, Armenia, Azerbaijan, Georgia, Kazakhstan, Moldova, Tajikistan, Turkmenistan, Uzbekistan, Ukraine, Serbia Montenegro, Croatia, Bosnia and Herzegovina and Macedonia.

All of these agreements are similar in that they provide healthcare cover for tourists from non European Union member states.

The Overseas Territories of Anguilla, the British Virgin Islands, Montserrat, St. Helena and Turks and Caicos can each refer, to the national health service, four patients per year, specifically for elective treatment.
In the case of the Isle of Man and Gibraltar, a financial allocation is set aside each year and is made available for elective treatment following clinical referral.

The following table shows the allocation provided by the UK to the Isle of Man under the terms of the bi-lateral healthcare agreement. This allocation is used to fund elective NHS healthcare. The Isle of Man may also have commissioned elective treatment outside of the terms of the agreement but this information is not held by the Department of Health centrally.

Allocation made available to the Isle of Man under reciprocal healthcare agreement:

Allocation to Isle of Man

 

£ million

2008-09

2.80

2007-08

2.65

2006-07

2.50

2005-06

2.35

2004-05

2.21

Note:
Prior to 2004-05 allocation was uncapped

 

The agreement with the Isle of Man contained a six-month notice period; the UK Government exercised that right and a termination date of 31 March 2010 was agreed with the Isle of Man. The Department gave notice on the agreements with both the Channel Islands and the Isle of Man on behalf of the UK. Prior to this, departmental officials consulted with the Ministry of Justice and with officials from the devolved Administrations.

5th November 2009

Health Services: Reciprocal Arrangements

Andrew Mackinlay: To ask the Secretary of State for Health for what reason the NHS is to withdraw from its reciprocal agreements with the health service of (a) Jersey, (b) Guernsey and (c) the Isle of Man; what assessment he has made of the consequences for the NHS of each termination; and if he will make a statement. [296390]

Gillian Merron: The Department considers it important that all of the United Kingdom's bilateral health agreements with other countries are evidence based, continue to be relevant and represent value for money for the British taxpayer.

The Department ended the bilateral agreement with the Channel Islands (including Jersey and Guernsey) and gave notice on the agreement with the Isle of Man, as it considers that they are out of place considering the wide availability of travel insurance, and there is little robust data to justify the business case and value for money for the national health service. The agreement with the Channel Islands ended on 31 March 2009 and the agreement with the Isle of Man will terminate on 31 March 2010. Following the end of these agreements, the UK will no longer provide allocations to fund referrals to the UK. Visitors from these islands will be subject to the same NHS charging regulations as all other overseas visitors, so they are advised to have travel insurance when visiting the UK to avoid incurring health care costs. Following termination of these agreements, UK travellers to the islands are also advised to have travel insurance.

16th July 2009.

Reciprocal Health Services: Elderly

Mr. Cox: To ask the Secretary of State for Health what assessment he has made of the effects on the health of elderly people of the termination of the reciprocal health agreement with the Isle of Man; and if he will make a statement. [286704]

Gillian Merron: The Department has not yet given formal notice on the bilateral agreement between the United Kingdom and the Isle of Man but it has informed the Isle of Man of the intention to do so. As the termination of the agreement has not yet been formalised, neither the UK nor the Isle of Man has confirmed which treatments will be chargeable to tourists after the termination of the agreement. However, the Department will recommend private travel insurance for tourists, as it does for all travel outside the UK. Given the wide availability of travel insurance, termination of the agreement is not expected to have a significant adverse effect on any group of the population, including the elderly.

15th July 2009.

Mr. Cox: To ask the Secretary of State for Health what assessment he has made of the net effect on the public purse of the termination of the reciprocal health agreement with the Isle of Man in the 12 months following termination; and if he will make a statement. [285960]

Gillian Merron: The Department has not yet given formal notice on the bilateral agreement between the United Kingdom and the Isle of Man but it has informed the Isle of Man of the intention to do so. Because of a perceived imbalance in the numbers of tourists being treated by both parties, under the bilateral agreement the UK has provided the Isle of Man with an annual allocation, to fund clinical referrals to the UK, of around £2.5 million in recent years. The UK will no longer provide this, once the agreement is terminated. Following the end of the agreement, UK residents will require travel insurance when visiting the Isle of Man, likewise Isle of Man residents visiting here.