Asked by: Lord Laird (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, further to the Written Answer by Lord Prior of Brampton on 13 June (HL566), what assessment they have made of the discrepancy between the total claims made by the UK against EEA countries and Switzerland and the total claims made against the UK by EEA countries and Switzerland.
Answered by Lord Prior of Brampton
There is no discrepancy, merely an imbalance due to demographic factors. European Union healthcare rules ensure that millions of United Kingdom citizens who work, visit or retire to other European countries can receive the free or reduced cost healthcare they need. Some 80% of the UK’s European Economic Area healthcare bill is for our pensioners who chose to retire to Europe.
As many more of our pensioners choose to retire to other EEA countries than pensioners from those countries retiring to the UK, it is inevitable we will pay more to cover the healthcare costs of people insured by the UK than we will receive from other EEA countries. People from Europe who choose to live, work and pay tax in the UK are fully covered by the National Health Service.
All EEA counties, including the UK, have a legal obligation to pay agreed claims relating to healthcare treatment provided. Once both sides are satisfied that such claims are accurate, they are paid in full.
Asked by: Lord Laird (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, further to the Written Answer by Lord Prior of Brampton on 13 June (HL566), what assessment they have made of why the UK has claimed £49,736,125 from EEA countries and Switzerland for the cost of the NHS providing treatment to people for whom they are responsible under EU law, but has reimbursed EEA countries and Switzerland £674,418,036 for the cost of providing treatment to people for whom the UK is responsible under EU law in 2014–15.
Answered by Lord Prior of Brampton
Because of European Union healthcare rules, millions of United Kingdom citizens who work, visit or retire to other European countries can receive the free or reduced cost healthcare they need. That is what we are paying the £674 million for.
Some 80% of this (over £500 million) is for our pensioners who chose to retire to Europe.
Many more of our pensioners choose to retire to other European Economic Area countries than pensioners from those countries retiring to the UK, it is therefore inevitable that we will pay more to cover healthcare costs of our pensioners.
Asked by: Lord Laird (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what payments were made, in sterling, (1) in the most recent year by the UK to each European Union member state for healthcare provided to UK citizens and pensioners resident in each of those states, and (2) by each member state to the UK for EU citizens and pensioners resident in the UK; and what were the respective totals.
Answered by Lord Prior of Brampton
The Department on behalf of the United Kingdom Government reimburses other European Economic Area (EEA) countries and Switzerland for the cost of providing treatment to people we are responsible for under European Union law, irrespective of nationality. In the same way, other EEA countries and Switzerland reimburse the UK for the cost of the National Health Service providing treatment to people they are responsible for under EU law, including UK nationals insured in another EEA country or Switzerland.
The table below provides latest available information about how much the UK paid to other EEA countries and Switzerland for healthcare, and how much was paid to the UK for NHS provided treatments.
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| EEA Medical Costs | Member State Claims (against UK) | UK Claims (against EEA, Switzerland) | ||
| 2014-15 | 2014-15 |
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| Austria | £5,473,017 | £366,756 |
| |
| Belgium | £5,816,026 | £4,323,308 |
| |
| Bulgaria | £255,924 | £363,911 |
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| Cyprus | £10,132,385 | £347,045 |
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| Czech Republic | £617,758 | £471,140 |
| |
| Denmark (Waiver) | N/A | N/A |
| |
| Estonia (Waiver) | N/A | £154,928 |
| |
| Finland (Waiver) | £10,047 | £243,740 |
| |
| France | £147,685,772 | £6,730,292 |
| |
| Germany | £25,873,954 | £2,189,664 |
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| Greece | £2,682,953 | £1,732,047 |
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| Hungary (Waiver) | £412 | £22,196 |
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| Iceland | £295,943 | £11,331 |
| |
| Ireland | £215,313,962 | £19,214,031 |
| |
| Italy | £7,304,484 | £1,510,850 |
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| Latvia | £14,725 | £300,319 |
| |
| Liechtenstein | £193 | £0 |
| |
| Lithuania | £283,625 | £293,616 |
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| Luxembourg | £683,410 | £75,151 |
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| Malta (Waiver) | N/A | N/A |
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| Netherlands | £8,655,688 | £3,251,412 |
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| Norway (Waiver) | £30,370 | £0 |
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| Poland | £4,336,701 | £1,523,402 |
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| Portugal | £6,351,400 | £700,653 |
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| Romania | £13,330 | £498,354 |
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| Slovakia | £438,715 | £124,348 |
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| Slovenia | £266,623 | £107,948 |
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| Spain | £223,290,021 | £3,412,338 |
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| Sweden | £1,918,038 | £1,367,213 |
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| Switzerland | £6,672,560 | £400,131 |
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|
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| Total | £674,418,036 | £49,736,125 |
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Source: Resource Accounting and Budgeting (RAB) exercise. Totals are based on estimates of the costs of EEA healthcare claims made annually for the purposes of provisions made in the Department of Health accounts in accordance with HM Treasury resource accounting rules.
Note: Waiver is an agreed intentional relinquishment of healthcare costs between Member States
Asked by: Lord Laird (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what plans they have to reduce deaths from passive smoking by introducing restrictions on smoking in public outdoor areas.
Answered by Lord Prior of Brampton
The Government has no current plans to extend smokefree legislation to open spaces. It is for individual organisations and local authorities to decide if they want to adopt a more extensive no smoking policy. Public Health England will continue its work to encourage voluntary action to protect children from the harms from exposure to secondhand smoke.
Asked by: Lord Laird (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what their assessment is of the number of people who have died from passive smoking in England in each of the last five years.
Answered by Lord Prior of Brampton
Exposure to secondhand smoke is a serious health hazard. More than 50 carcinogens have been identified in secondhand smoke.
The report of the United States Surgeon General titled The health consequences of involuntary exposure to tobacco smoke concluded that secondhand smoke causes premature death and disease in children and adults who do not smoke. The scientific evidence indicates that there is no risk-free level of exposure to secondhand smoke. Children exposed to secondhand smoke are at an increased risk for sudden infant death syndrome, acute respiratory infections, ear problems and more severe asthma. Smoking by parents causes respiratory symptoms and slows lung growth in children. Exposure of adults to secondhand smoke has immediate adverse effects on the cardiovascular system and causes coronary heart disease and lung cancer. Legislation to stop smoking in vehicles carrying children will come into force in England on 1 October 2015.
The report of the Royal College of Physicians titled Going smoke-free: The medical case for clean air in the home, at work and in public places included estimates that secondhand smoke exposure caused approximately 12,200 deaths in the United Kingdom in 2003, and that the majority of these deaths occurred as a result of exposure to secondhand smoke in the home. These estimates were made prior to the introduction of smokefree legislation in England in 2007. Over the past decade, the proportion of smokers who say that they do not smoke in the home has increased.
The evidence is clear that smokefree legislation in England has had beneficial effects on health, as set out in the report The Impact of smokefree legislation in England: evidence review which was published alongside the “Tobacco Control Plan for England” in March 2011. The reports referred to have already been placed in the Library.
Asked by: Lord Laird (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what is their estimate of the number of people who died as a result of passive smoking in each of the last five years.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
Exposure to secondhand smoke is a serious health hazard. More than 50 carcinogens have been identified in secondhand smoke.
The report of the United States Surgeon General titled “The health consequences of involuntary exposure to tobacco smoke” concluded that secondhand smoke causes premature death and disease in children and adults who do not smoke. The scientific evidence indicates that there is no risk-free level of exposure to secondhand smoke. Children exposed to secondhand smoke are at an increased risk for sudden infant death syndrome, acute respiratory infections, ear problems and more severe asthma. Smoking by parents causes respiratory symptoms and slows lung growth in children. Exposure of adults to secondhand smoke has immediate adverse effects on the cardiovascular system and causes coronary heart disease and lung cancer. Legislation to stop smoking in vehicles carrying children will come into force in England on 1 October 2015.
The report of the Royal College of Physicians titled “Going smoke-free: The medical case for clean air in the home, at work and in public places” included estimates that secondhand smoke exposure caused approximately 12,200 deaths in the United Kingdom in 2003, and that the majority of these deaths occurred as a result of exposure to secondhand smoke in the home. These estimates were made prior to the introduction of smokefree legislation in England in 2007. Over the past decade, the proportion of smokers who say that they do not smoke in the home has increased.
The evidence is clear that smokefree legislation in England has had beneficial effects on health, as set out in the report “The Impact of smokefree legislation in England: evidence review” which was published alongside the Government’s “Tobacco Control Plan for England” in March 2011.
The reports referred to have been placed in the Library.
Asked by: Lord Laird (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether the Medicines and Healthcare Products Regulatory Agency has advised that people with implanted pacemakers, implantable cardio veter-defibrilators or neurostimulators can use the scanners at airport security; whether the agency will publish the information that has allowed the policy of not using scanners for such people to change; and whether they have advised airports in the United Kingdom.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
The Medicines and Healthcare products Regulatory Agency (MHRA) has published advice on how patients with pacemakers, implantable cardioverter defibrillators or neurostimulators can safely use airport security scanners. Full details of the current version of this advice are available at the following address on the gov.uk website:
This advice states that we are not aware of any interference between body scanners and these devices, and gives some simple advice on how to avoid interference with screening wands and metal detectors.
This advice was published in 2010 following the introduction of body scanners to United Kingdom airports. A copy has been attached.
The advice was based upon a review of published literature.
Prior to 2010 the MHRA had not published airport security advice for these patients and therefore there has been no change to published policy.
Responsibility for advising airports in the United Kingdom rests with the Department for Transport (DfT). The MHRA advice has been reflected in the Code of Practice for Acceptable Use of Security Scanners in the Aviation Security Environment issued by DfT which can be found at:
https://www.gov.uk/government/publications/information-on-the-implementation-of-security-scanners.
A copy of the Code of Practice is attached.
DfT requires airports to follow this Code of Practice as part of the Directions served on the deployment of security scanners.
Asked by: Lord Laird (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what proposals they have to eliminate smoking from public areas outside any buildings.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
The Government has no plans to extend smokefree legislation to outside public areas.
Asked by: Lord Laird (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, further to the Written Answer by Earl Howe on 24 October 2014 (HL2125 and HL2126), what plans they have to address the current shortage of general practitioners; whether they will review their decision to reduce the number of students entering medical school this year; and whether they intend to rely on foreign medical graduates coming to this country to fill vacancies for the foreseeable future.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
There are more than 1,000 more general practitioners (GPs) now working and training in the National Health Service than from the position in September 2010, the most recent figures after the General Election – these data are published once a year in September. The next census as at 30 September 2014 will be published in March 2015.
Transforming Primary Care set out the intention to make available around 10,000 primary and community health and care professionals by 2020, in support of the shift in how care will be provided. Bringing forward substantial numbers of new GPs through training is a key part of this, and Health Education England’s (HEE) mandate commitment will increase the total number of GPs available by 5,000.
In order to understand the needs of the primary care workforce of the future, HEE has commissioned an independent review. On 10 December 2014, HEE announced that Professor Martin Roland, Professor of Health Services Research, University of Cambridge, will Chair the Primary Care Workforce Commission.
The work was commissioned by HEE at the request of the Secretary of State for Health, due to the future health and care system requiring greater emphasis on community, primary and integrated services, and to ensure that we have the primary care workforce to meet the changing needs for healthcare, therefore it will focus on:
- patient and population need;
- emerging models of care to respond to the population need;
- maximising new skill sets; and
- education and training.
HEE are currently implementing a number of projects to support recruitment into practice. This includes a pre-GP year pilot in five Local Education and Training Boards that provides targeted educational development for those expressing interest in general practice, and the launch of a primary and community care programme.
HEE plan to undertake a review of the medical student intake in 2015 in the context of the HEE Strategic Framework 15, the HEE Workforce Plan for England 2015-16, and the recently published NHS England Five Year Forward View.
Asked by: Lord Laird (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, further to the Written Answers by Earl Howe on 24 October 2014 (HL2125 and HL2126) and 1 July 2013 (WA 191–2), why the review of medical and dental student intakes recommended by the Health and Education National Strategic Exchange for 2014, which was to be led by Health Education England, did not take place; and why, in its absence, they reconsidered the policy of reducing student intake.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
Health Education England (HEE) plans to undertake a review of the medical student intake in 2015 in the context of the HEE Strategic Framework 15, the HEE Workforce Plan for England 2015-16, and the recently published NHS England Five Year Forward View.
Working with the Chief Dental Officer for England, HEE took the decision to recommend a reduction in the 2014 student dental intake by 10%. This was in response to a number of issues including detailed analysis supplied by the Centre for Workforce Intelligence that highlighted key changes in the improvement in dental health within England and the need for NHS England to ensure it had available the appropriate workforce to meet the needs of the service going forward.