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Fourth Standing Committee
on Delegated Legislation
Tuesday 6 July 2004
[Mr. Eric Illsley in the Chair]
Draft Social Security (Income Support)
Amendment Regulations 2004
9.55 am
The Parliamentary Under-Secretary of State for Work and Pensions (Mr. Chris Pond): I beg to move,
That the Committee has considered the draft Social Security (Income Support and Jobseeker's Allowance) Regulations 2004.
Good morning, Mr. Illsley. It is a pleasure to be discussing this uncontentious and favourable proposal under your chairmanship. The purpose of the regulations is to reflect a recent development in the national health service. In August 2001, my right hon. Friend the Secretary of State for Health announced that the Government would legislate to make it clear that the NHS could commission hospital treatment in other member states. The National Health Service Act 1977 and the National Health Service and Community Care Act 1990 were accordingly amended with effect from November 2002.
The Department of Health sees the ability to commission hospital treatment abroad as part of the national health service's wider efforts to reduce waiting times. A six-month pilot scheme ran from October 2001, during which 190 patients were treated overseas. Most cases were joint replacements and cataract treatment. The pilot was considered successful, and directly purchased NHS treatment abroad is continuing. It is commissioned through the Guys and St Thomas' NHS Trust, supported by a national overseas treatment board funded by the Department of Health. In future years direct purchase is expected to focus on key waiting list pressures. Average time spent abroad is between two and three weeks.
Since July 2002, primary care trusts have been able to purchase hospital treatment abroad in another European economic area country on the recommendation of an NHS consultant when they believe that it is in the best interests of the patient. Successful applications have been running at about 850 cases a year. Patients are not compelled to have their treatment abroad, but if they do so they may be able to receive it more quickly. As the Committee will be aware, maximum in-patient waiting times have already been reduced from 15 months in 2002—they were considerably longer in previous periods, such as when they rose to 18 months—to just nine months today, on the way to our target of three months by 2008.
My ministerial colleagues in the Department of Health see overseas treatment as a relatively short-term option while domestic capacity is developed. Nevertheless, the benefit system needs to adapt to take account of this provision, however short-lived. The Government's view is that claimants receiving a social security benefit should not be disadvantaged by
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making use of those opportunities. We therefore announced that people claiming state pension credit, income support and jobseeker's allowance would be able to retain their entitlement when abroad for treatment in those circumstances. The pension credit regulations already contain an appropriate provision; these regulations make the necessary amendments for the other two benefits.
The normal conditions of entitlement for jobseeker's allowance include being in Great Britain, being available for and capable of work, and seeking work actively each week. As things stand, payment of JSA will cease if jobseekers travel abroad for NHS-funded hospital treatment, since they cannot satisfy any of those conditions. They are not in Great Britain, they are not capable of work while they are receiving the treatment, and moreover, they cannot be immediately available for work, and are hardly in a position to seek work actively.
However, the Jobseekers Act 1995 enables regulations to prescribe circumstances in which jobseekers can be treated as satisfying each of these conditions, and that power has already been used for other situations. The purpose of the amendment regulations is to add the receipt of NHS-funded hospital treatment abroad to the existing list of circumstances in which jobseekers can be treated as being in Great Britain. They also make the necessary cross-references to enable the other conditions to be treated as satisfied.
The amendments that the regulations make to the Jobseeker's Allowance Regulations 1996 will make it possible for jobseekers to continue receiving JSA when they take up the option of receiving hospital treatment abroad. The treatment must be provided under the national health service legislation as amended in 2002. The amendments ensure that jobseekers are not excluded or placed at a disadvantage compared with other NHS patients.
Similarly, people must usually be in Great Britain to qualify for income support. There is currently an exception for absence for medical treatment, but only in limited circumstances. First, the exception applies only to people who are claiming income support because they are incapable of work. It therefore excludes those, such as lone parents, who are claiming for a different reason. Secondly, it places a four-week limit on payment while being treated, and stipulates that the treatment must be for the specific incapacity that caused the claim in the first place. [Interruption.] I am very pleased that that mobile phone is yours, Mr. Illsley.
Not all income support claimants who might go abroad for treatment under the revised powers of the NHS will be able to take advantage of that current exception from the usual rule. The amendment regulations therefore expand the Income Support (General) Regulations 1987 to ensure that income support remains in payment for all claimants who go abroad for hospital treatment funded by the NHS.
Mr. James Clappison (Hertsmere) (Con): The Minister is explaining the purpose of the regulation with admirably clarity. A factor that might determine
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how many people take advantage of this opportunity is how successful the treatments are in other countries. The Minister mentioned hip operations and cataracts in particular, but people might also go to European hospitals for treatment for cancer. Does he have any statistics for the difference in outcomes and survival times for treatment for cancer received in this country and in European countries? I am happy for him to write to me if he does not have those figures at his fingertips.
Mr. Pond: I shall seek clarification on that point from my colleagues in the Department of Health. I suspect that the issue is outside the scope of the regulations, but it is legitimate to raise it. Although this approach was trialled for cataract and hip operations, we are not suggesting that it should be limited to those conditions. The hon. Gentleman will know that overall patient satisfaction surveys for the United Kingdom suggest that people are happy with the quality of care that they receive here. This is not an alternative to people receiving care in the UK or to the Government increasing the capacity of the UK's health service. It is, however, another way of ensuring in the relatively short term that we fulfil our promise to the British people to reduce waiting times as much as possible and to maximise choice in the NHS.
The Social Security Advisory Committee, which of course has a statutory right to be consulted on regulations such as this, has decided that it does not want the draft regulations to be referred formally to it. I confirm that, in my view, the provisions of the draft Social Security (Income Support and Jobseeker's Allowance) Amendment Regulations 2004 are compatible with the European convention on human rights, and I commend them to the Committee.
The Chairman: Before I call the hon. Member for Tatton (Mr. Osborne), I apologise to the Minister for the earlier interruption. I also remind the Committee that we are debating the jobseeker's allowance, not the merits of NHS treatment abroad.
10.3 am
Mr. George Osborne (Tatton) (Con): As the Minister said, the regulations are not particularly controversial. It is always a shame for anyone in the Opposition when the Social Security Advisory Committee does not consider regulations, because one can usually read out things from its report for a good half hour. The committee's report is usually extremely critical of the Government of the day, so it was a disappointment to find that it had not produced one.
I do not object to the regulations. They are particularly good for those of us who believe it to be a good thing that the NHS monopoly on provision is being steadily eroded as health services are delivered by private providers in the UK and abroad. We welcome that, and we want to see more of it. Perhaps there will be more of it in time. Obviously it would be unfair if those claiming income support or jobseeker's allowance were discriminated against simply because they received their health treatment abroad.
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However, I have questions to put to the Minister, to fulfil my constitutional duty of holding the Government to account. First, the explanatory notes say that some 850 people a year receive treatment paid for by the NHS in a European economic area country. How many of them are on income support or jobseeker's allowance? The explanatory notes simply say that ''a proportion'' would be. Obviously, I could have written that. I would like to know the number. The Government are introducing a change to the law, which they must think is required. How many people are affected? How many people have had problems with their JSA claim? How many of the 850 people a year experience problems, and what has happened to them? Perhaps the Minister could explain.
The explanatory notes say that the number of people sent abroad for NHS-funded treatment is
''not expected to exceed 1000 cases per year.''
The Minister was at pains to point out that receiving treatment abroad was a short-term option, as the NHS has improved and some of the differences in treatment rates that my hon. Friend the Member for Hertsmere mentioned have decreased. Is the Minister right to be so cautious? As the world becomes a smaller place, as travel becomes easier and as ''choice''—the new buzz word of both the Leader of the Opposition and the Prime Minister—becomes the mantra of both parties, is it not likely that more people will go abroad for treatment, that specialisms—for example, cancer specialisms—will develop in other European countries, and the NHS will be happy to pay for people to go abroad and receive specialist treatment rather than developing the capacity here? Why is the Minister being so cautious? Is not it likely that more and more people will go abroad for taxpayer-funded treatment?
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