Upfront migrant health charges will only cause more ills
Jeremy Hunt today launched a consultation on Government plans to charge overseas (that’s non-EEA) citizens working and studying in the UK £200 a year to access health care and charge short-term visitors to use the health service too. At present non-EU citizens can only access emergency health care for free. They are charged for all other health services .
Data in the Guardian today suggests that non-payment of these charges makes up only 0.01% of the total NHS budget – so a tiny dent to the service compared to the £20 billion of efficiency savings Hunt is forcing the NHS to make.
On the subject of costs, let’s consider the additional financial burden that putting Hunt’s plan into action will place on public administration. UKBA is already buckling under the strain of job cuts so will not be able to handle additional requirements on overseas visitors without large-scale reinvestment. So where is the saving?
There is also a public health cost to the plan. The British Medical Association and the Royal College of Practitioners have voiced concern that charging migrants to use the NHS is likely to deter many migrants already working and living here from using the health service as it sends out a signal that it is not a service for them. Despite assurances from Hunt on the Today Programme that exemptions would be made for migrants with diseases such as TB and HIV to be treated for free, people with these conditions may not realise there is this subtlety in legislation (who starts pouring over Parliamentary papers when they start to feel under?) and so decide to not seek medical treatment. This would put us all at serious risk.
Migrants already use the health service less than the resident population, as a Nuffield study shows and this policy will further discourage an already vulnerable group from accessing health services they are entitled to.
Hunt’s proposals will also turn medical staff into border police as they are obligated to assess whether a patient is entitled to free care or not, a task fraught with difficulty. Medical staff neither have the time to fulfil this added obligation nor the inclination to do so as it may risk denying patients access to essential healt care, which is illegal.
If Hunt is worried about saving money or saving lives, he would not have made the proposals he did today. Unfortunately Hunt is guided by more base instincts – votes and publicity. The Tories are desperate to look suitably draconian on migrants in order to win back UKIP voters. Yet, if he wanted to answer to voters serious concerns about healthcare, Hunt would do well to tell Osborne to reverse the cut in the top rate of tax that would be a neat way to raise millions to for the NHS.
The frustrating fact about the consultation Hunt has launched today is that evidence about the impact of requiring migrants to pay before having access to the health service has been sitting on the Department for Health’s desk for two years now. In 2011, the DoH reported on a consultation into ‘Access to the NHS by foreign nationals’ which revealed that the majority of those consulted thought that asking overseas visitors to pay before having access to the health service:
‘…would be an extra financial burden on the individual and administrative burden on the UKBA and educational establishments… [and] discourage[e] students and workers from the UK, with associated economic impacts.’
What was true in 2011 is even more true now Government’s visa changes make it even harder for non-EU citizens to study and work in the UK, costing the economy over £2 billion.
So, while Hunt may only be proposing to charge migrants to use the NHS for symbolic reasons, the symbols he is sending out are giant flashing warning signs that say: students and workers who contribute billions to the economy are not welcome and the Government has no interest in helping people in austerity Britain who have been telling the TUC they are struggling to get by.