This post originally appeared on Dr Helen Williams’s blog.
Jeremy Hunt has announced a consultation period for a new policy that would require a proposed bond of £200/year for the first five years for non-EU immigrants to access the NHS. He claims that this is ‘fair to British taxpayers’. This policy is neither fair nor evidence-based. Here are some of the reasons why:
1. Immigrants already pay to access the NHS. Not only do they pay a visa fee to come, they then pay National Insurance contributions, just like the ‘British taxpayer’ to whom Hunt refers.
2. There is no evidence of ‘healthcare tourism’ to the UK, despite government discourse. The better-researched estimates are that unpaid treatment for foreigners in the NHS costs £30-50m/year. This is compared with an annual NHS budget of around £104bn, meaning that such costs equate to around 0.15% of the annual budget, which makes the proposed levy seem like using a sledgehammer to crack a walnut.
3. Even with the levy, the NHS would not reach full recovery of unpaid foreign debts, as an increased focus on enforcement will cause higher legal and administrative costs. Debt collection is not free.
4. Limiting immigrants’ access to emergency services only will have the undesirable effects of sending people who could be treated easily and affordably by a GP to A&E and of people delaying treatment for conditions until they are much worse. Early treatment is effective and affordable; emergency treatment is not.
5. The government insists that ‘Britain is open for business’, despite placing ever-greater restrictions on student visas and other deterrent policies in pursuit of the seemingly-arbitrary goal of reducing net migration to ‘tens of thousands’. The proposed levy would only apply to non-EU nationals, who already have to prove greater wealth and a secure job in a highly-skilled industry.
6. Despite Hunt’s claims to the contrary, such a policy very much turns GPs into border agents, just as universities have been saddled with increasing immigration policing, and there are proposals that landlords should also be responsible for checking the immigration status of tenants. GPs already have to check passports and visas for every new person registering at their surgeries. Doctors now express concerns that this policy could cause conflicts with their Hippocratic oath and that it could lead to outbreaks of epidemics from untreated illnesses.This is by no means an exhaustive list but provides some of the most glaring errors in the policy proposal.