Tag Archives: nhs

Immigration and the NHS @ 65

The NHS makes it to 65, despite endless reorganisations and increasing amounts of private sector involvement. (Got to tread carefully with what I say because I have some experience of the National Programme for IT, but this is in a personal capacity only). Meanwhile, something that’s been in the news recently is the idea of charging foreigners an annual fee for GP services. There are all sorts of reasons why this is a bad idea. First of all, introducing charges means introducing a charging mechanism. Sounds obvious, and of course it is, but it hasn’t been thought through properly. If some people are going to be charged and others are not, you need to find a way of proving that some people don’t have to pay. What form will this take? I don’t know, but whatever it is, it will be expensive. This also raises the risk of fraud. Since the Life in the UK Test was introduced, people have cheated in the test, got someone else to sit it for them, or produced fake certificates. Basically, if something has a cash value, people want it and don’t want to pay for it. How much would it cost to introduce a charging system and make sure it remains secure? It certainly won’t be cheap. Remember that this will have to check the eligibility of the entire population, whether or not they come from abroad.

Another bad thing about this is the impact on public health. Asylum seekers get free healthcare during their application process. Most of them end up in the UK because they pay a broker to send them somewhere, often with no particular destination in mind as long as it’s not where they came from. If they’ve spent days in the back of a lorry they probably won’t be in the best of health just because of the journey, and they may come from countries where things like yellow fever, cholera and dysentery are rife. Because of this they need healthcare: not just for their benefit but also to make sure they don’t introduce diseases into a population that doesn’t have immunity to them. These charges won’t affect asylum seekers (I certainly hope they don’t, anyway), but I have serious concerns that someone who isn’t an asylum seeker might have similar health problems but won’t or can’t pay the fee and end up infecting people. They will still get emergency care and certain public health cover, but it seems an unnecessary complication to differentiate between what’s covered and what is not. The current list of notifiable diseases is at http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/NotificationsOfInfectiousDiseases/ListOfNotifiableDiseases/. The initial symptoms of most of them are very similar to flu. What happens if they’re thought to have something notifiable that turns out to be treatable with bed rest and lots of fluids, or if they haven’t paid to register with a GP, feel off colour, and then turn out to be a 21st century Typhoid Mary when they’ve infected loads of people?

The real issue with all this is immigration policies that have got completely out of hand. When the official Home Office Twitter account publishes a tweet like this there’s something seriously wrong:

There is sometimes an assumption that these policies will only apply to foreigners. Wrong. To avoid letting people slip through the net the only way to check is to ask everyone. To get a job you have to prove that you’re legally entitled to work. In the latest immigration bill there are plans to introduce a check for people wanting to rent accommodation. Why? If someone can afford to pay a deposit, produce references and provide a month’s rent in advance, what benefit will it bring if they also have to prove to a letting agency that they did not come from another country illegally? They are already liable to being deported if they have. I do think it’s about time more people stood up to the “send them back where they came from” crowd rather than coming up with more and more hysterical ideas. “You are wrong because…” can be a courageous thing for politicians to say (in the Yes Minister sense), but sometimes it needs to be said.