Immigration Bill

Lord Avebury Excerpts

Wednesday 12th March 2014 Lords Chamber

[Lord Taylor of Holbeach]

I cannot give the noble Baroness an absolute answer to that question. Of course one of the reasons why the rollout is important is that we need to check to see if there are any adverse implications in this policy.

[Lord Avebury (LD)]

My Lords, can I ask the Minister a question about asylum seekers and persons appealing against a refusal of asylum who are occupying rooms in private houses? It has been said that there are quite a few people doing this, notwithstanding the fact that accommodation is normally provided for them under the Immigration and Asylum Act 1999. Can my noble friend elucidate what provisions are being made for documents to be produced by those who are occupying rooms in private houses because they are not covered by the provisions of Schedule 3, to which he has referred? They deal only with the accommodation that is provided to most asylum seekers under the 1999 Act when they cannot afford to pay for accommodation of their own. However, there is still an important residual group of people who find space in private houses. They will need documentary proof that they are allowed to live in those houses and thus ensure that landlords are not breaching the conditions by taking them in.

[Lord Taylor of Holbeach]

I think I have made it clear that for people who have asylum seeker status, where it is not safe for them to return and therefore they may be failed asylum seekers, the Home Office will provide the necessary documentation to show that they have a right to accommodation even though their status may well be that of failed asylum seekers.

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[Lord Patel (CB)]

My Lords, after Monday’s debate, I do not think this should take very long. Amendment 58 relates to Clause 33, on immigration health charges, and specifically to subsection (3)(b), which says:

“An order under this section may in particular … specify the amount of any charge (and different amounts may be specified for different purposes)”.

My amendment would remove the words in brackets. As I understand it, we already have the defined charges of £150 for students and £200 for other immigrants.

In the debate we had on Monday, I asked the Minister:

“Once that levy has been paid, it will allow them”—

we were speaking about students—

“to access all health services. Is that quite clear?”.

The answer the Minister gave was:

“Yes, that is exactly right. They will have the same access to health services as is available to a permanent resident”.—[Official Report, 10/3/14; col. 1573.]

Later in our discussions I said:

“As I understood it, I thought he said that once the health surcharge—let us say it is £200—is paid, for the duration of their legitimate stay in this country all health services will be available to them”.

In his reply, the Minister corrected me. He said:

“It is a per annum charge, so if they are here for three years and are not a student it will be three times £200”.

I accept that. But he went on to say:

“But yes, that is exactly right”.—[Official Report, 10/3/14; col. 1574.]

That is, there will be no further charges and all health services will be available to whoever has paid the levy or the health service charge—students or other immigrants.

In that case, I do not know why there is a need to have the words,

“and different amounts may be specified for different purposes”.

We need to know what these purposes are and whether there will be extra charges. If there are, what will they be for, and what will be the tariff? That is my amendment. I beg to move.

[Lord Avebury]

My Lords, when we discussed this previously, I, too, asked my noble friend the Minister about the relationship of this provision to Clause 33(4), which says that,

“the Secretary of State must … have regard to the range of health services that are likely to be available free of charge to persons who have been given immigration permission”.

I said that that implied that certain services provided by the health service were not going to be free of charge to these people. My noble friend tried to reassure me on this point but it is there in the Bill. It seems inconsistent with the repeated declarations that were made by my noble friend the Minister—which the noble Lord, Lord Patel, has just quoted—that once you have paid this levy, you are free to access all health services provided by the NHS. If that is the case, Clause 33(4) should be deleted from the Bill.

[Lord Hope of Craighead (CB)]

My Lords, when we discussed Clause 33 previously, the Minister was subjected to a very large number of points. I suggested then—and beg leave to suggest again this evening—that somebody should go over the clause very carefully and look at all the bits in brackets, of which there are quite a lot, and the various subsections and so on, to try to trim it down and make sure that it contains what is really necessary and does not have the opportunities for obscurities and criticism that it presently contains.

It is quite a difficult clause and I understand very well why when one gives power to make an order one wants to give as much scope as one can to the Minister, but this clause goes rather too far by trying to hedge too many bets, and I suggest that it should be looked at very carefully.

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[Lord Taylor of Holbeach]

My Lords, it is helpful that we have had this debate; I am pleased that the noble Lord, Lord Patel, has moved the amendment. As he said, it was originally designed to supplement his amendment relating to students. I think that we have got a good story to tell in connection with students. If I may, however, I shall deal with the particular amendment, Amendment 58.

The noble Lord is right that the provision is not immediately transparent; indeed, the noble Lord, Lord Rosser, has challenged me on this point, too. I understand that the intention of the noble Lord, Lord Patel, may have been in respect of the exclusion of certain expensive discretionary treatments from the free access afforded by having paid the surcharge—I think that that was his concern. I said on Monday, and I am happy to repeat today, that no such exclusions will apply when the surcharge is introduced, and none is planned for the future either. We intend that the payment of the surcharge will provide the same access to health services as is available to a permanent resident.

I turn to the penetrating critique from the noble Lord, Lord Rosser. Both he and the noble and learned Lord, Lord Hope, felt that a degree of ambiguity lay within the clause, so perhaps I may explain why Clause 33(3)(b) states that,

“different amounts may be specified for different purposes”.

The answer is that it allows regulations to specify different amounts of surcharge for different categories of migrants—currently, there are only two amounts: the £200 rate and the £150 rate—without which we would not be able to give the discount to students, which is one of the elements of the Bill. We need this capacity to do so. We do not have it in mind that there will be other categories, but this is the way in which the discount for students is facilitated by the legislation. It does not refer to NHS charging in the legislation.

Perhaps I may refer to the comments made by my noble friend Lord Leigh of Hurley, because we have a very different health system here from that in the USA and in Australia which requires a different solution. Health insurance requirements would be expensive and compromise our own competitive position in the international market for students and for workers, which is not what we want the Bill to do. Most EU countries do not enforce the Schengen visa health insurance requirement at their borders. A student applying to Harvard in the USA, for example—my noble friend Lady Williams of Crosby referred to Harvard and its great pull as a centre of learning for overseas students—has to pay a fee of $958 per year to access basic health services. To access Harvard’s more comprehensive health insurance plan, which is comparable to what the £150 rate gives access to, would cost a further $2,190 per year. That gives some measure of what is involved. We have already committed to this discount for students—that is what this clause is about—in recognition of their contribution to the UK, reinforcing, I hope, arguments that I am trying to make at regular intervals in our debates. They will pay just £150 instead of £200, which is 1% of the cost of coming to study in the UK and exceptional value for money, as I am sure noble Lords will agree.

Why does the Bill allow surcharge payers to be charged for further treatments? So that noble Lords are clear, I should clarify that the Bill does not prevent the exclusion of certain expensive, discretionary treatments from the free access. However, we have made it clear that we intend that no such exclusions will apply when the surcharge is introduced. The Department of Health has been clear that it will consider these in future only in the event of exceptional and compelling specific justification for health purposes; and any changes would need to be put before Parliament in the form of revised NHS charging regulations. One might say that this is for treatments which may in future emerge where it is considered that the health service quite properly should charge not just migrants but members of the UK population.

My noble friend Lord Avebury asked whether there was a problem with the drafting of Clause 33(4). The drafting purpose of Clause 33(4) is to provide a clear link in the Bill to health treatment. Without it, the clause would give an unlimited power to charge for any purpose, which is the intention neither of the clause nor of that particular subsection of it. I note what noble Lords have said about the wording of the subsection. It has been carefully drafted, but if I can provide noble Lords with an explanation of line-by-line implications, I shall do my best to do so before we get to Report. Meanwhile, I hope that the noble Lord will withdraw his amendment.

[Lord Avebury]

Where the Bill uses the words,

“likely to be available free of charge”,

in Clause 33(4), it anticipates the possibility that the Minister mentions—that while we do not intend to charge anybody at the outset of the operation of the Bill for services of particular cost, we have it in mind to do so in the future. That would apply to students and to short-term migrants as well.

[Lord Taylor of Holbeach]

I think that I made it clear that the wording is designed to enable the health service, if it feels that particular treatments should be charged for, to do so. There is no intention to do so at present, but it is important that the Bill makes it clear that this is a facility which the health service wishes to reserve for itself. I think that it is quite proper for it to do so, but there is no intention on the introduction of the health charge for there to be any additional fees for additional treatments.

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[Baroness Lister of Burtersett]

Given that the Minister was able to slip out of answering this point on Monday—it did not seem fair to push him on it after he had covered so many points—perhaps I might remind him about the evidence base for health tourism. I have a snippet of information that one piece of research that the Department of Health is relying on is that, out of nearly 1,000 migrants screened by overseas visitors officers in more than 15 trusts during August 2013, only four individuals—0.4% of the sample—were identified as “health tourists”. Even if the Minister cannot now tell us what the evidence is for this claim of health tourism, I would be grateful if he could commit to write specifically on this issue, given that it kind of got left out of his last letter.

[Lord Avebury]

My Lords, when the noble Lord is replying on that point, will he deal with story of the 300 maternity patients who were alleged to have been treated at St Thomas’s hospital? When we last discussed this, the allegation was found to have been apocryphal. I would be grateful if the Minister would repudiate it.

[Lord Taylor of Holbeach]

I would not wish to get involved in hearsay or gossip or, indeed, the suggestion that some of this stuff is just newspaper chat. I will get back to the noble Baroness, Lady Lister, with a reasoned reply explaining the Government’s analysis of the situation. However, the purpose of this measure is not to do with health tourism at all; it is to do with providing a charge whereby people who stay here for more than six months make a contribution to the NHS. It will make it more difficult for people who are not entitled to access healthcare to do so, but that is a secondary purpose.