Immigration (Health Charge) (Amendment) Order 2018

Lord Lansley Excerpts

Wednesday 28th November 2018 Lords Chamber

That brings me to the wider context, which is the general level of Home Office fees, which has already been referred to. Would it not have made sense, as my noble friend says, to have awaited the report on fee levels that is due from the Chief Inspector of Borders and Immigration before going ahead with this measure? Can the Minister give us an idea of when the Home Office expects to receive the chief inspector’s report and when the Home Office will publish it—those can be two very different things; there can be quite a long gap in between—and will she undertake that it will not be published on the eve of a recess in the middle of a whole lot of other reports so that no one notices, as is the Home Office’s wont?

[Lord Lansley (Con)]

My Lords, may I recount a story to the House from several years ago? I think it was around the time I was first appointed Secretary of State for Health. I was visiting a GP surgery in Cambridge, close to my constituency. The GP said to me, “There’s one thing I want you to think about. We have, obviously, many students come to Cambridge University. When they arrive they register with GPs, and many register with us. Happily, in some cases they never come to see us, but others do. When they come to see a doctor, I talk to them and prescribe whatever it might be. Then, when they go out of the door, the Americans, the Australians and the Chinese—many of these students come from outside the European Union—immediately go to the reception desk and ask where they’re going to pay. They are rather staggered to be told, ‘But you’re not paying. You pay nothing’. They say, ‘How can this be? Here we are in your country. If we were at home, we would be paying’”. They regard it as an absurd proposition. They are not here permanently and, in their view, they are therefore not entitled to the free care that those permanently resident in the UK should receive. This is an anomaly created by the use of the term “ordinarily resident” for access to NHS services. Although, as Secretary of State, I did not introduce the health surcharge, I none the less supported it when it was introduced.

The noble Lord, Lord Rosser, made a good job of objecting to something which I think he knows—and the House should know—is an entirely reasonable proposition. Not only should people who come here to take advantage of the opportunity to work here make the appropriate contribution to NHS services, the amount should be determined in relation to the average costs, which is a bargain for anyone actually accessing NHS services. Therefore, I will not support the amendment and support the order.

I say this in parenthesis to the noble Lord, Lord Paddick, about Filipino nurses. The Philippines has consistently—over many years—trained more nurses than it could possibly require in the expectation that Filipino nurses will get jobs abroad, principally in America. Many Filipino nurses came to Papworth Hospital in previous years. They have been extremely successful and many have settled. In recent years, we have had principally European Union nurses, but we would do well to have more Filipino nurses in future—if we can attract them, given the higher salaries that they enjoy in America. We are certainly not depriving the Philippines of nurses that it requires and it has never been the Government’s intention to do so.

That said, I shall not support the amendment. The Government are right and moderate in the increase to the charge that they seek.

--- Later in debate ---

[Lord Lansley]

I cannot bear that assertion being put on the record without being refuted: American taxation pays for healthcare—it pays for Medicare, Medicaid and the CDC. American public expenditure on health is nearly as large, as a proportion of GDP, as British expenditure on health. It is just incredibly inefficient. As my noble friend says, those who travel to America and work do not get access to Medicare or Medicaid.

[Baroness Williams of Trafford]

I am glad to have a former Health Secretary standing behind me to put noble Lords—and me—absolutely right.