Immigration (Health Charge) (Amendment) Order 2018

Lord Paddick Excerpts

Wednesday 28th November 2018 Lords Chamber

The Explanatory Memorandum states, somewhat surprisingly, that there was no public consultation on the increase in charges. Why was there no public consultation, particularly since the impact assessment runs to some 36 pages of assumptions and estimates on the impact, costs and increases in revenue arising from the changes and asserts that the increase will increase public confidence in the immigration system? Maybe a public consultation would have brought to light some of the issues I am raising in respect of children and the potential impact on the skills shortage in nursing, construction and the hospitality sectors, for example. This last is an issue that, according to the press, is of concern, post Brexit, to the business world and to those running public services, as well as, apparently, some members of the Cabinet. The Government should reconsider the fairness and appropriateness of the proposed increases we are discussing as a matter of urgency. I beg to move my amendment.

[Lord Paddick (LD)]

My Lords, I thank the Minister for explaining this order and I wholeheartedly agree with the noble Lord, Lord Rosser, that this House should not approve it, for the three reasons he set out. The first is that, taken together with other excessive charges made by the Home Office on those seeking to come to or remain in the UK, the increase in the immigration health charge provided by this order makes it unaffordable for many to come to or remain in the UK, even though they have a legal right to do so. Secondly, while the immigration health charge is intended for those seeking to stay temporarily in the UK, as the noble Lord, Lord Rosser, has said, many people whose applications for permanent leave to remain are being considered will also be unfairly caught by this charge. The final issue is that, in addition to paying the immigration health charge, many of those affected will be working in the UK, paying income tax and national insurance. They will effectively be paying twice for any treatment they receive from the National Health Service.

We have discussed before the level of charges levied by the Home Office for such things as visa applications. These are way above the cost of processing such applications. When this 100% increase in the immigration health charge is added to these already excessive costs, it becomes unaffordable for many even to contemplate coming to the UK, even though they are perfectly entitled to do so. As the noble Lord, Lord Rosser, pointed out, children seeking permanent leave to remain are now granted only a maximum of two and a half years’ leave at a time. They would have to make four applications before they reach the required 10 years’ residency, costing £6,521 per child at current prices. They are now going to have to add another £4,000 in immigration health charges, bringing the total for one child to £10,521 just to remain in the UK.

There are exemptions from the health charge and other immigration charges, yet the process is so complicated and ineffective that, as the noble Lord said, only 8% of children are granted fee waivers. Many families are having to make the choice between being plunged into poverty and being forced to leave the UK—which is, of course, exactly what this Government are trying to do, whether or not they have changed the packaging from “hostile environment” to “compliant environment”.

The Government’s own impact assessment clearly anticipates a reduction in the number of people seeking to enter or remain in the UK, as a result of doubling this charge. The impact assessment also shows that there will be a net cost to the Exchequer in dissuading working migrants from coming to the UK, because immigrants contribute more overall to the public purse than they cost in public expenditure. They do so already, without the immigration health charge increase. There is one clear conclusion from the impact assessment. This is a financially self-harming, ideological and constituent part of the hostile—or compliant—environment, designed to deter those from overseas coming to or remaining in the UK, even if they come here to make a valuable contribution to the UK economy.

The irony of the Government’s whole approach to immigration and the punitive charges levied by the Home Office is encapsulated by the case of nurses from non-EEA countries coming to work in the NHS. First, this Government create a hostile environment for all immigrants by holding a referendum on membership of the European Union where false stories of excessive immigration are deployed by the leave side, resulting in a massive increase in hate crime against those from other countries while making EU migrants in particular feel vulnerable and unwanted. Having caused an exodus from the health service of EU nationals working in it, the NHS is then forced to employ non-EEA nationals to fill the gaps. It has to pay an additional £1,000 per non-EEA national employed per year in immigration skills charges. Meanwhile a qualified nurse from, say, the Philippines—a country that can ill afford to spend money training nurses only to see them leave for the UK once qualified—not only costs the NHS £1,000 a year more than an EEA national employed in the same role but also has to pay £400 a year towards the cost of the NHS, even though she is employed by the NHS. She will effectively pay twice for the NHS by paying tax and national insurance in addition to the immigration health charge.

Of course, revenue from the immigration skills charge is supposed to be put into training UK citizens to reduce the need for skilled immigration. Instead, the Government have abolished student bursaries for nurses, making it less likely that UK citizens will train to become qualified nurses and creating more demand for nurses from overseas. Numbers applying to begin training in September 2018 dropped 12% when compared to the same time last year, resulting in a total decline of 16,580 applications since March 2016—the last year in which students received financial support through the bursary. The fall in mature student numbers has been even more extreme, with a 16% drop by the June application deadline compared to the same point last year and a total decline of 40% since June 2016. As the noble Lord, Lord Rosser, said, there are currently estimated to be 40,000 nurse vacancies in England alone.

This Government are creating not only a hostile environment for immigrants but a hostile environment for common sense and decency. This order is very much to be regretted.

[Lord Hylton (CB)]

My Lords, the Refugee and Migrant Children’s Consortium is deeply concerned about this order, which doubles the health surcharge. These concerns are, I suggest, important because of the interaction with other charges. In the past, people who were here legally but with uncertain future residency could expect to remain after six years, with good behaviour. Now they will be granted only two and a half years in extensions and thus may have to pay over £6,500 just to remain, as the noble Lord, Lord Rosser, pointed out. On top of this, they may have to find £2,000 for an immigration health surcharge, in what one might call a double whammy. This is particularly hard on those on low earnings because of their uncertain status. They are also doubly taxed if they suffer PAYE and national insurance on their wages.

The noble Lord, Lord Paddick, rightly mentioned the case of nurses from the Philippines. Ill health, or health at all, may thus become a cause of homelessness if rent arrears lead to eviction. The Government may say that there are exemptions for some. However, children in care are exempt, but not children who live with their natural family. A family with four children may have to pay £8,100 on several occasions. The situation may be even worse if the family is also paying fees to register for British citizenship. An impact assessment has been published, but it makes no reference to working parents and their children.

This is an anti-family measure. Her Majesty’s Government should withdraw this order and think again. They must consider its impact on those least able to pay and not just on fat cats and non-doms. Will they please also rethink the exemptions? I support the amendment.

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[Lord Paddick]

I do not want to prolong the agony for the Minister, but the point about America is that the tax people pay there does not pay for healthcare. That is why people have to have insurance. Immigrants come to this country, get jobs and pay national insurance and income tax, which pays for healthcare. But only immigrants have to pay a charge in addition to the national insurance and income tax they pay to fund the health service. Can the Minister explain why?

[Baroness Williams of Trafford]

Temporary immigrants have to pay the healthcare charge, but anyone with indefinite leave to remain or who is a citizen of this country contributes to the NHS through general taxation. We are not going to agree on this.