Draft Immigration (Health Charge) (Amendment) Order 2016

Anne McLaughlin Excerpts

Monday 29th February 2016 General Committees

[Anne McLaughlin (Glasgow North East) (SNP)]

I am struggling to understand what the benefit of the order is and what its justification is, and I want to raise a few points. I understand from what the Minister said that perhaps things have changed slightly since I read up on the matter. The idea that this is a cost-cutting measure is interesting, because we do not know what it costs us for Australians and New Zealanders to use our national health service, notwithstanding the fact that most of them are young and therefore less likely to use the NHS in the first place. The NHS has only recently started to collect data based on the nationalities of those using it, and I would like to hear more about that.

The reciprocal arrangements we have traditionally had with Australia and New Zealand work only if we do actually reciprocate. The Minister said something that I did not hear completely. Will he clarify what he said about how we still have a reciprocal arrangement between Australia and the United Kingdom? I am not content that, as the hon. and learned Member for Holborn and St Pancras said, people have come over here and are paying national insurance and income tax, and they are also paying a surcharge for health, whereas we do not do that when we go over there.

Also, my understanding is that there is a lot of— [Interruption.] The Government Whip is shaking his head, so perhaps he can answer me and tell me where I have got it wrong. I know that they are not happy in Australia and New Zealand: they are saying, “Well, we’ll make it a reciprocal arrangement. We’ll reciprocate and we’ll impose a charge”. There are calls for that to be done, and those who would suffer most from that are UK nationals, because we outnumber the number of people coming to this country. For example, there are 63,000 New Zealanders living in the UK—which apparently makes up 0.09% of the population—whereas there are 265,500 UK nationals in New Zealand. In that respect, we have had the better end of the deal. The figures are slightly different when it comes to Australia, but my understanding is that we still outnumber the number of Australians who have come here.

I would be grateful for any clarification. If the Government Whip was shaking his head because I had misunderstood something, I would be very grateful to hear that.

--- Later in debate ---

[James Brokenshire]

As I indicated in my opening comments, in the first six months since its introduction, the immigration health surcharge raised more than £100 million in income for the NHS in England, Scotland, Wales and Northern Ireland. It is important to make that point, and we will report on the first year’s income, as the hon. and learned Member for Holborn and St Pancras asked me to do.

I also want highlight the fact that a comprehensive study of migrant use of the NHS in England commissioned by the Department of Health found that the total cost of visitors and temporary visitors accessing NHS services in England alone was estimated to be up to £2 billion a year, with around £950 million spent on temporary migrants, such as students and workers, from whom no charge had been recoverable previously.

[Anne McLaughlin]

Am I not right in thinking that that is the Prederi report, which states that those are the best estimates, but that accuracy is by no means assured because of uncertainty about the numbers of people and their behaviour?

[James Brokenshire]

These are always estimates, but we judge that to be a reasonable estimate on which to base our policy. That was the basis on which the House legislated for the creation of both the immigration health surcharge and the previous order. In our analysis, non-EEA temporary migrants—workers and families—here for longer than 12 months had a weighted average cost to the NHS of a little more than £800 a head and a total estimated gross cost of more than £500 million a year. The figures for non-EEA students, for any length of stay, were just over £700 and about £430 million respectively.

The Government believe that those subject to immigration control should have a form of access to public services that reflects their immigration status. The previous order brought migrant access to the NHS into line with existing policy on access to benefits and social housing. It is a migrant’s immigration status, not their tax contributions, that governs their access to those services. We believe that the levy is appropriate and reasonable, and recognises the contribution that temporary migrants make to the wider economy.

Questions were asked about reciprocity, and in particular the reciprocal healthcare agreements with Australia and New Zealand. There is no intention to discontinue those agreements. They are more than 30 years old, however, and all three Governments concur that the time is right to review them and ensure that they are appropriate to the contemporary needs of our travelling citizens. The Department of Health has therefore entered into discussion with Australia and New Zealand on the scope of the agreements. The Government have no intention of discontinuing the agreements, but Ministers and officials in the Department of Health are looking at them.

Reciprocal healthcare agreements provide for a national of one country on a short, temporary stay in another country to receive free treatment. The agreement with Australia provides for a resident of one country who is visiting temporarily in the other, without becoming an ordinary resident, to be provided with free immediate medical treatment. However, all our Governments highly recommend the possession of adequate travel insurance because the agreements do not cover all treatment needs. In particular, they do not cover the costs of a medical evacuation.

What happens to our citizens going to Australia or New Zealand is a matter for consideration. Australia already levies a health charge for certain categories of visa applicant, including older migrants applying to become permanent residents and those with existing healthcare needs. In addition, students are required to have health insurance. In New Zealand, there is a consultation fee for anyone accessing GP care, and all foreign fee-paying students applying to study there are required to hold acceptable medical and travel insurance. Most visa applicants to the two countries are also required to meet minimum health standards, and in some cases they must undergo a medical examination. A visa may be refused if a migrant has a health condition that is likely to result in significant healthcare and community service costs.

It might be considered that this measure makes it harder for Australians and New Zealanders to come here, but I have already indicated that visitors would remain unaffected as a consequence of the reciprocal arrangements. Some 97% of Australian and New Zealand nationals who apply for a UK visa are successful. We continue to place great value on our links with both countries and remain committed to strengthening our relationship with them. However, we operate in a wider context, which includes the challenges of healthcare costs and managing migration flows. I find it interesting that the Scottish National party appears to be turning its face against additional funding for the NHS in Scotland. That is obviously the SNP’s prerogative, but we judge that this measure is appropriate, and I commend it to the Committee.

Question put.