Immigration Bill

Baroness Barker Excerpts

Monday 10th February 2014 Lords Chamber

[Baroness Barker (LD)]

My Lords, I have long been of the opinion that immigration law is one of the best tests of the values and principles to which any country subscribes. It is also one of the best litmus tests by which to judge a country. I therefore wish to align myself with the comments made by my noble friend Lady Hamwee earlier on this afternoon when she spoke on the Bill.

The desperately sad thing is that we have been here before. In 2004, the Blair Government consulted on a similar proposal to exclude visitors from free primary healthcare. They did it as an excuse to try to deny failed asylum seekers access to NHS services, particularly secondary care. They never published the results of their consultation and quietly shelved the matter. Here we are again, all these years later, with another Government, under pressure from the right-wing press, coming up with the same set of proposals. It is a desperately sad reflection on the way we are asked to make legislation on this subject that we are yet again put in this position.

In July 2013, Jeremy Hunt admitted that he did not know whether health tourism was a problem at all. He said:

“The truth is that we do not know the cost”—

of unpaid NHS charges—

“which is why we are carrying out an independent audit this summer”.—[Official Report, Commons, 16/7/13; col. 908.]

The Government produced two pieces of quantitative and qualitative research to go along with these Bills. The conclusion that can be drawn from them is that there is currently no systematic data collection whatever on NHS use by migrants, chargeable or otherwise.

The quantitative data were a top-down estimate of migrant use, modelled from data that were sometimes of varying quality and from a large number of assumptions. They used, for example, the international passenger survey data. They did not give us any actual new information about use of the NHS by migrants. In the quantitative research, researchers repeatedly put caveats around the findings of their model, saying that,

“any point is just a likely value in a plausible range”.

That is to say, the much publicised figure of £1.76 billion, which has been bandied around, is about 50% likely to be wrong. I really do not think that this is a proper basis on which to bring about such a fundamental change in access to the NHS.

The quantitative survey was subtitled, “Observations from the Front Line”. It gave the impression that front-line staff in acute health services had come up with systematic observations about migrants and their use of the NHS. In fact, what it revealed was that there was no systematic observation, and that quite often people were simply asked questions on the basis of their appearance or nationality. Such a flawed basis of research is really no way in which to change the fundamental right of access to the NHS for all of us.

By creating a barrier to accessing primary care services, we open up a huge health threat to the whole population. It is entirely possible that there will be serious implications in the diagnosis and treatment of infectious diseases and in herd immunity for childhood diseases, for which we need immunisation of the whole population. There is a significant public health risk associated with restricting access to primary care, and it is not something that we should do lightly. There is not much evidence, I know, but there is one small study from Médecins du Monde—doctors of the world—which has a small clinic in Tower Hamlets that works with people who are vulnerable and do not have access to NHS services.

It is a very small study, but what MdM found was that its GP list of patients was pretty much like that of every other GP surgery. The majority of people who come to see the doctors do not require any treatment at all. A small, but significant, number of people require some minor medication and a follow-up visit. A fraction of patients require secondary care. Admittedly, this is only a small study, but rather than paying all our attention to some of the alarmist stories that we see in the press, we really ought to look at those small figures.

The biggest point that I want to make is that if we are to go ahead with anything in this Bill, we should do it solely on the basis that its implementation will be accompanied throughout by proper research and evidence-tracking, so that in future we will not be reduced to passing laws on the basis of what the Daily Mail might think is the truth.

In the time available to me, I shall pass on to one other issue. I thank the right reverend Prelate the Bishop of Leicester for his thoughtful speech. On the issue of sham marriages and civil partnerships, I understand that the Government believe that there are between 4,000 and 10,000—we are back to shaky evidence bases again. They say that in 2012 there were approximately 1,900 cases of sham marriages and civil partnerships under Section 24 of the Immigration and Asylum Act 1999. How many of those were sham civil partnerships, as opposed to sham heterosexual marriages, and what were the countries of origin of the non-EEA partners?

I understand that the proposal to extend the notification for civil partnerships and marriages from 15 days to 28 is to enable registry officials to satisfy themselves that they are genuine. Under this Bill, the Home Office will also be allowed to extend that period to 70 days for further investigation, if there is reason to believe that the marriage or civil partnership is not genuine. However, it is not clear to me whether there is any appeal process which people will be able to use if they have been wrongly adjudged to have entered into a sham marriage or civil partnership. Will the Minister enlighten us on whether there is an appeals process, what it is and how people will be enabled to use it?

Finally, I turn to one other issue. Noble Lords who read yesterday’s Observer will have seen that LGBT asylum seekers have been subjected to the most shockingly degrading line of questioning during their interviews. Does the Minister agree that demeaning and intimidating people just because they are gay has no part whatever to play in our justice system? Will he assure us that this is going to stop—and stop now? We are not Uganda. We do not treat gay people like that in this country, no matter how hard our times are.