Immigration Bill

Baroness Manzoor Excerpts

Monday 10th February 2014 Lords Chamber

[Baroness Manzoor (LD)]

My Lords, the fact that I am not addressing the wider implications in this Bill regarding students, detention caps and the positive contribution immigration makes does not mean that I do not have interest or concern in these important areas. I align myself with comments by my noble friends Lady Hamwee and Lord Dholakia and the noble Lord, Lord Bilimoria.

As many noble Lords have stated, it is widely acknowledged there are significant delays and inefficiencies in the administration of immigration law, and this Bill will need to have greater clarity if it is not to add to this complexity. As the former Legal Services Ombudsman for England and Wales, I know the importance of having in place effective and efficient systems for casework and of ensuring good quality decision-making. Like other noble Lords, I note with some disappointment that the latest statistics at the Home Office reveal that 32% of deportation decisions and 50% of entry clearance applications were successfully appealed last year. This is a high margin of error in casework. Yet Part 2 seeks to erode independent oversight in appeal rights making them difficult to access and curtailing judicial discretion. On present information on the quality of casework, it does not seem fair or just. Can the Minister reassure the House that he will ensure that the current quality of casework will be improved before reducing the opportunities for people to challenge decisions as the current standards in casework are a great concern? As my noble friend Lord Teverson said, it is an issue for competent management.

Clauses 33 and 34 in Part 3 could also potentially create new layers of bureaucracy for the NHS, as well as having some serious implications for race relations in the country. This may have unintended consequences. The clauses as they stand may require individuals to prove their identity before accessing services. In practice, this will invariably include individuals who are British citizens. As the noble Lord said, this may create unnecessary mistrust and suspicion. I would be grateful if the Minister can address these concerns to ensure that the myth does not become a reality.

As someone who has worked in the NHS for many years, I understand why NHS staff are not best placed to check the immigration status of their patients or to check that any surcharge payment was paid when a visa was first granted. Indeed, immigration status changes constantly, and it will be difficult to ensure all patients’ information is kept updated or to make sure that healthcare systems are equipped to understand immigration issues. Nurses’ and clinicians’ duty of care is to their patient and should be entirely focused on assessing and treating their clinical needs.

What about the healthcare and treatment of the children of individuals who have not paid the surcharge who become ill? Can the Minister give some reassurance that children will always receive free healthcare whatever the immigration status of their parents, as is their right under law? Like the Royal Collage of Nursing, the Terrence Higgins Trust and others, I believe that unless there is clear evidence that non-EU migrants are placing a significant burden on the NHS, the main focus should be on improving the current arrangements for chargeable patients. I pose the question: why is this not working now and, indeed, will this Bill improve it? If evidence shows the current system is not working effectively, then steps should be taken to rectify this, rather than applying a blanket approach to charging longer term migrants, who—and I agree entirely with the Royal College of Nursing—if in employment, will already be contributing to the NHS through taxes and national insurance. This is neither fair not equitable, as the noble Lord, Lord Patel, said. However, I welcome the Government’s decision to maintain free access to GP consultations, and maintain the current exemptions to charging, and in future to the surcharge, and to continue to include asylum seekers, refugees and victims of trafficking. But charging for healthcare in Clause 33 and redefining who counts as an ordinary resident—Clause 34—could increase the number of vulnerable people living in the UK. Even though infectious illnesses will be treated for free, having a two-tiered system will create confusion, and could delay and discourage people seeking the most appropriate help or having no help at all. This clearly has implications regarding public health and may end up costing the NHS more, particularly as the surcharge paid by migrants may not find its way into the NHS purse.

The Terrence Higgins Trust states that the current proposals will also have a negative impact on the Government’s efforts to, “reduce attendance and admissions to A&E, reduce undiagnosed HIV, and reduce late diagnosis of HIV”, and “improve long-term health and wellbeing of the population”.

I would be grateful if the Minister would address these issues, as I, like the noble Baroness, Lady Meacher, would prefer answers at this stage rather than having them debated in Committee. I am sure the Government would not wish to create a bigger problem than the one it is currently claimed exists in the NHS, and hope that they move to a more research and evidence-based approach to immigration.