Immigration Bill

Earl of Listowel Excerpts

Monday 10th March 2014 Lords Chamber

Moved by

[The Earl of Listowel]

48: Before Clause 15, insert the following new Clause—
“Pregnancy exemption
Any—(a) restriction on eligibility for services, or(b) charge,in this Part shall not apply to any person who is pregnant.”

[The Earl of Listowel (CB)]

In moving Amendment 48, I will speak to Amendments 55, 63 and 65 and support my noble friend Lord Patel’s Amendment 60. I apologise for not having been able to take part at Second Reading. Perhaps it would be helpful to the Committee if I paused for a moment.

[Baroness Anelay of St Johns (Con)]

My Lords, the noble Earl, Lord Listowel, is trying to introduce his amendment and I would ask that noble Lords leave quietly. That was quite a din. I also remind noble Lords that, when they leave, they should not walk in front of the speaker. It not only drowns him out, it means we cannot even see him.

[The Earl of Listowel]

I am most grateful for that intervention. Amendment 48 would exempt pregnant women from all charges and penalties associated with Part 3, particularly with regard to health charges and concerns for landlords about having tenants who might not be legal migrants. I want to take pregnant women out of this picture.

I recognise the difficulties that the Government face in terms of immigration. I grew up in Hampstead but I have lived and worked near Bermondsey, and I know that for the people of Bermondsey and other similar areas there can be more challenges due to immigration than in places such as Hampstead, around schooling and access to the health service but particularly around housing. There are real concerns and the shortage of housing can be a cause of social tension.

This, too, is a knotty political question, but if the Government and Opposition could come to some consensus about how to provide enough social housing and affordable housing for our people, many of these tensions might be far less acute than they are today. I know that is a great challenge but it relates to this issue and the concerns of our people about migration.

Perhaps it is helpful to think about how maternity has a certain sacred association. If one wanders around the Sainsbury Wing and looks at the earliest paintings there, one sees paintings from the 13th century of the Madonna and child, and nativity scenes. Respect for the mother and child during that very important period at the beginning of a family is at the heart of our Christian faith. It is not too surprising that France, Spain and Portugal—some of the Catholic countries—exempt pregnant women from any charges for accessing their health services. It points to the wisdom of the great faiths, as we increasingly realise how vital the very earliest months of a child’s life, from conception through the first two years of life, are to the successful later development of children.

Indeed, the right honourable Iain Duncan Smith did very important work concerning early intervention with families. Graham Allen MP, who worked with him in that endeavour, has set up the Early Intervention Foundation, which aims to raise awareness of the crucial period between conception and two years of age, and perhaps a little bit beyond that. Frank Field MP and Andrea Leadsom MP have set up the All-Party Parliamentary Group for Conception to Age Two—The First 1,001 Days, to really focus our minds on this crucial time in a child’s development. It takes several years for a child to grow into the physical stature of an adult but the brain is developing extremely rapidly in the first months of life and achieves its main development by age four. It is crucial to think carefully about how we treat mothers and their very young children.

I should have said something about newborns in my amendment. I talked only about pregnant women, but I hope that the Government will also think about mothers with newborn children within the first two years of life.

On several occasions I have had the privilege to speak to mothers in temporary accommodation through the Barnardo’s Families in Temporary Accommodation project. What came through particularly from their stories was the sense of isolation that they experienced and how difficult it was because of their temporary accommodation—they may be placed a long way from family or anybody of their ethnic group.

--- Later in debate ---

[Lord Avebury]

No, what I was saying is that I hope that the treatment would be given irrespective of the woman’s entitlement while checks are being made to see whether she is a valid patient of the NHS or is someone who should incur the charges. However, if the charges do fall on the woman, I hope that they will simply lie on the table, as obviously a substantial proportion of the costs of treatment of migrants has done in the past. From the official figures given by the Department of Health, I think it was two-thirds of the charges incurred—not just by pregnant women but by persons who were not entitled to treatment presenting themselves to the NHS. In no case that I have heard of were patients denied treatment, but the charges piled up and the debt was left there on the table. I do not know what the mechanisms for recovery will be under this system, and perhaps the Minister will deal with that point in his reply.

I assume, and want confirmation, that no woman would ever be denied treatment, but if it was ascertained subsequently that she was not entitled to it, the debt would be recorded somewhere. Whatever steps the NHS might take to recover it would be fair enough, but if it could not be recovered, like so many other debts which have been incurred by migrants generally in the past, would it be written off to the NHS? I would like reassurance from the Minister on that point.

Undocumented migrants such as overstayers and failed asylum seekers, of whom there are estimated to be half a million, are unlikely to be able to pay for maternity or indeed any other medical services. If such people work, they are on or below the minimum wage and are now likely to become unemployed with the tightening up of checks by employers on their right to work. Health authorities may invoice patients from this group, but can the Minister say what proportion of the debt is recovered and whether there is anything in this clause, or indeed in the Bill as a whole, that will make it easier to collect the money? Will they be able to transfer the debts at a discount to a debt collector, and will they be any better off than they would have been in the past before this clause was enacted?

[The Earl of Listowel]

My Lords, in listening to my noble friend Lord Patel’s concerns, which I share very strongly, about children and the charging of children, it occurred to me that there might also be an issue about the immunisation of children. If significant numbers of children do not get immunised, that might pose a threat. I would appreciate the Minister addressing that question in his reply.

[The Parliamentary Under-Secretary of State, Home Office (Lord Taylor of Holbeach) (Con)]

My Lords, this has been a very full discussion about all aspects of healthcare and healthcare charging, some of which lie within the provisions of the Bill and some of which lie way beyond it and are actually part of the Department of Health’s consultation. I guess there are two ways of dealing with this debate: I can give either the short answer or the long answer. I have chosen to give the long answer—I hope that noble Lords will indulge me—in the hope that I will be able to disabuse them of some of their anxieties and reassure them. I am very mindful of the kind words from the noble Baroness, Lady Lister, but I am also slightly anxious as a result of the description of my noble friend Lord Howe. I am equally concerned to try to be as upfront as I can be about what the Bill provides for and to reinforce my noble friend’s letter, which noble Lords will have received, which seeks to place measures in this Bill in the context of wider health service charging.

Perhaps it would be helpful to provide a brief reminder of the intentions behind Clauses 33 and 34. I will refer to my noble friend Lord Howe’s letter because it sets out the context for these provisions, which is the Department of Health’s wider programme of work on migrant access and financial contributions to the NHS. Likewise, I want to reassure noble Lords that, first and foremost, the NHS is, and will remain, free at the point of delivery for permanent residents. But it is a national service, not an international health service. We believe that migrants should have a form of access to the NHS that is commensurate with their immigration status. That is our policy position.

--- Later in debate ---

[Lord Taylor of Holbeach]

My Lords, I remember that the noble Baroness painted this scenario and I understood it well enough; I am sorry if I missed that point in picking up another. There are exceptions for refuge accommodation and local authority-provided housing. After all, a broad range of individuals are in this situation. Social services will be able to help them with long-term housing needs and asylum seekers will also be authorised to rent. If I have not satisfied the noble Baroness, I do not want to mislead her or the House by giving her an off-the-cuff response which is beyond my brief at the minute. I will write to her, and copy in everyone, on this matter.

I am looking through these notes, and see that I have satisfied a number of questions—such as those raised by the noble Lord, Lord Patel, on children—in the way in which I have answered the broader matters. However, I recognise, too, that I may not have covered all the points made by noble Lords, but I am very mindful of the time. If noble Lords will forgive me, I will ask the noble Earl, Lord Listowel, to withdraw his amendment. I thank all noble Lords who have contributed to the debate, which is by way of a warm-up, I suspect, for further adventures in these fields with the amendments that are yet to come.

[The Earl of Listowel]

My Lords, I thank the Minister for choosing to give the lengthy reply rather than the short one. This is clearly a matter of great concern to many of us, so I am most grateful to him for taking the time to answer our points as carefully as he could. I beg leave to withdraw the amendment.

Amendment 48 withdrawn.