Immigration Bill

Lord Leigh of Hurley Excerpts

Wednesday 12th March 2014 Lords Chamber

[Lord Hope of Craighead (CB)]

My Lords, when we discussed Clause 33 previously, the Minister was subjected to a very large number of points. I suggested then—and beg leave to suggest again this evening—that somebody should go over the clause very carefully and look at all the bits in brackets, of which there are quite a lot, and the various subsections and so on, to try to trim it down and make sure that it contains what is really necessary and does not have the opportunities for obscurities and criticism that it presently contains.

It is quite a difficult clause and I understand very well why when one gives power to make an order one wants to give as much scope as one can to the Minister, but this clause goes rather too far by trying to hedge too many bets, and I suggest that it should be looked at very carefully.

[Lord Leigh of Hurley (Con)]

My Lords, I attended some of the debate on Monday and heard my noble friend Lord Bourne refer to the £200—or £150 because he was talking about the student rate at about £3 a week—as being very reasonable and fair. As he said,

“it is the cost of a Sunday newspaper”.—[Official Report, 10/3/14; col. 1605.]

It seems sensible that there is some flexibility in this health charge.

The cost to the National Health Service for an individual between the ages of 15 and 44—presumably young enough to be in reasonably good health normally —is £700 a year. Of course, that rises for older people. As your Lordships may be aware, Professor Meirion Thomas has written extensively about the abuse of health tourism. Because we are not in the Schengen visa system, people do not need compulsory health insurance to come to the UK and as a result he has identified many instances of abuse by healthy people and particularly by people who are not well and pregnant women coming to this country to get health treatment without any coverage of costs.

It is true that the National Health Service has charged such “health tourists” some £300 million but it is also true that it has managed to collect only 16% of the amount it has invoiced. Other countries, such as America, Canada and Australia, have much more severe restrictions on people coming in without health insurance and consequently we get more than our fair share. I would argue for flexibility in the health charge and clarification, as the noble Lord, Lord Patel, requested, of the parts of the health service to which it applies.

[Lord Rosser (Lab)]

My Lords, I would hope that if the intention of the words that the amendment seeks to delete is as the noble Lord, Lord Leigh of Hurley, speculated, the Minister will stand up in response and say it loud and clear to get it on the record.

I did not intervene in the debate on Monday. I read Hansard subsequently and I, too, was left somewhat confused as to the Government’s position. So I looked at the Explanatory Notes, and they do not explain the significance or purpose of the words,

“and different amounts may be specified for different purposes”,

which rather seems to defeat the primary objective of a document headed “Explanatory Notes”. The notes refer only to what is in Clause 33(3)(f), which is a reference to a “reduction, waiver or refund”. I then looked at the Home Office factsheet on Clauses 33 and 34, which also remains silent on the intention of the words, except to say that those who have paid the surcharge will be able,

“to access free NHS care to the same extent as a permanent resident, subject to some exceptions for particularly expensive discretionary treatments”.

I then looked at the letter we all received from the noble Earl, Lord Howe, dated 6 March, in the hope that the Department of Health might be able to throw some light on this, but the letter provides no help on the purpose or intention behind these words, which this amendment seeks to delete—although obviously the amendment has been tabled with a view to getting an explanation from the Minister as to what this means.

I then looked at what the Minister said on Monday. I came to the conclusion that the Minister, too, was unable to tell us why these words are in Clause 33. He said on Monday that those who have paid the levy will be allowed the same access to all health services,

“as is available to a permanent resident”.—[Official Report, 10/3/14; col. 1573.]

As the noble Lord, Lord Avebury, pointed out, Clause 33(4) states:

“In specifying the amount of a charge under subsection (3)(b) the Secretary of State must … have regard to the range of health services that are likely to be available free of charge to persons who have been given immigration permission”.

The Minister also said on Monday that when the Bill was initially implemented, it was the Government’s,

“clear policy intention that there will be no further charges for treatments”.—[Official Report, 10/3/14; col. 1572.]

But the Minister accepted that this policy stance was not in the Bill. He said that the Government,

“will clarify the position on implementation”.—[Official Report, 10/3/14; col. 1575.]

Frankly, the Government should be clarifying what their Bill means today. Will the Minister now indicate what the words,

“and different amounts may be specified for different purposes”,

are actually intended to mean, and will he give some concrete examples? What different amounts and for what different purposes do the Government have in mind? Is Clause 33(3)(b) simply some sort of ghost paragraph that the Government think may come in handy at some time in the future for purposes about which they are currently unclear? Can the Government’s present position on why and at what stage these words in the Bill will be applied best be summed up as, “Don’t know where, don’t know when”?

I hope that the Minister can today give us clear reasons—which is what the noble Lord, Lord Patel, asked him to do—as to why these words are needed in the Bill and clear up the confusion that I think a number of Members of the Committee, both those who intervened in the debate on Monday and those who subsequently read Hansard, feel exists at present.

--- Later in debate ---

[Baroness Lister of Burtersett]

Following what the noble Baroness, Lady Barker, said about the importance of the evidence base, I take us back to our debate on Monday. In that debate, a number of noble Lords questioned the evidence base for the claim that there is a problem of so-called health tourism in this country. They asked the Minister what the evidence base was for that claim and questioned the Department of Health’s report on it. The Minister had an awful lot of points to make in his summing up speech and, after about 30 minutes, he quite understandably thought that he had had enough and probably everyone else had, too. Although he has already helpfully circulated a letter following our first day, I could not see anything in it that responded to the concerns raised on all sides of the House. I use this opportunity to invite the Minister to respond on that this evening.

[Lord Leigh of Hurley]

Perhaps I should declare an interest as a chartered accountant. As such, I looked at Amendment 66F with care. I agree that it is important to have a proper review, analysis and evidence of real costs, but the trouble with the proposed new clause is that it asks for a calculation of the total charges paid, among other things, but it does not look for an assessment of the cost against those charges. For the proposed new clause to be meaningful and for the assessment of the health charge to be made, one would have to look at the costs incurred by the National Health Service for the £200 or £150.

[Baroness Barker]

As someone who is not a chartered accountant, I thank the noble Lord for the free advice. If I were to redraft the clause, I would include that in it.