Immigration (Health Charge) (Amendment) Order 2020

Lord Mann Excerpts

Wednesday 23rd September 2020 Lords Chamber

[Lord Mann (Non-Afl)]

My Lords, I welcome the Government’s proposal, which seems sensible and appropriate. It has always been rather baffling that our welfare system is based on the principle of contribution and that our NHS is not in a position to get full and fair funding from all sources—particularly from those coming to this country from abroad. Having looked at the systems in Germany, France and Switzerland, for example, I can see that they are very different because they have that principle built in. Of course, they benefit from having ID cards. If Parliament had listened to the noble Lord, Lord Blunkett, when he was Home Secretary, that sensible proposal might have made it much easier at an earlier time. Indeed, some of our history might have been rather different if we had brought in identity cards.

One reason why identity cards would have been helpful is this. I uncovered some data from 2016; I have not seen it openly published since, although I am sure that it has been published somewhere. When I uncovered the figures, I found them quite extraordinary. They showed the differential between this country and other countries in terms of recharging for healthcare; that is, not recharging the individual, but for those European countries with which we have reciprocal agreements, we were recharging the sum of £49 million for their citizens to use our NHS, whereas through the British Government the British taxpayer was being charged—directly to the Government, not to individuals —£651 million. The deficit with Ireland was more than £200 million, while the figure for Spain, where there appears to be a significant number of British citizens who are often elderly and therefore use the Spanish healthcare system, was also a deficit. In other words, with all the Brits living in Spain and using the health service there, we were still in a deficit situation.

The Minster may not be able to do so at the moment but it would be useful for him to state afterwards in writing what the current situation is. There is no reason why our NHS should not be recouping those sums; they do not come from the individual but from the Government. Some £600 million a year, broken down into individual hospitals, is pretty much what the NHS deficit was running at until the current crisis. All that would be required is the presentation of some form of identity including nationality for that automatic process to be easily followed. A cultural barrier is holding this back, which is also why I am so supportive of this contributory initiative, of which the Attlee Government would have been proud and probably should have thought of at the time.

Let us have fairness in the system. It would be helpful if the Minister could take this issue back to her ministerial colleagues to ensure that we are charging back foreign Governments, not individuals, for their health treatment here. If not, perhaps there should be an explanation of where weaknesses in the system remain, so that some of us can pursue them with vigour.