Immigration Bill

Lord Winston Excerpts

Monday 10th February 2014 Lords Chamber

[Lord Patel (CB)]

My Lords, perhaps I may start by saying to the noble Viscount, Lord Eccles, that all Patels are brothers and sisters, and that they never do anything illegal knowingly.

To get back to more serious matters, I guess that the Minister must be heartened that we are nearly half way through.

[Lord Winston (Lab)]

We are not even half way.

[Lord Patel]

He will not have heard many supporters of this Bill and he is not likely to hear more. I will try not to repeat much that has already been said but I hope to add to it. Noble Lords must not misunderstand me: I feel strongly about the issues already raised, particularly those related to universities, students and health charges. I will also mention briefly the effect that the Bill may have on other vulnerable groups, particularly pregnant women and children.

I declare an interest: I am chancellor of the University of Dundee and, rather unusually, still hold a professorship at the same university in obstetrics. Fortunately, I have not been called on for any services to be delivered for a while.

As has already been mentioned, Universities UK, which represents vice-chancellors of bona fide universities—we are not talking about bogus universities which might be mentioned in the “Panorama” programme—feels strongly that a Bill that will,

“remove appeal rights for students and staff applying for further leave to remain … introduce a surcharge for access to NHS services … require private landlords to check the immigration status of their tenants … increase the scope for government to raise fees for visas and immigration services”,

is fundamentally flawed. It believes that,

“it would be in the wider interests of the UK to exempt international students from the effects of the Bill”.

I would add postgraduate students to that list.

It has already been mentioned that, according to government figures, international students in higher education contributed £10.2 billion to the UK economy. We have already heard that it has been recorded for the first time that there was a drop of about 1% in students in 2012-13. To give some more detailed figures, as regards the total entrants by subject from non-EU countries, in STEM subjects there was a drop in 2011-12 of 8% and a further 2% in 2012-13. These are official figures.

In some STEM subjects, for instance in veterinary science, there was a 22% drop; in medicine and dentistry, there was a 6% drop; and in computer science, there was an 11% drop. While the drop has not been as significant in some non-STEM subjects, a trend is beginning to show. It is even demonstrated in postgraduate students and, more importantly, it is now beginning to show in research students. What is fundamental is that the trend is downwards.

We have to ask why, when people like me once considered the United Kingdom to be the prime place to go for undergraduate and postgraduate education, they now are trying to go somewhere else. It is a compound effect of the visa restrictions, increased charges and now the other charges that this legislation would impose. Some 32% of post-docs are from non-EU countries. They often come with their families. This Bill will make it more expensive for them.

Much has already been said about students and I support all that, so I come now to Clauses 33 and 34, which relate to NHS charges. I fully accept that there is a need to protect the public purse by limiting access to healthcare in some circumstances and preventing the deliberate misuse of scarce resources. However, any measures we introduce should be practical, necessary, appropriate and, to borrow the words of the noble Baroness, Lady Smith of Basildon, evidence based. The Bill introduces a change to the residency criteria in Clause 34 so that eligibility for free NHS services is dependent on migrants having indefinite leave to remain. How many migrants who do not have indefinite leave to remain are working, paying tax and making national insurance contributions? Is it equitable that they should also pay the charges?

I am also concerned about the equity of these changes as there are significant variations in the time it takes for individuals to become eligible for indefinite leave to remain. The introduction of the health surcharge could also make the UK a less attractive destination for skilled workers from outside the EEA, particularly in shortage areas such as the National Health Service. Everybody here is familiar with the sight of lots of doctors and many more nurses from non-EU countries in our hospitals. They might have come here to train and remained here.

There are other issues too. The rationale given for the changes, in the impact assessment accompanying the Bill, is that the current arrangements are too generous and leave the NHS open to abuse. The Department of Health commissioned a two-phase independent audit of visitors and temporary migrants using the NHS. The Government brought in the legislation based on this. I am concerned that the Government’s proposals could create unintended drawbacks for the NHS and for patients in particular. The proposals are likely to create a complex patchwork of charging and access entitlements where some services, such as GP appointments, remain free while others, including A&E visits, will be charged for.

The Bill also introduces changes to residency criteria so that eligibility for free NHS services depends on migrants having indefinite leave to remain, as I already mentioned. However, a medical student who comes to the UK on a Tier 4 visa and remains on that visa for seven or eight years to finish the undergraduate course and then goes on to a Tier 2 visa because he needs postgraduate training would take 10 to 12 years to get indefinite leave to remain. Is that equitable? Why should he be penalised for 10 years?

I am also concerned that proposals for a health surcharge in Clause 33 risk having a negative impact on the UK’s attractiveness as a destination for skilled workers, particularly in shortage occupations where the economy cannot find sufficient workers either from the UK or the EEA workforce. In the UK, consultants in emergency medicine, haematology and old-age psychiatry are on the shortage occupation list. Non-consultants and non-training medical posts—most of the junior doctors you often see in the hospital—in anaesthesia, general medicine and psychiatry are also on the list. There are many more specialties now being added because of the shortage. The health surcharge, when combined with visa application fees and maintenance requirements, risks having an impact on the UK’s ability to attract high-quality migrants in medical jobs on the shortage occupation list. This could clearly have a negative impact on healthcare.

The Bill also includes provision for migrants who have paid the health surcharge to be able to access free NHS care to the same extent as a permanent resident. However, it also allows for exclusion from free access to be specified for particularly expensive discretionary treatments. It is not stated why, if the initial payment is considered to be fair, appropriate and comprehensive, there will also be discretionary payments for some high-risk conditions and the Bill does not state what they are. It gives the overall impression that, if you want to come to this country for study or work, it will cost you.

The issue of pregnant women was mentioned by the noble Lord, Lord Avebury. There are potential health impacts for pregnant women from Clauses 33 and 34. The proposed changes will deter some pregnant women from seeking and accessing maternity care. This will have a negative impact on the health of these women and their babies and perversely will lead to a need for more medical care at a greater cost. Charges at the point of care create risks that women will not present to the NHS, will present late in pregnancy or will be denied access because of their inability to pay. This prevents midwives and doctors from giving the appropriate health advice and treatment early in pregnancy. It cannot be right to include pregnant women.

The newspaper headlines say that the number of babies born to immigrant mothers is increasing, but the papers do not clearly define immigrant mothers. I guess anybody who is not white might be an immigrant mother. Anybody who might be white but is known to come from another European country will also be regarded as an immigrant. An exemption from NHS charges for all pregnant women and children is required in this Bill.

In short, I hope that we will see all students and postgraduates removed from this Bill before it becomes law and that NHS charges for pregnant women and children will also be removed. That is what I hope the Minister will accept and what I will be looking for in the amendments I will bring.

[Lord Winston]

My Lords, it is always a pleasure to speak after my noble friend Lord Patel. I just wish that I had his experience. However, I can declare a relevant interest. Apart from being an academic at Imperial College, where I hold a chair, I am also the chancellor of Sheffield Hallam University, I am on the council of Surrey University and I am chairman of the Royal College of Music. As far as I am aware, I have not delivered a baby at any of these institutions. However, I think that that broad experience is quite relevant to this debate, as is the fact that over the past three or so years I have probably spoken in about one-third of British universities and have met overseas students from every Russell group university.

Therefore, I think I can say with some assurance that I am a bit surprised at the Minister’s apparent complacency with his speech. He is widely respected in this House and his lovely manner belies what is a pretty cruel Bill, which is a very serious issue for us. One of the things the Minister said was that this Bill strikes the right balance. In my view, it clearly does not, as pretty well every speaker has said. Secondly, the Minister asserted that the figures for overseas students had held steady. That is not true. Admittedly the overall 1% fall is trivial and could be a statistical freak but there is plentiful evidence that numbers of the key students who we really need in this country are falling, particularly in the STEM subjects where there is the greatest contribution to our national economy and that of our universities. Thirdly, he said that the NHS contribution is designed as a fair contribution. It is not a fair contribution because most students who come to this country are young, fit people who will not require National Health Service treatment. When I was a post-doc, I went as a research fellow to Belgium. I took with me not only my long-suffering wife, who is sitting near the Chamber, but also my baby daughter. One of the assurances that I had when going on that year’s trip was the recognition that if my daughter fell ill she would have free treatment. In general, that is something that has been an important principle.

If the figures for coming into this country as an overseas student are indeed almost holding steady, that is because of the outstanding education students receive at British universities. It has nothing to do with easier access to the UK, which is the implication. The access is quite clearly not easy. It is complacent to suggest otherwise.

It worried me, too, when the noble Lord, Lord King, seemed to say that this Bill was partly needed to appease—and I am paraphrasing, so forgive me—public opinion. I do not think that we should be appeasing public opinion if it is the wrong legislation.

[Lord King of Bridgwater]

I did not say that and the noble Lord was embarrassed when he tried to say that I did. I was simply saying that it is no good for the country to feel that there is no concern about problems that are coming up over illegal immigration and abuse of the immigration system. It is our responsibility in Parliament to help command public confidence, otherwise we will face a much more serious situation in the future.

[Lord Winston]

I accept what the noble Lord said and I bow to his great experience as a previous Secretary of State. None the less, one of the issues, surely, is that we need to engage with the public so that they recognise what is good for the country and what is less good for the country. I fear that the Bill does not do that, which is a problem.

I do not want to repeat what the noble Lord, Lord Bilimoria, said in his outstanding speech, with all the figures that he gave, but the complacency is surprising. I know that it is out of order to show a document in the House, so I will not raise it to shoulder level. But a document from the Home Office, which is 167 pages thick, arrived this afternoon before the debate. There was no possibility of being able to absorb this information, which is so detailed, about why the Home Office justifies this legislation.

We should recognise that there is a deep-seated concern outside the United Kingdom about the way that students are greeted in this country. I say that as a regular visitor to Caltech, which is of course in California, and an irregular visitor to Harvard, Johns Hopkins University and the University of California, most recently. Invariably, in all the laboratories there are outstanding students—particularly Indian students—all of whom are convinced that we are not open for business. When we mentioned that to Home Office Ministers giving evidence to the Science and Technology Committee, it was consistently denied. It also transpired, when we asked the border control agency and the Home Office Ministers who were representing the Government at those inquiries, that none of them could give us clear figures about which students were going through customs, broken down into how many were from Russell group universities and how many were studying STEM subjects. That is a big deficiency because those are particularly the people we want to keep.

There is unquestionable evidence from students that they are concerned about the amount they pay for visas, and there is a suggestion that over the next 10 years that amount of money overall might raise around £700 million. Perhaps the Minister can correct me when he comes to reply. So £200 per annum for the National Health Service may not seem much to people like ourselves, who are, after all, well off. But let us cast our minds back to when we were students. Most of us did not actually have to pay fees. Students who are paying fees are looking for every single penny, no matter where they come from. The last thing they want to be is a burden on relatives or friends. If they can go somewhere where they will be less of a burden, they will undoubtedly increasingly choose those universities.

I want to tell the Minister what one of my students at Imperial College said: “Stop treating us like money machines”. That is a very real issue for our students. How is that £200 arrived at? What would it raise? How many students will use the NHS? Who will organise it through the NHS bureaucracy? What will be the cost to the NHS to make sure that this impost is paid? Lots of figures have been bandied around about how much extra those students from outside the EU bring in. It may be £7.9 billion or £11.3 billion, which is the biggest figure that I have seen. But even that does not take into account, for example, the entire intellectual property that is produced by overseas students. My colleague, Dr Carol Readhead and I have produced 25 patents and spun out a company at Imperial College. Most of the IPR was actually generated closely in conjunction with the university at Caltech, and without the patent lawyers in California I could not have established that company in London. That is an important point to be made.

Imperial College, like the Royal College of Music, is a good example of where it will be a colossal problem if the Bill goes through as it is. It is worth bearing in mind that 68.3% of Imperial College’s fee income comes from international students compared with 31% of the student body. We should look at those figures for a moment and understand what they mean. I hope particularly that our Liberal Democrat friends will recognise them when it comes to amendments. We have been left with a crashing problem with the rise in student fees. Frankly, international students are subsidising the education of British students to a real extent. At Imperial College, it will cost at least £30,000 to £35,000 for an engineering student and maybe more for a medical student. Of course, our students are paying £9,600. There is a real issue here about whether or not we maintain this as a business. If we threaten our universities, we risk serious damage. As it turns out, I am not particularly worried about Imperial College, but some other universities undoubtedly will have a massive problem.

I will finish because I have gone on for 10 minutes, which is longer than I intended. There is clear evidence that numbers are being reduced from some areas, particularly India, Nigeria, Japan and Turkey. We are talking a range of about 50% reductions from those countries. That is a real issue. Some 160 languages are spoken at Imperial College. The Royal College of Music is a much smaller place and 60 languages are spoken there. Those people have a huge and vital importance to Britain, not merely for its economy but for its future. We should be trying to encourage some of those scientists to stay in this country and support our economy in the future in all sorts of ways. At the moment, post-docs from my laboratory have left and gone—one to America recently and one to Asia. That is highly regrettable.