Adult Dependent Relative Visas

Debate between Rachel Maclean and Ben Lake

Wednesday 3rd November 2021 Westminster Hall

[Rachel Maclean]

Yes, I fully understand the hon. Gentleman’s point, but the Government’s duty is to formulate rules that are fair to the British taxpayer and the NHS, and that ensure a fair system. I will come on to the specific issues about the health service to which the right hon. Member for East Ham alluded, but it is vital that our immigration policies do not place an unfair burden on the taxpayer.

We want to ensure that people here legally are welcomed and celebrated—which we do in this country—as part of a fair and sustainable immigration system. All family migration to the UK, including that of adult dependent relatives, must be on a properly sustainable basis that is fair to both migrants and the wider community.

Our position on adult dependent relatives remains that we have rules in place to support those who are most in need, but we are clear that the rules cannot provide a route for every parent to join their adult child in the UK and to settle here. It is simply not sustainable for the economy or the health service for there to be a routine expectation of settlement in the UK for parents and grandparents aged 65 or over. Therefore, only those who require long-term care that cannot be delivered in the country in which they live should be eligible to settle here.

We fully understand that such cases provoke strong feelings, as Members have articulated, and they can result in difficult choices for individuals, but it is essential that the rules are fair and balanced for the taxpayer, given the significant NHS and social care cost that can arise when those adult dependent relatives settle in the UK. Failure to maintain that balance puts the legitimacy of the entire system at risk.

I now turn to the issue of the NHS. Of course, we are hugely grateful for the vital contributions of all NHS staff, in particular during the pandemic. The Government have no intention whatever of punishing that group. By contrast, we have introduced a range of unprecedented measures to ensure that the health and care sector is supported fully. However, it is only fair that I address the points that have been made.

The impact of medical professionals potentially leaving the NHS was an issue that was raised five years ago and considered as part of the Home Office review of the adult dependent relative rules published in December 2016. That report considered the number of NHS staff who support adult dependent relatives overseas. It is likely to be a small proportion of the total population of professionally qualified clinical staff.

Furthermore, there is no evidence to show that significant numbers of medical professionals have left or been deterred from applying to work in the UK since the revised rules were implemented. It was concluded that, while some who might sponsor someone to come to the UK might choose to leave as a result of the revised rules, including some in skilled employment, the impact remains proportionate to the policy aim.

The latest figures show a 19% increase in skilled worker visas in the year ending June 2021, and that the majority of that increase was due to the new health and care worker visa, which saw 45,722 grants, accounting for 44% of the total skilled worker visas granted. In fact, such was the demand of overseas doctors and nurses wanting to work in the UK, in 2018 the Government lifted the cap on doctors and nurses. The Health Secretary at the time said:

“Overseas staff have been a vital part of our NHS since its creation 70 years ago. Today’s news sends a clear message to nurses and doctors from around the world that the NHS welcomes and values their skills and dedication.”

As I said, there is no evidence that significant numbers of professionals have been deterred from applying to work in the UK since the new adult dependent relative rules were implemented, and nor is there evidence to show that professionals have left the UK.

The NHS has made significant savings since the rules were introduced. The 2016 report notes that once assumptions were taken into account, the figures suggested potential NHS savings of around £249 million over 10 years. This policy will be kept under review. We are of course sympathetic about the impacts on individuals and families, but the policy must apply fairly across our society. It would not be right to provide a more generous approach for healthcare professionals than for other groups.

[Ben Lake]

Just to elaborate and perhaps add to the considerations, there is of course an impact on the family, but there is also an impact on the community. In many rural areas, such as mine, if we lose a solitary GP, who has to go back, we will not have a GP practice for a very large area, so there is that wider impact too. We should bear in mind that even though it may be an individual example, it has quite a widespread impact.

[Rachel Maclean]

Of course, I recognise the impacts of the issues highlighted by the hon. Gentleman. On the point made by the right hon. Member for East Ham, that we have not considered other ways to avoid the burden on the NHS and local authorities, making comparisons with other countries and their systems, I advise him that we did consider other ways. The Home Office published a review of the adult dependent relatives rules in December 2016. As I said, we continue to keep that under review. The report is published on gov.uk, so I encourage him to look at that.

As part of the review, specific considerations were given to alternative methods of achieving the main aim, which is reducing the burden on the taxpayer and NHS costs. Those alternatives were mandatory medical and care insurance, amendments to the immigration health surcharge and a bond scheme, requiring up-front payment, which would be offset against the cost of any later NHS care. Particular consideration was given to how far each of those would achieve the policy intention, be feasible to administer, and continue to allow an adult dependent relative, with significant long-term personal care needs that could not be met in their home country, to join their relative.

Those options were considered to place a potentially unreasonable administrative burden on the NHS, while also raising significant concerns over affordability and discrimination. For example, mandatory private healthcare insurance was considered likely to be prohibitively expensive, especially if it was to cover NHS emergency treatment and/or social care and residential care. It would also benefit only those applicants whose sponsor had substantial means. Those without a close relative with such means would be excluded from the UK, even if they required long-term personal care that could only be provided by their relative here. There is also no guarantee that insurance taken at the date of application would not be later cancelled or not renewed, including in circumstances outside that person’s control, such as a significant deterioration in their health or a change in the financial circumstances of their sponsor making the insurance unavailable or the premiums unaffordable.

Any alternative scheme requiring an up-front payment of many thousands of pounds would, by definition, exclude those cases unable to pay it, regardless of the level of their personal care needs. Similarly, in the light of the estimates I mentioned earlier—that a person aged 65 to 74 costs the NHS £2,287 per year—such a scheme for adult dependents would likely need to be set at significantly more than its current level. That is why it was concluded that the revised rules were set at the right level to provide immediate settled status in the UK and free access to the NHS to those relatives whose care needs could not be met in their home country, while protecting the NHS and the tax burden.

Covid-19: Extension of Driving Theory Test Certificates

Debate between Rachel Maclean and Ben Lake

Thursday 28th January 2021 Commons Chamber

[Rachel Maclean]

The hon. Gentleman temps me into a broad discussion that it would not be appropriate for me to undertake at this point, because we are discussing the particular issue of extending the theory test. I want to do full justice to this issue, and I will answer the questions that he has asked.

As I was saying, learner drivers will have had their practice sessions significantly curtailed. It is vital that we ensure that new drivers have current relevant knowledge and skills—that is a vital part of the preparation of new drivers, who are disproportionately represented in casualty statistics. That is an important point and one relevant to the point the hon. Gentleman just made. A 2008 study by the Transport Research Laboratory indicated that one in five new drivers had a collision within their first year of driving unsupervised. I am sure the hon. Gentleman would agree that that is a high proportion. The Transport Research Laboratory also found that the hazard perception test is linked to a measurable reduction in some accidents. Those with higher scores on the test have safer records as new drivers.

The DVSA has not stood still on this issue: following a series of improvements to the learning and testing process, a 2017 revaluation found that only one in 11 new drivers had a collision within the first six months. Although that is a significant improvement, we cannot afford to be complacent about road safety and the risks to new drivers.

There will be those who ask—the hon. Gentleman made this argument powerfully—why the theory test expiry date cannot be extended in the same way as MOT certificates were extended during the first lockdown. The hon. Gentleman asked me to address this point, suggesting that it is a quick fix. Unfortunately, driver theory testing and MOT testing represent different issues in terms of the underlying legislation, road safety risk and potential risk of covid-19 transmission. For that reason, they cannot be directly compared.

The hon. Gentleman also asked me specifically why, if the Government of Northern Ireland have made the decision, we cannot do the same thing. We have, of course, looked at the matter and considered it as part of our deliberations, but ultimately such matters are devolved to the Government of Northern Ireland and it is rightly a decision for them.

As the hon. Gentleman will know, the MOT due dates for cars, motorcycles and light vans were automatically extended by six months from 30 March 2020 to help prevent the spread of covid-19. Drivers at that time, however, were advised that all vehicles must continue to be properly maintained and kept in a roadworthy condition.

The DVSA’s focus should rightly be on developing solutions to address the availability of theory tests and the backlog of practical driving tests that has arisen as a result of the pandemic. I am aware of proposals to allow approved driving instructors to sign off their learner and issue driving test pass certificates. Unfortunately, that is not possible. The Motor Vehicles (Driving Licences) Regulations 1999 require driving test examiners to pass an examination before being authorised by the Secretary of State to conduct practical driving tests. The Road Traffic Act 1988 allows a full driving licence to be issued only if the person has passed the test of competence to drive.

To increase the availability of theory tests, which I know the hon. Gentleman is concerned about, the DVSA has extended theory test centre opening times where possible and extended the booking window from three months to four months to give candidates more choice of available dates.

[Ben Lake (Ceredigion) (PC)]

On the point about increasing the availability of theory tests in future to deal with the anticipated backlog, will the Minister consider, certainly in some rural areas such as Ceredigion, looking at introducing perhaps even temporary theory centres? At the moment, if somebody lives in Lampeter, not only did they lose the practical test centre two years ago, but they face a 50-mile round trip to attend the theory test centre. Will she consider that?

[Rachel Maclean]

I assure the hon. Gentleman that we want to ensure that theory tests are available to all candidates. I will certainly consider the matter that he raised and discuss it with my honourable colleague in the other place.

I assure hon. Members that once testing can resume safely, the DVSA will continue to work closely with Pearson, the provider, to monitor demand and explore ways in which it can further expand testing capacity and reduce waiting times. We are very focused on social distancing at those test centre sites, the wearing of face coverings and using physical screens between test booths.