Oral Answers to Questions

Debate between Rachel Maclean and Stephen Timms

Monday 28th February 2022 Commons Chamber

[Rachel Maclean]

My colleague the Policing Minister will be speaking to that amendment later, and we will be consulting on this specific issue. However, I want to highlight that there are already offences on the statute book to tackle this particular abhorrent form of behaviour.

[Stephen Timms (East Ham) (Lab)]

14. If she will take steps to resolve the immigration status of overseas students who have been falsely accused of cheating in English language tests.

Adult Dependent Relative Visas

Debate between Rachel Maclean and Stephen Timms

Wednesday 3rd November 2021 Westminster Hall

[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.

[Stephen Timms]

The Minister makes the point that there is no evidence of doctors leaving the UK for this reason. We do know that 6,000 doctors left to go overseas in the five years between 2015 to 2020. She is right that we do not know the reason why they all left, but it is clear that at least hundreds went for this reason, and possibly more of those 6,000. Is she not concerned about that loss of skilled, committed doctors from the health service, at a time when—as the Chair of the Health and Social Care Committee, the right hon. Member for South West Surrey (Jeremy Hunt), pointed out at lunchtime today—there is a shortage in nearly every speciality?

[Rachel Maclean]

I thank the right hon. Gentleman for his point. He is right to ask the question. As I said earlier, we do not have verified evidence of those numbers, and nor do we have specific evidence pointing to this specific reason. There may be a number of reasons why people choose to leave and work in another country. Moreover, I point to the evidence in front of us about the people who are choosing to take up those skilled visas to come to this country, so these rules are clearly not a deterrent. I refer to my earlier remarks about the policy intention behind introducing these changes to the rules, which is to make sure that only those people who genuinely need to come here are covered by these rules, and therefore would be able to come here under the system that we have.

In conclusion, I recognise that this is an emotive subject, and I pay tribute to the right hon. Member for East Ham for the way in which he has articulated it. Of course, I and the Government want to support the NHS. We keep our policies under review, as I have said, and we have given considerable care and consideration to the factors that he has mentioned.

[Stephen Timms]

The Minister is being very generous with her time. She has made much of the cost issue; I think she indicated that for somebody elderly arriving in the UK, we would expect health and care costs of something like £175,000, but a GP has had £500,000 invested in them. I wonder whether an assessment has been made somewhere of the value for taxpayers—the straightforward financial cost—of forcing somebody who is highly trained out of the country, versus the cost of care for their elderly relative.

[Rachel Maclean]

I can reassure the right hon. Gentleman that the costs have been considered in the round, including the costs he refers to and others. In fact, those figures I quoted at the beginning of the remarks did not include care costs, which I am sure he will agree are significantly higher than the other figures I have referred to, which are purely for treatment and costs.

Motion lapsed (Standing Order No. 10(6)).