ourNHS

Should you have to 'earn' your right to use the NHS?

More NHS migrant charging proposals, although migrants pay more than average tax already, set a divisive new trend.

Alex Langford
8 January 2014
migrant child healthcare_0.jpg

Image: VivrLatino

Migrants will be forced to pay additional charges for healthcare services including prescriptions and diabetic check-ups, under new government plans.

On top of having to pay £200 on entering the UK to maintain the decadent luxury of their own health, a new government report highlights how even after making that payment, non-EU migrants will be liable for a raft of extra charges.

Such news will be deflating, but not surprising, to healthcare professionals who have become accustomed to seeing their NHS undermined by painfully misguided politicians.

The policy lacks both common sense and kindness. It risks both money and something far more valuable - social cohesion in a time of difficulty.

With the incessant, deafening drone of media xenophobia, you’d be excused for not knowing the truth about migrants. They don’t cost us money, they make us money. They’re far less likely to be on benefits than their native British counterparts, and likely to be paying far more into the system in taxes than they take out by using public services. The very same report that the government uses to justify charging migrants notes that they account for 4.5% of our population but just 2% of our NHS spending.

In fact, of the £2 billion quoted by Jeremy Hunt as the amount health tourists cost the NHS every year, £1.4 billion pays for the care of non-permanent residents, who the report freely admits are most likely to be here to “work or study”. The majority of these people pay tax, the rest bolster the economy through tuition fees and injections of foreign currency. Only £70 million is truly spent on “health tourists” – just 0.06% of the annual NHS budget. To charge the majority of migrants, who pay their way like most Britons, for the culpable minority is at best unfair and at worst a sly and determined racism.

“But they’ve only been here 5 minutes!” is the common response from the misinformed observer. “They haven’t earned the right to use our NHS!”

That isn’t how our NHS works though, is it? No one should have to earn the right to health. The NHS doesn’t judge who is worthy of free medical care based on their prior contribution or future ability to contribute. Instead, the cost of experiencing the misfortune of experiencing ill health is shouldered by society. So many groups in society pay little or nothing into our NHS - severely disabled people, children, the long-term unwillingly unemployed – and we never question their entitlement to health.

There are bad apples in every barrel. Some migrants will not contribute to the degree we expect as a society. We should deal with such cases firmly, but the removal of their equal right to health is not a justified punishment for any crime. No one asks for British people who under-contribute to society to be charged extra for healthcare, however lazy, avoidant or criminal they become.

No-one suggests that migrants pay extra for the Fire Service in case their house catches fire, or for the Police in case they’re the victim of a crime. Yet those in power deem falling ill an acceptable reason to bill someone. I’m not the only one to be deeply worried that sneaking in NHS charges for migrants is the first step on a path to an Americanised system in which anyone who hasn’t contributed enough is charged.

The two-tier system this policy will create, in which migrants are made to pay extra for their health despite already having contributed more on average than British people, would create distrust and suspicion. It would drive a stake through our cohesion and togetherness, which is our most valuable tool in surviving economic hardship.

Even if there genuinely was money to “recoup” from sick people, it would take the design and implementation of a complex, dynamic computer system to process those “entitled” to health. We all know how well government-led NHS computer projects go – the last one cost £10 billion and didn’t see a single day of use. Now there’s a cost I’d like to recoup.

We rely on innumerable thousands of migrants who work for the NHS every day. It is they who are Sustaining Services, Ensuring Fairness, as the report is titled. Meanwhile the government proposes migrants continue to care for our sick, and pay tax for the privilege, but still have to pay extra to receive the same care if they fall ill themselves.

I do understand. At times of desperation, we search for scapegoats. We embark on witch hunts. But there are no witches here, just devious and divisive politics.

 

How do we work after coronavirus?

The pandemic has profoundly changed our working lives. Millions have lost their jobs; others have had no choice but to continue working at great risk to their health. Many more have shouldered extra unpaid labour such as childcare.

Work has also been redefined. Some workers are defined as 'essential' – but most of them are among the lowest-paid in our societies.

Could this be an opportunity?

Amid the crisis, there has been a rise in interest in radical ideas, from four-day weeks to universal basic income.

Join us on 5pm UK time on 20 August as we discuss whether the pandemic might finally be a moment for challenging our reliance on work.

In conversation:

Sarah Jaffe, journalist and author of 'Work Won't Love You Back: How Devotion to Our Jobs Keeps Us Exploited, Exhausted, and Alone', due to be published next year.

Amelia Horgan, academic and author of 'Lost in Work: Escaping Capitalism', also due to be published next year.

Chair: Alice Martin, advisory board member of Autonomy, a think tank dedicated to the future of work.

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