Stop distracting us with the 'health tourism' sideshow

Health Secretary Jeremy Hunt's plans to charge non-EU migrants 150% of the cost of NHS treatment are a sideshow that will do nothing to address the real challenges facing the NHS under his government.

Kailash Chand
15 July 2014

Jeremy Hunt’s announcement yesterday that he plans to charge non-EU patients 150% of the normal cost of NHS treatment is driven by UKIP politics. Under these plans, non-EU patients receiving a £100 procedure could get a bill of up to £150.This follows plans already unveiled to charge migrants a £200 per year "NHS" levy when they apply for a visa.

Of course, we must ensure that those seeking to access healthcare in the UK are eligible to do so. There is little doubt that the current system needs tightening up, but there is insufficient evidence that health tourism is genuinely consuming large amounts of NHS funding. Similarly, there is no significant data to support the suggestion that a substantial number of overseas visitors are coming to the UK specifically to seek out free treatment. 

Hunt commissioned research from two firms, Prederi and Creative Research, to come up with the £500m a year figure - but the companies themselves admitted this research was "based on incomplete data, sometimes of varying quality, and a large number of assumptions". Actual 'deliberate' health tourism was estimated by Prederi to cost between £20 and £100million - at most, 0.1% of the £100billion a year it costs to run the NHS.  As Jonathan Portes of the Institute of Economic Research has said, the extent of deliberate health tourism has been "hugely overstated" and is in fact a "very small part of NHS expenditure". 

And what of people who just happen to be here visiting or working from overseas when they get sick?

The NHS itself was developed with the help of immigrant workers and professionals from across the world. Thousands of doctors emigrated from India, Pakistan, Bangladesh and Sri Lanka during the 1950s, 1960s and 1970s, to work for a health service afflicted by an acute post-war shortage of medical staff.

In 1978, at the age of 25, I myself moved to England from Punjab, and I have worked for the NHS for 35 years. We know that, like me, 30% of NHS professionals were born overseas. Without them, the NHS would come to a standstill. Shortage of doctors and nurses is already having a huge impact on healthcare.

There are also wider risks. Timely treatment keeps people out of hospital, stops the spread of infectious disease such as tuberculosis, and ultimately saves money. Denying treatment to people who need it – including pregnant women, torture survivors, and those with communicable diseases – is inhumane, impractical and could result in further costs to the NHS should a patient's condition deteriorate.

The health secretary would be wise to concentrate on the major pressures on the NHS rather than being distracted by imposing an unworkable system of charging for health tourism. If this plan comes to fruition it will at best reduce the role of doctors to debt collectors. At worst it will deter them from registering migrants and asylum seekers as well as setting up a new system of charging that could be extended to others. Tampering with the core principle of the NHS , that it is free at the point of delivery, runs the risk of loading scarce resources on a minority issue, while the more meaty challenges remain unresolved.

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