There has been much deliberate confusion in the media between “health tourism” – the legitimate two-way traffic that provides a net income for the NHS – and the supposed cost to the NHS of long-term or short-term immigration. The attractions of making immigrants the political scapegoats for an underfunded NHS battered by privatisation is easy to see. The National Health Action Party, coming from the heart of the NHS, and dedicated to its survival, proceeds on the basis of the evidence.
The NHA Party doesn't believe “immigrant” is a dirty word – how could it? More than a third of registered doctors completed their primary medical qualification outside the UK. And past migration of tens of thousands of health professionals has been key to building the NHS and maintaining services ever since its foundation in 1948. Many second- and third-generation migrants are also second- and third-generation NHS workers.
Most temporary migrants who come to Britain specifically for healthcare are not a burden on the NHS. When schoolgirl Nobel Prize winner Malala Yousafzai was brought to the Queen Elizabeth Hospital in Birmingham for world-class specialist treatment after being shot in the head, the Pakistani government paid all transport, migration, medical, accommodation and subsistence costs for her and her party. Just as the NHS may, in appropriate circumstances, foot the bill for specialist care abroad when it is not available here.
It is undeniable that some people do come from overseas just to get receive free healthcare and we do not deny it. But the real cost of “health tourism” – in the sense of people who have travelled to the UK for the sole purpose of getting free healthcare to which they are not entitled – is actually only about £20m to £100m, according to the Department of Health. Nowhere near the UKIP claim of £2bn - and less than the estimated cost of policing anyone who looks or sounds as if they may have come from abroad. What's more, twice as many foreign visitors pay to use the NHS as exploit free health care, and the cost of treating British people who become ill while travelling in Europe is actually five times higher than the cost of treating ill visitors from other European countries in the UK.
EU migrants who come here are overwhelmingly young, healthy, tax-paying workers, and therefore pay far more in to the NHS than they will ever take out – unless they choose to settle here permanently, in which they will present the same profit and loss account as the rest of us. For most migrants though, as for the British who choose to work abroad, a few years working in another country is just a prelude to returning home.
Inevitably, though, some EU migrants will need the NHS while they are here. Therefore -
- Greater efforts should be made to recoup money payable to the NHS from other member states under the EU's reciprocal agreement on health care abroad through the use of a European Health Insurance Card (EHIC).
There is reliable evidence that migrants from the EU have contributed £20 billion to the UK economy and do not, overall, reduce employment opportunities for British-born workers. That said, we recognise that successive governments have done little to alleviate the extra pressures that migration to specific areas can place on local communities in terms of health care, education, housing and employment. Therefore -
- We want government to use the “migration bounty” wisely in localities to accommodate migrants and to encourage integration and a cohesive community.
The cost of nationwide policing to weed out the occasional chancer outweighs any possible saving. Therefore -
- We oppose NHS staff being instructed to refuse treatment to “ineligible” foreign patients seeking medical treatment.
But there are also two vital principles at stake: one moral and one scientific. First, NHS staff have a duty of care to all people seeking healthcare, and should not be required to turn people away when they are at their most vulnerable. And, second, they cannot fulfil their duty to protect the public’s health if anyone is deterred from seeking prompt treatment for illness or infection by hostile questioning. In countries where healthcare is not free at the point of need, we see that not treating those who can't afford to pay generates a much bigger cost – both in money and lives lost – in the wider society. We cannot afford to sacrifice good medical practice for headline-grabbing political posturing.