Healthcare (International Arrangements) Bill — House of Lords, 2019-02-05
Topic: Health
Roualeyn Hovell-Thurlow-Cumming-Bruce (Crossbench, Unknown): I thank the noble Lord for his clarity Health tourists are a different category. The BMJ reported 18 months ago that in the year before, some 50% of births at a particular London hospital were to mothers not entitled to NHS services. I realise that this is a completely different category, but health tourism is something we are all aware of. The estimates I have read of the cost of this to the NHS vary from £300 million to £500 million; a senior doctor at a London hospital estimates that the figure is well over £1 billion. There appears to be a well-organised shuttle service of sorts from west Africa, giving access to those who can afford the service, no doubt for a great price. Are our doors really that wide open to this abuse of taxpayers’ money Why my interest? I am not a ranting, Brexiteering, screaming far-right nationalist, I promise you. I am doing this as a taxpayer and we, the legislature, owe a duty of care to all British taxpayers and citizens. The Second Reading is the first opportunity for us to debate the key principles, the main purpose of the Bill and to flag up concerns. To read that the cost of the mix of inefficiency and fraud may cost the NHS only £300 million or £500 million is insulting. Just try getting that out of the Treasury for your next worthy project. Does the Inland Revenue stop chasing us when it gets down to the last £300 million? We are all taxpayers, all paying for this shortfall. In 2014, the visitor and migrant NHS cost recovery programme was, I believe, implemented. It sought a target, for some reason, of £500 million per annum. To do this it wanted to improve existing charging systems, laying a health surcharge on non-EU citizens. This Bill provides an opportunity to readdress this programme and so support the principle of fairness by ensuring that those not entitled through treaties pay for their care. It requires that the particulars of NHS access entitlement must be made completely clear to foreigners as they arrive in the UK, in order to avoid confusion for both patients and service providers In our great liberal democracy I could easily be perceived as a bogeyman or pariah—no one else has raised these points before in this debate. Please do not do that. It is taxpayers’ money; it is hard cash. We have a duty, as I have said, to stamp out abuse. Please do not turn a blind eye to this shameful state of affairs. The UK is not a rich country at the moment. We are doing our best to recover from the great recession of 2008 to 2012. We had austerity—closing rural schools and closing or reducing hundreds of other public services. Yet we appear to waste hundreds of millions of pounds because this is in the "too difficult" category. At the least, we could let DfID pay for the illegal health tourists through the aid budget. After all, it is foreign aid We must create an effective system to record the origin of unentitled users of the NHS, and allow for the accurate reconciliation of costs as the system is set up to do. To stop health tourism, users must pay. It is not a job for medical practitioners, but we have hospitals staffed by highly paid administrators. If remedied, hundreds of millions of pounds could be added to the funding of the NHS. Why is cost recovery not more effective and what, if anything, is being done to radically overhaul the system which allows this shameful waste of taxpayers’ money?