Immigration (Health Charge) (Amendment) Order 2020 — House of Lords, 2020-09-23
Topic: Health
Susan Williams (Conservative, Centre-right): My Lords, I thank all noble Lords who contributed to what was quite a quick debate; nevertheless, they were thoughtful and insightful contributions. The health charge remains an attractive offer for migrants. It provides near comprehensive access to NHS services without further charge, regardless of the amount of care needed. It is not there to reduce migration, as the noble Lord, Lord Paddick, attests; moreover, it ensures that migrants do not need to worry about meeting the cost of unexpected treatment or arranging health insurance, which, for some people with health conditions, must be costly I turn to some of the specific issues that were raised. As set out in our manifesto, the Government believe that the health charge rate should broadly reflect the cost of treating those who pay it. However, the rates for students and those eligible for the youth mobility scheme will continue to be discounted. As I said, a new discounted rate for children will be introduced. The increased surcharge will continue to represent a very good deal for migrants who pay it, given the range of NHS services that can be accessed without further charge. The cost compares favourably to private medical insurance here and abroad, which is a common requirement for individuals wishing to migrate to many other countries We are really grateful to our essential workers and key workers who have performed such a public service throughout this pandemic, including emergency service workers, transport workers, teachers, delivery drivers, supermarket workers and many others. However, it is only fair to expect people arriving in the UK who work in non-healthcare roles to make a contribution to the full range of NHS services they can access from the point of arrival I will talk a bit about the reimbursement scheme, because the noble Lord, Lord Rosser, touched upon it. Tier 2 migrants who paid the health charge on or after 31 March 2020, but who would have qualified for the new health and care visa had it been in operation at this time, are being refunded. Migrants who work in the NHS and the wider health and care sector and who paid the charge on or after 31 March but who do not qualify for the health and care visa may be eligible for reimbursement of the charge. In July of this year, the Minister for Health announced that this scheme would be launched in October. As I said earlier, more details will be published by the Department of Health and Social Care shortly Volunteers have been raised today and previously, and we absolutely pay tribute to the contribution they make to our communities. The Department of Health and Social Care is considering who will be eligible to apply for the surcharge reimbursement scheme and will publish that information shortly On tier 2 refunds, tier 2 migrants and their dependants who paid the health surcharge on or after 31 March of this year are, as I said previously, being refunded. Those who believe they are eligible for a refund on this basis may contact the Home Office; the relevant contact details are available on the GOV.UK website The noble Lord, Lord Rosser, and others talked about the impact on families and young people and the total cost of the applications people are faced with paying. I am absolutely aware of concerns regarding the combined costs—I think the noble Lord, Lord Paddick, raised this—of both the health charge and the visa fees, and the impact that this might have on families and young people in particular. The Government are committed to ensuring that the surcharge remains affordable for family groups and intend to provide, through this draft order, a reduced surcharge rate for children. The Government are clear, however, that migrants must pay the charge when they make an immigration application and should plan their finances accordingly The noble Lord, Lord Rosser, talked about those in a vulnerable situation, perhaps facing destitution. There is a fee waiver in place for those making specified human rights applications who are destitute or at risk of imminent destitution. Where the fee is waived, the requirement to pay the health charge is accordingly waived also. If you can demonstrate that you do not have adequate accommodation or any means of obtaining it, or cannot meet other essential living needs, that would be considered destitution The noble Lord, Lord Paddick, asked what cut the Home Office takes of the £624. I do not know if the Home Office does take a cut; he is asserting that it does. I do not have the answer today, and I will find that out for him. However, as to how the Government estimate the cost to the NHS of treating the charge payers, that was produced by the Department of Health and Social Care. Not to buck-pass, but the cost was produced by the DHSC, based on analysis it carried out in April 2019 using—the noble Lord is absolutely right—2017-18 NHS England data. I do not know how that data differs from the following year, but I will find out, and therefore get a more up-to-date picture for the noble Lord. The small increase from the previous analysis was mainly driven by health inflation and updated data. Mindful of the need to ensure that the surcharge is not set above cost recovery, the Government have decided to set the surcharge at £624 per person per year The noble Lord, Lord Mann, asked about recharging. It is something that has exercised me in the past: we pay ever so much and we get so little back. I do not know what the up-to-date figures are—he tells me £49 million versus £600 million, which is quite a gap indeed—but clearly it is a matter for the NHS to collect the money. The noble Lord is nodding in an exasperated way—he knows that. If I can, I will get him more information on what the up-to-date figure might be The noble Lord, Lord Rosser, asked how we are targeting people affected by the change. We are looking to engage as many eligible people as possible through various means of communication The noble Lord, Lord Blunkett, talked about other people who may not be eligible but who have played their part in tackling the pandemic. While currently a subcategory of the tier 2 immigration route, the health and care visa offer will form part of the future skilled workers route. We intend to review the list of eligible occupations that can benefit from the offer to reflect the introduction of the expanded skills threshold, ensuring that those health and care professionals who meet the skills threshold can benefit from this offer I hope that I have answered all the questions. If I have not, I will follow up in writing.