A new policy to regulate migrant access to the NHS has its stupidities, finds Richard Walsh
Welcome to the mad world of immigration policy and apologies for irony.
The Home Office is currently consulting on "Controlling Immigration - Regulating Migrant Access to Health Services in the UK".
At first glance it might appear that a whole new large market might arise for PMI because they propose to create a new residency test for access to NHS services.
Currently any person with a visa for more than 6 months gets free access to the NHS from the date they enter the UK.
The proposal is that "free" NHS services should only apply to those given indefinite leave to remain - a process which usually takes about five years to achieve. But what would this mean in practice?
The focus is on the ever diminishing number of scapegoats - migrants from outside the EU. Of course this doesn't include, for example, failed asylum seekers.
No we are going for workers and students who of course contribute nothing to the UK - apart from taxes, huge payments to Universities and a skilled workforce.
Ruled out is any re-negotiation of what people from the EU get - eg they could get the amount that their own state would have paid for treatment and be responsible for the rest. And there are a lot more of them.
The consultation looks at two options for attacking our small group of undeserving people. The first is a "migrant health levy" where all those without indefinite leave to remain in the UK would pay a levy to access all NHS services to cover the period of their leave.
The whole levy would be paid up-front, in the same way as an applicant pays a visa fee.
The money, of course, would go into the HMT pot and not to the NHS and would apply to high value people, skilled workers, students, entertainers, musicians, and family migrants. So how much would the fee be?
The Department of Health estimates that the full annual costs of healthcare average around £1,600 per person, and ranges from around £700 for those under 44 to over £6,000 for the very elderly.
One could see an average that might equate to a PMI policy but that is not what is proposed. Instead they propose a levy of £200/year ie £600 for a student on a three year course. Totally pointless.
Option two would be a requirement to have PMI. The requirement to hold health insurance is common practice in other EU countries.
The main advantages of a PMI based system are that it would give temporary migrants the freedom to choose the level of care they wanted and whether they wanted to be treated wholly privately or charged via the NHS and it could give some savings for the government.
The obvious way to do this would be to require the sponsoring employer or educational establishment to provide a guarantee that a migrant's healthcare is provided for.
For students, it could be added to their fee and given to a local clinical commissioning group and/or PMI provider. It could also form part of the responsibilities for employers, an approach that is currently taken in other countries.
Personally, I think the whole thing is a waste of time, will gain very little money and add to the desired objective of stopping the best people coming to the UK.
However if it has to go ahead, for political reasons, go for a PMI/NHS/employer/educational establishment partnership based on real cost.
Richard Waklsh is a director and fellow of SAMI Consulting www.samiconsulting.co.uk