What better way of diverting attention from the government’s failure to address NHS underfunding ahead of the autumn statement than to turn up the heat on immigrants? You know, those hordes of NHS-clogging health tourists who come over here, steal all the GP appointments and make you wait half the night in A&E. Makes you sick, doesn’t it? No wonder our poor NHS is struggling.
Except, as Chris Wormald – the Department of Health mandarin whose comments have dominated front pages – knows better than anyone, the cost of so-called health tourism is a drop in the ocean of NHS spending. An estimated £200m a year is spent treating people who have travelled to the UK with the deliberate intent of obtaining free healthcare to which they are not entitled. That’s a mere 0.3% of the overall NHS budget.
Wormald, addressing parliament’s public accounts committee, revealed government proposals to clamp down on “health tourism” by requiring all NHS patients to prove their identity with two forms of identification, including a passport, before being allowed to receive hospital treatment. It is difficult to believe that the department’s most senior civil servant made his remarks – on the eve of Philip Hammond’s first autumn statement – in all innocence of their likely media impact, and without the blessing of his political masters. He even told MPs: “It is quite a controversial thing to do, to say to the entire population: you’ve got to prove your identity.”
I’ll say. The UK has a long and grubby history of politicians and newspaper editors exploiting Britons’ love of the NHS to indulge in migrant-bashing; and it is something I, as an NHS doctor, am heartily sick of. I am a clinician, not an immigration officer. My job is to care for my patients irrespective of their race, religion, sexuality or nationality.
This is not starry-eyed naivety. I know better than most what a “health tourist” looks like because they are, on occasion, my patients. One, a young woman, was brought by her parents to my hospital from a country in sub-Saharan Africa where her rare auto-immune disease had gone undiagnosed and untreated. She arrived paralysed, mute and covered in sores. She left healed, whole and independent.
Yes, she cost the NHS tens of thousands of pounds. Indeed, you might claim her parents “took the NHS for a ride”. But, in a cradle-to-grave health service founded on tolerance, humanity and inclusivity, I will continue to treat my patients according to need not insinuation.
It’s not that I object to the policy per se, but to its exploitation for political ends. The truth is, the timing of this announcement is straight out of the Trump school of media management – using migrants as collateral damage to cover for the real reasons why the NHS is in crisis. If fiscal responsibility was really the issue here, why is the government not flexing its muscles with forgetful pensioners? After all, the NHS loses more money on missed GP appointments than it does on health tourism. Similarly, the NHS spends £200m a year more on stationery than it does on health tourism – but waging war against feckless pencils just doesn’t quite have the same resonance with the Ukip contingent.
Exploiting anti-immigrant feeling to distract the public from the catastrophic impact on the NHS of this government’s year-on-year underfunding is as irresponsible as it is cynical, potentially fuelling a narrative that stokes anger and hostility towards non-British nationals. Only this week the Daily Mail blamed dangerously long ambulance waits on the unprecedented demands from “migration, the ageing population and patients dialling 999 as they cannot reach their GP”, claiming: “Some paramedics have also reported pressure from migrants who either do not register with a surgery or do not know where to find a walk-in centre.”
In fact, as anyone who works on the NHS frontline is bitterly aware, it isn’t “health tourists” but the government’s £22bn of cuts during this parliament that is decimating our ability to deliver safe, quality care. Our wards are missing doctors and nurses: we’ve never known such a dangerous mismatch between our numbers and those of our patients. This year, whole emergency, paediatric and obstetric departments have closed because of a lack of medics. Now entire hospitals are slated for closure up and down the country.
In this context, it is disingenuous for Wormald to intimate that, alongside migrants, NHS staff like me might be part of the funding problem, with our lackadaisical attitudes towards squandering taxpayers’ money on treating any old Tom, Dick and Harry: “We are not here to criticise NHS frontline staff,” he said, “but what we want is a culture of everybody who works in it to understand financial rigour. We need a culture where we are more careful with the tax pound.”
Perhaps. But from my frontline staff perspective, what patients need more than anything is a culture of candour from the NHS’s political custodians. The longer they deny – or distract from – their dangerous and draconian cost-cutting, the more fearful for our patients my colleagues and I become.