The Daily Mail could barely conceal its joy as Tory ministers spelled out new ways in which a re-elected Johnson government would “get tough on post Brexit migrants” – and jack up the “Immigration Health Surcharge” (HIS) from £400 to at least £625 per person.

This is just one of a “battery of measures” to delight the immigrant-hating Daily Mail, but of course it would be an additional deterrent to any potential health professionals who might consider coming to work for our NHS, including some of those who until the Brexit vote were coming in numbers from the EU:

“after Brexit, all foreign patients – including those from the EU – will have to pay a £625 fee, which is expected to raise an extra £500 million a year for the NHS.”

Half price visa

It was only a couple of weeks ago Johnson announced that health workers would be encouraged to come to Britain by a special half-price visa (although, as we explained in our last issue, for EU nationals it is not a halving of price, but a new imposition of a £464 fee).

The 50%-plus increase in the IHS, pushing the up-front cost of coming here to more than £1,000 in addition to regular taxes is an added deterrent, despite the desperate staffing shortages in the NHS.

Staffing crisis puts patients at risk

The latest increase in charges is the outcome of a relentless campaign by the Daily Mail and other right wing newspapers, which have peddled the myth of “health tourism”, and hugely inflated the costs of treating the small numbers of overseas visitors who make use of NHS treatment.

In October the Mail headlined a largely fictitious “calculation” by unnamed Department of Health bureaucrats, which claimed that the IHS had been set too low at £400 because “Each payer of the IHS ends up costing the NHS an average of £625 a year.”

In 2018 Immigration Minister Caroline Nokes claimed that the health department had been modelling the costs incurred by IHS payers and estimated it as averaging £470.

Now the Daily Mail is quoting new figures, allegedly “based on actual usage by IHS payers”, showing  that, on average, each IHS payer cost £631: “£88 in GP appointments, £35 in dental and eye care, £55 in prescriptions, £237 in hospital care including A&E, and £216 in other costs, including ambulance services, mental health and administration.”

The document containing these imaginary figures has of course not been published, nor has any explanation been offered of its completely implausible assumptions on the scale of use of the NHS by migrants.

Not only do migrant workers who pay the surcharge also pay the same level of  income tax and other taxes which fund the NHS, but there is evidence showing that migrants often use the NHS less than native populations:

“People who migrate tend to be younger and healthier than native populations. Older people and those with disabilities and severe illness are less likely to move, apart from in extreme circumstances. This underpins a longstanding epidemiological phenomenon, called the “healthy migrant effect”

The King’s Fund argues that “The average use of health services by immigrants and visitors appears to be lower than that of people born in the United Kingdom, which may be partly due to the fact immigrants and visitors are, on average, younger.”

Safe staffing: It’s not just about nurses and doctors

The Health Foundation points out that: “Migrants are good for the NHS. Existing evidence shows that immigration makes a positive contribution to the UK health service. Migrants contribute through tax, tend to use fewer health services compared to others, and provide vital services through working in the NHS.”

Sadly such evidence is unlikely to deter Tory ministers seeking votes by playing up the prejudices and ignorance of racists or the Daily Mail playing to its most xenophobic readers.

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John Lister
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