My Lords, the economic and human rights issues raised by this important Bill have been effectively examined by noble Lords today. However, I and others well understand the Government’s need to find ways to reduce the impact of illegal migrants upon our hard-pressed health services and upon the British taxpayer. I also welcome the Government’s adjustments to the Bill following representations made over recent months. Particularly welcome are the exemptions for asylum seekers, refugees and victims of human trafficking.
Other noble Lords have spoken eloquently about the importance of perception and the need to avoid sending a message to the world that Britain is closed for business. I also want to refer to the powerful arguments against the creation of stateless persons; I simply endorse those contributions. I will touch only briefly on the provisions for private landlords and the NHS charging issue raised in Part 3. My aim is to raise a number of questions in the hope that the Minister can clarify the points raised before Committee, so that we might cut down some amendments that would be unnecessary in the debate at that point.
We need to understand the relationship between the existing system within the NHS to charge non-EU visitors to the UK for certain services and the combination of the proposed surcharge, payable before entry to Britain, with the plan to continue charging non-EU migrants for expensive health interventions. It seems that the Department of Health has been unable to assess fully the extent of the problem which these new provisions are designed to rectify. I recognise that a surcharge paid before entry to Britain is greatly preferable to charging people at the time of health treatment. If the surcharge were limited to short-term visitors and were the only charge, I would be inclined to support it. However, we know that the surcharge will apply much
more widely than current provisions for visitors, and that migrants will continue to be charged as well for expensive treatments.
It is important to know what the threshold is for those charges for expensive treatments. If the threshold is in fact low, we could end up with a health surcharge and extensive charging for individual treatments. This would have equity implications for migrants and a significant cost implication for the NHS in administering the charging system. Most importantly, it would continue the unfortunate introduction of questions about affordability just when the person is going in for treatment. Personally, I am rather hostile to the very idea of introducing financial issues of affordability at the time of treatment, which is why I rather favour the surcharge idea. I hope that the Minister can clarify to what extent these charges will exist within the health setting.
A second question is whether charging longer-term migrants who are in employment and paying taxes and national insurance is regarded as reasonable by the Government. It would be helpful to know their rationale for this proposal. Have they undertaken an impact assessment of it on the willingness of overseas employees to come to this country and take up jobs here?
A related issue concerns British citizens who work overseas for some years and then return to this country many years later to take up employment here. It had not occurred to me that this Bill could conceivably affect them, but others have raised the question and it would be good to have the Minister’s reassurance that British citizens in this situation will not be affected.
In relation to primary care, can the Minister clarify whether access for migrants to initial GP and nurse consultations will include the prescriptions that would arise from many of these consultations, or will the prescriptions be charged in full to patients? The same question applies to community care. If a migrant with a mental health problem cannot access community care because they cannot afford it at the primary care level, have the Government assessed the risk of these provisions increasing the costs of secondary services that would, I believe, be provided free of charge in emergencies to migrants? They should be, but there is undoubtedly a relationship between providing good services in primary care and so reducing the impact on secondary care costs.
I put on record my strong support for my noble friends Lord Hannay and Lord Bilimoria and others who argue that foreign students should be exempt from the Bill. As others have said, higher education is an important export industry for this country. Yet foreign student numbers are falling fast, as others have pointed out. The Government plan to exempt halls of residence: if there is a rationale for that, then surely there is a rationale for exempting all student lodgings, for example. It seems that the Government are shooting themselves in the foot on that one.
On the more general issue of plans to use landlords as unpaid immigration officers, I share the concern of my noble friend Lord Best that landlords are likely to avoid by a very wide berth the possible hassle and fee, or fine, involved in unwittingly failing to spot an illegal migrant. This proposal could have a serious impact
on the availability of private rented accommodation to all but the most obviously British of potential tenants.
The Government’s briefing indicates that the checks will be straightforward and quick for law-abiding landlords and tenants to comply with. Can the Minister clarify what is meant by “straightforward”? For example, if the landlord asked to see the prospective tenant’s passport, with a visa no doubt stamped inside, would that be sufficient to avoid future questions and investigations involving the landlord concerned? I hope that it would be.
The Minister referred to plans to protect vulnerable people. This is another area where I have to say that I am not convinced. Government briefing refers to “much simpler documentary requirements” for homeless and vulnerable people. The problem will surely be the absence of any documents in the possession of homeless people and of women fleeing domestic violence. I cannot imagine them having any bits of paper in their pocket in that situation.
Here we are assured that an e-mail Home Office service will provide the necessary information for some cases: if this has not been done within 48 hours the landlord can proceed and rent the property. For those with no documentary evidence we are told that there will be another option to obtain confirmation from the Home Office that the prospective tenant can rent a property, but no time limit is given for that process. Can the Minister explain the difference, again before Committee, because it really does not seem helpful? Some clarification at this early point could save the time of the House in Committee and I look forward to receiving the Minister’s information.
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