My noble friend is very prescient because I was just about to turn to Amendment 63. It is exceptionally difficult to prove that a migrant had a prior intention to use the NHS. Pregnant migrants would simply say that they fully intended to return home for the birth of their child. It would be difficult, if not impossible, for us to prove otherwise if they were a temporary migrant. This amendment would require GPs and hospital staff to act as immigration officers, and that is exactly what we are trying to avoid in setting this charge.
I have an answer here for my noble friend on victims of sexual assault. I have been speaking for 30 minutes, which is way beyond the conventions of the House, in answering these amendments. I am quite prepared to go on if noble Lords are prepared to do so. Other noble Lords are waiting to hear the Statement, and I have to crave their indulgence. If I skip any points, I will try to sweep them up by writing to all noble Lords who have spoken on this group of amendments, but there are an awful lot of points. I am literally but halfway through my speaking notes.
My noble friend asked about the operation of NHS charging regulations. Urgent treatment will always be provided no matter what the circumstances, and the Department of Health will still have the power to exempt treatments from charges. It is considering what exemptions for vulnerable groups are appropriate as part of its reform programme; there is no provision in the Bill.
My noble friend also asked whether women who have outstanding NHS debts will receive care. Women who pay the surcharge will not incur NHS debts. Where illegal immigrants or visitors incur debts, they will still receive treatment where it is immediately necessary or urgent. Their NHS debt for this treatment exceeding £1,000 will be taken into account by the Home Office when determining future immigration applications.
I reassure my noble friend Lady Tonge and the noble Baroness, Lady Finlay, that pregnant women in need of NHS care will receive it. Our intention is that surcharge payers will receive this care free of charge, at a fraction of the real cost of maternity services. Those who do not pay the surcharge, such as tourists and illegal migrants, who might otherwise be charged for maternity care, are also protected. Guidance to the NHS is explicit that, in order to protect the lives of both mother and unborn child, all maternity care, including routine antenatal care, must be provided to all women without delay caused by charging issues. I hope that I have made that clear in all the answers that I have given: the health of mother and child is paramount, regardless of the charging regime or the status of the mother.
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I want to address the point that the noble Baroness, Lady Smith, made about victims of domestic violence. The Government are quite clear that domestic violence is a terrible thing and are committed to combating it in all its forms. If an individual is the victim of domestic violence, they have full protection of the criminal and civil law and of the law enforcement
agencies, regardless of their immigration status. That is not in question. But that is not to say that all victims of domestic violence should expect that they can stay here in the UK. There is provision in the Immigration Rules to grant indefinite leave to remain to victims of domestic violence who are here as the partners of someone who is a British citizen or settled in the UK, or a Foreign or Commonwealth member of Her Majesty’s forces who would be able to become settled were it not for service in those forces.
The noble Earl, Lord Listowel, also asked about access to vulnerable people. On child immunisations, the Government are committed to protecting public health as a priority. The Department of Health has confirmed that existing exemptions from NHS overseas visitor charges will remain for treatment of specific infectious diseases; that includes HIV, for example. The Department of Health is considering which groups and treatments should be exempt from NHS overseas visitor charging as part of its wider reform programmes, and we will look at child immunisation in that way.