Controlling immigration: the snake oil of our time

Nigel Farage has rolled into a village with all sorts of problems and has offered an illogical but easy panacea. The problem comes when the other politicians try to "out-Farage" him.

Today, I watched as a monarch, wearing a crown encrusted with more than 3,000 precious gems, announced to a group of lords and bishops what “her” government’s plans for the Parliamentary session were and granted them God’s blessing. Later, in the ironically named House of Commons, the Eton-educated, millionaire grandson of a baronet, a direct descendent of King William IV and fifth cousin of the aforementioned monarch, gave further details. If this is a democracy, it is cleverly disguised on days like these.

Tightening control of immigration, as expected, occupied centre stage. Piecing together leaks, briefings and subsequent announcements, this appears to include restricting benefits and healthcare (presumably to address the relevant “tourisms”), access to driving licences, forcing landlords to check a tenant’s immigration status, ensuring surviving foreign spouses do not collect pension benefits to which equivalent British spouses would be entitled. In the analysis which followed, we were assured repeatedly that all this had nothing to do with the recent surge in Ukip’s popularity.

Do I have a problem with a bill designed to "ensure that this country attracts people who will contribute and deter those who will not"? Absolutely not. Similarly, I would have no problem, in principle, with a Bill designed to ensure that the eastern grey kangaroo ought to be a protected species in Hampshire. Is there any actual evidence that either is a real problem which merits legislative priority? Absolutely not.

Evidence from the DWP on the relative burden imposed by EU migrants on welfare is unequivocal: of the 1.8 million non-British EU citizens of working age living here, about 5% claim an "out of work benefit" compared with 13% for Britons. And what about other services? Unsurprisingly, since the majority of migrants are young healthy adults, research shows that they impose a disproportionately small burden on health and education.

All the much ballyhooed "health tourism" costs the NHS between £7m (according to the Health Minister) and £20m (according to the Prime Minister). How much money would you need for the administration of a system in which every doctor and nurse, in every practice and hospital, would be made to check the nationality and immigration status of every potential patient?

All in all, a comprehensive study of the last wave of migration from countries which acceded in 2004 demonstrates conclusively that year after year they contributed to the public purse roughly 30% more than they cost. In short, they are a huge asset. How is it, then, that we (I am one such migrant, albeit from a different era) find ourselves in the eye of a political storm and the target of sustained attack?

It would be facile to say that the answer is Nigel Farage. He has merely acted as the catalyst, by stepping into an emotional vacuum left by mainstream parties. The British economy is in deep distress and crying like a baby, not conscious of or unable to express the source of its discomfort. The other leaders were standing over the cot arguing about whether it is hungry or thirsty or teething or has colic. Farage has stepped into the nursery picked it up and put a dummy in its mouth. The dummy will do nothing to address the underlying problem, but it is comforting.

Like a Snake Oil salesman, he has rolled into a village with all sorts of problems and has offered an illogical but easy panacea. Unemployment? Lack of economic growth? Unfairness? Corruption? Arthritis? Unrequited love? Try some of this Bash-A-Foreigner ointment and everything will be dandy - or your money back.

The real problem arises when Cameron, who purports to be the village pharmacist, decides it is too difficult to disabuse people of this notion and easier to get into the Snake Oil racket. It legitimises the confidence trick and emboldens the charlatan. All Farage needs to do is make the - now legitimate - claim that he sells The Original Snake Oil. Avoid Imitations.

And the confidence trick is a rather gigantic one. The OECD says income inequality is growing in this country faster than any other rich nation in more than 40 years. The richest 300 people in the world possess more wealth than than the poorest three billion – the equivalent of the populations of the UK, the US, India, Brazil and China combined. The annual income of the 100 richest people could end global poverty four times over. Stocks in the UK and the US hit pre-crisis peaks, but nothing is “trickling down” and absolutely no action has been taken to avert another shock which will kick us like a FTSE in the Nasdaqs.

At a time like this, when we all sharpen our elbows and worry increasingly about securing a more equitable slice of the pie, a job which pays a living wage, care when we are old or sick or both, a safety net of kindness, an education and a future for our children, the idea that the people standing in our way are fictional Romanians and foreign widows is not only daft, but immensely dangerous. Roll up, roll up.

The Queen with an immigrant. Photo: Getty

Greek-born, Alex Andreou has a background in law and economics. He runs the Sturdy Beggars Theatre Company and blogs here You can find him on twitter @sturdyalex

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Testing migrant children’s teeth for their age is not only immoral – it doesn’t work

Ministers have flirted with this idea for over a decade. It’s bad policy, as well as poor ethics.

This week, the Home Office finally ruled out the use of x-rays to establish the age of childhood migrants.

It’s welcome news, but this story predates the dispersal of the Calais “Jungle” camp. 

For over ten years, ministers in Conservative and Labour governments have flirted with these tests. And it’s been up to us – the practitioners who’d be expected to administer them – to pick holes in a policy that’s a great way of securing headlines, but simply cannot deliver on the claims made by its cheerleaders.

It goes without saying dentists are health professionals, not border guards. But our objections run deeper than that. And it’s worth revisiting the arguments, just in case future governments start grasping for silver bullets.

It’s ineffective

We can talk about philosophy later, but let’s start with a pretty fundamental objection: dental x-rays are simply not a reliable way of establishing age.

No two mouths are alike. I’ll add my own to that list, as I still sport two of my baby teeth.

Children and young people mature at different rates, so the level of accuracy in these tests changes with time. And these x-rays can estimate age in younger children much more accurately than in adolescents. So as children mature at different rates, the potential margin of error gets ever larger with age.

For example, the third molars, commonly known as wisdom teeth – the last permanent teeth to develop – can form any time between the ages of 16 and 23, and a small proportion of individuals never develop third molars at all (I’ll have to pop my name to that list too).

A 2010 study of 300 young people aged between 11 and 25, whose age was determined based on dental x-rays, showed this method of testing consistently over- or under-estimated age, with a two-year average difference between dental and known age.

So if you are searching for a litmus test that will tell you whether a subject is 17 or 19 years old you won’t find it here.

It’s inappropriate

A few MPs and pundits have found it hard to acknowledge the codes health practitioners sign up to, which make this test a no go.

We must always act in the best interest of our patients when providing a medical procedure. And it is beyond question that the process of radiography is a medical procedure that should be carried out only for medical purposes, and where the patient stands to benefit.

Now many people might not consider this test an invasive procedure. However, x-rays do carry a small risk of possible long-term physical impact, and current best practice in this area dictates that exposure to radiation should be kept as low as reasonably possible over a lifetime. They should be carried out sparingly and where there is a well-defined potential clinical benefit, which must always outweigh the potential clinical harm.

As taking x-rays to determine the age of an individual carries no clinical benefit, it frankly isn’t appropriate to expose a patient to the potential clinical harm it can cause.

It’s unethical

Our lawmakers cannot simply dispense with fundamentals like consent to show they are “taking action”.

It is a legal principle that before practitioners carry out any medical procedure, the recipient – or someone who can consent on their behalf – must be given a full understanding of the nature of the procedure, its significance, impact and potential consequences before signing up to it.

For the children arriving from Calais, this would be a difficult task without English as a first language. Consent may also be required from a suitable adult. Yes, these children may be unaccompanied, but it does not mean the need for valid consent and protecting the child’s best interests can simply be ignored.

The letter of the law might be inconvenient, but it is a requirement that can only be compromised where the urgency and necessity of the circumstances demand rapid action in a patient’s best interests. And even in these circumstances the validity of treatment has sometimes ended up being challenged in the courts.

Given that taking x-rays in order to determine age is not medically justifiable in the first place, the urgency justification really doesn’t come into play. And that means dental colleagues – in the absence of valid consent – could find themselves performing an act that constitutes a criminal battery.


In the past, ministers have debated whether there is a credible “public interest” case that might override these little legal or philosophical objections. But these practical and ethical concerns can’t really be separated.

But why bother constructing a case for a test that frankly isn’t much cop? Dentists can only hope the latest message from the Home Office marks the beginning of a consensus, which draws a line under a decade of wishful thinking.

Judith Husband, Chair of the British Dental Association’s Education, Ethics and the Dental Team Working Group.