How much does "health tourism" actually cost the NHS?

Jeremy Hunt promises to end the "costly abuse" of the health service by foreigners, but just £12m or 0.01 per cent of the NHS budget was lost in 2011-12.

Based on the attention the government is devoting to the issue, you could be forgiven for believing that "health tourism" is a significant problem. Ahead of his speech on the subject on Wednesday, Jeremy Hunt has vowed to end the "costly abuse" of the NHS by foreigners, declaring that "by looking at the scale of the problem and at where and how improvements can be made we will help ensure the NHS remains sustainable for many years to come". In the speech, Hunt will announce plans to introduce a new tracking system linking a patient's NHS number to their immigration status and GP charges for those not entitled to free care. But how "costly" is this "abuse"?

In 2011-12, the NHS officially spent £33m on treating foreign nationals, £21m of which was recovered. This means that just £12m, or 0.01 per cent of the health service's £109bn annual budget, was lost to "health tourists". In March, when David Cameron raised the issue in his speech on immigration, Hunt claimed the true figure was £200m but produced no evidence to support his claim. But even if we accept the Health Secretary's estimate, this figure accounts for just 0.18 per cent of the NHS budget and that's before we take into account the savings made from British nationals using foreign health services and the administrative cost of the new "crackdown".

As ever when immigration is discussed, it's also important to remember that migrants contribute far more in taxes than they receive in benefits and services. An OECD study earlier this month found that they make a net contribution of 1.02 per cent of GDP or £16.3bn to the UK, largely because they are younger and more economically active than the population in general. As I've noted before, if David Cameron wants to reduce the national debt (and he hasn't had much luck so far), he needs more immigrants, not fewer. While zero net migration would cause the national debt to rise to more than 160 per cent of GDP by 2060-61, an open-door approach would see it fall to around 40 per cent from its current level of 75.2 per cent.

Health Secretary Jeremy Hunt speaks at the Conservative Party's annual Spring Forum on March 16, 2012 in London. Photograph: Getty Images.

George Eaton is political editor of the New Statesman.

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Labour's purge: how it works, and what it means

The total number of people removed will be small - but the rancour will linger. 

Labour has just kicked off its first big wave of expulsions, purging many voters from the party’s leadership rolls. Twitter is ablaze with activists who believe they have been kicked out because they are supporters of Jeremy Corbyn. There are, I'm told, more expulsions to come - what's going on?  Is Labour purging its rolls of Corbyn supporters?

The short answer is “No”.

If that opener feels familiar, it should: I wrote it last year, when the last set of purges kicked off, and may end up using it again next year. Labour has stringent rules about expressing support for other candidates and membership of other parties, which account for the bulk of the expulsions. It also has a code of conduct on abusive language which is also thinning the rolls, with supporters of both candidates being kicked off. 

Although the party is in significantly better financial shape than last year, it still is running a skeleton staff and is recovering from an expensive contest (in this case, to keep Britain in the European Union). The compliance unit itself remains small, so once again people from across the party staff have been dragooned in.

The process this year is pretty much the same: Labour party headquarters doesn’t have any bespoke software to match its voters against a long list of candidates in local elections, compiled last year and added to the list of candidates that stood against Labour in the 2016 local and devolved elections, plus a large backlog of complaints from activists.

It’s that backlog that is behind many of the highest-profile and most controversial examples. Last year, in one complaint that was not upheld, a local member was reported to the Compliance Unit for their failure to attend their local party’s annual barbecue. The mood in Labour, in the country and at Westminster, is significantly more bitter this summer than last and the complaints more personal. Ronnie Draper, the general secretary of the Bfawu, the bakers’ union, one of Corbyn’s biggest supporters in the trade union movement, has been expelled, reported for tweets which included the use of the word “traitors” to refer to Labour opponents of Corbyn.  Jon Will Chambers, former bag carrier to Stella Creasy, and a vocal Corbyn critic on Twitter, has been kicked out for using a “Theresa May” twibbon to indicate his preference for May over Andrea Leadsom, in contravention of the party’s rules.

Both activities breach the letter of the party’s rules although you can (and people will) make good arguments against empowering other people to comb through the social media profiles of their opponents for reasons to dob them in.  (In both cases, I wouldn’t be shocked if both complaints were struck down on appeal)

I would be frankly astonished if Corbyn’s margin of victory – or defeat, as unlikely as that remains in my view – isn’t significantly bigger than the number of people who are barred from voting, which will include supporters of both candidates, as well as a number of duplicates (some people who paid £25 were in fact members before the freeze date, others are affliated trade unionists, and so on). 

What is unarguably more significant, as one party staffer reflected is, “the complaints are nastier now [than last year]”. More and more of the messages to compliance are firmly in what you might call “the barbecue category” – they are obviously groundless and based on personal animosity. That doesn’t feel like the basis of a party that is ready to unite at any level. Publicly and privately, most people are still talking down the chances of a split. It may prove impossible to avoid.

Stephen Bush is special correspondent at the New Statesman. He usually writes about politics.