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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How Theresa May laid a trap for herself on the immigration target

When Home Secretary, she insisted on keeping foreign students in the figures – causing a headache for herself today.

When Home Secretary, Theresa May insisted that foreign students should continue to be counted in the overall immigration figures. Some cabinet colleagues, including then Business Secretary Vince Cable and Chancellor George Osborne wanted to reverse this. It was economically illiterate. Current ministers, like the Foreign Secretary Boris Johnson, Chancellor Philip Hammond and Home Secretary Amber Rudd, also want foreign students exempted from the total.

David Cameron’s government aimed to cut immigration figures – including overseas students in that aim meant trying to limit one of the UK’s crucial financial resources. They are worth £25bn to the UK economy, and their fees make up 14 per cent of total university income. And the impact is not just financial – welcoming foreign students is diplomatically and culturally key to Britain’s reputation and its relationship with the rest of the world too. Even more important now Brexit is on its way.

But they stayed in the figures – a situation that, along with counterproductive visa restrictions also introduced by May’s old department, put a lot of foreign students off studying here. For example, there has been a 44 per cent decrease in the number of Indian students coming to Britain to study in the last five years.

Now May’s stubbornness on the migration figures appears to have caught up with her. The Times has revealed that the Prime Minister is ready to “soften her longstanding opposition to taking foreign students out of immigration totals”. It reports that she will offer to change the way the numbers are calculated.

Why the u-turn? No 10 says the concession is to ensure the Higher and Research Bill, key university legislation, can pass due to a Lords amendment urging the government not to count students as “long-term migrants” for “public policy purposes”.

But it will also be a factor in May’s manifesto pledge (and continuation of Cameron’s promise) to cut immigration to the “tens of thousands”. Until today, ministers had been unclear about whether this would be in the manifesto.

Now her u-turn on student figures is being seized upon by opposition parties as “massaging” the migration figures to meet her target. An accusation for which May only has herself, and her steadfast politicising of immigration, to blame.

Anoosh Chakelian is senior writer at the New Statesman.

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