Why Hunt's crackdown on "health tourism" could cost more than it saves

"Health tourism" currently costs £12m, just 0.01 per cent of the NHS budget. The new crackdown could cost far more.

Jeremy Hunt is spending this morning discussing the government's plan to charge non-EU migrants a fee of at least £200 a year to access the NHS. He said: "We need to ensure that those residing or visiting the UK are contributing to the system in the same way as British taxpayers, and ensure we do as much as possible to target illegal migration. We have been clear that we are a national health service - not an international health service - and I am determined to wipe out abuse in the system. The NHS is a national treasure and we need to work with the entire health system to develop plans and make sure it is sustainable for years to come." The government is also planning to end free access to GPs for those from outside the EU who stay for less than six months. 

For entirely political reasons (the rise of a certain europhobic party may have something to do with it), the problem of "health tourism" has been much exaggerated. 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. In March, when David Cameron raised the issue in his speech on immigration, Hunt claimed that 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".

On the Today programme this morning, Hunt chose not to use the £200m figure, instead conceding: "the truth is we don't know the number". He added: "if you take the lowest number, which is the £12m that we don't collect, that alone is around 2,000 hip operations". But could Hunt's plans end up costing more than they save? The chair of the Royal College of GPs, Clare Gerada, estimates that staff costs alone will amount to £500m, more than 40 times the £12m currently lost to "health tourism". Gerada also warned that immigrants with infectious conditions, such as TB, could end up "wandering around for fear of being charged" or going to more expensive emergency units, which could cost more. "We need to make sure that what comes out the other end is sensible, proportionate and fair and doesn't cost us all much more money and put us at much more risk than the current situation which is one that, even at the worst estimates, is a tiny proportion of NHS costs," she said.

Hunt insisted that the government's consultation would take all of these issues into account, but his clear inclination to impose new curbs on foreigners won't assuage fears that the Tories are once again putting politics before policy. 

Health Secretary Jeremy Hunt speaks at the Conservative conference in Manchester last year. Photograph: Getty Images.

George Eaton is political editor of the New Statesman.

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“Trembling, shaking / Oh, my heart is aching”: the EU out campaign song will give you chills

But not in a good way.

You know the story. Some old guys with vague dreams of empire want Britain to leave the European Union. They’ve been kicking up such a big fuss over the past few years that the government is letting the public decide.

And what is it that sways a largely politically indifferent electorate? Strikes hope in their hearts for a mildly less bureaucratic yet dangerously human rights-free future? An anthem, of course!

Originally by Carly You’re so Vain Simon, this is the song the Leave.EU campaign (Nigel Farage’s chosen group) has chosen. It is performed by the singer Antonia Suñer, for whom freedom from the technofederalists couldn’t come any suñer.

Here are the lyrics, of which your mole has done a close reading. But essentially it’s just nature imagery with fascist undertones and some heartburn.

"Let the river run

"Let all the dreamers

"Wake the nation.

"Come, the new Jerusalem."

Don’t use a river metaphor in anything political, unless you actively want to evoke Enoch Powell. Also, Jerusalem? That’s a bit... strong, isn’t it? Heavy connotations of being a little bit too Englandy.

"Silver cities rise,

"The morning lights,

"The streets that meet them,

"And sirens call them on

"With a song."

Sirens and streets. Doesn’t sound like a wholly un-authoritarian view of the UK’s EU-free future to me.

"It’s asking for the taking,

"Trembling, shaking,

"Oh, my heart is aching."

A reference to the elderly nature of many of the UK’s eurosceptics, perhaps?

"We’re coming to the edge,

"Running on the water,

"Coming through the fog,

"Your sons and daughters."

I feel like this is something to do with the hosepipe ban.

"We the great and small,

"Stand on a star,

"And blaze a trail of desire,

"Through the dark’ning dawn."

Everyone will have to speak this kind of English in the new Jerusalem, m'lady, oft with shorten’d words which will leave you feeling cringéd.

"It’s asking for the taking.

"Come run with me now,

"The sky is the colour of blue,

"You’ve never even seen,

"In the eyes of your lover."

I think this means: no one has ever loved anyone with the same colour eyes as the EU flag.

I'm a mole, innit.