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.

Photo: Getty
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Jeremy Corbyn sat down on train he claimed was full, Virgin says

The train company has pushed back against a viral video starring the Labour leader, in which he sat on the floor.

Seats were available on the train where Jeremy Corbyn was filmed sitting on the floor, Virgin Trains has said.

On 16 August, a freelance film-maker who has been following the Labour leader released a video which showed Corbyn talking about the problems of overcrowded trains.

“This is a problem that many passengers face every day, commuters and long-distance travellers. Today this train is completely ram-packed,” he said. Is it fair that I should upgrade my ticket whilst others who might not be able to afford such a luxury should have to sit on the floor? It’s their money I would be spending after all.”

Commentators quickly pointed out that he would not have been able to claim for a first-class upgrade, as expenses rules only permit standard-class travel. Also, campaign expenses cannot be claimed back from the taxpayer. 

Today, Virgin Trains released footage of the Labour leader walking past empty unreserved seats to film his video, which took half an hour, before walking back to take another unreserved seat.

"CCTV footage taken from the train on August 11 shows Mr Corbyn and his team walked past empty, unreserved seats in coach H before walking through the rest of the train to the far end, where his team sat on the floor and started filming.

"The same footage then shows Mr Corbyn returning to coach H and taking a seat there, with the help of the onboard crew, around 45 minutes into the journey and over two hours before the train reached Newcastle.

"Mr Corbyn’s team carried out their filming around 30 minutes into the journey. There were also additional empty seats on the train (the 11am departure from King’s Cross) which appear from CCTV to have been reserved but not taken, so they were also available for other passengers to sit on."

A Virgin spokesperson commented: “We have to take issue with the idea that Mr Corbyn wasn’t able to be seated on the service, as this clearly wasn’t the case.

A spokesman for the Corbyn campaign told BuzzFeed News that the footage was a “lie”, and that Corbyn had given up his seat for a woman to take his place, and that “other people” had also sat in the aisles.

Owen Smith, Corbyn's leadership rival, tried a joke:

But a passenger on the train supported Corbyn's version of events.

Both Virgin Trains and the Corbyn campaign have been contacted for further comment.

UPDATE 17:07

A spokesperson for the Jeremy for Labour campaign commented:

“When Jeremy boarded the train he was unable to find unreserved seats, so he sat with other passengers in the corridor who were also unable to find a seat. 

"Later in the journey, seats became available after a family were upgraded to first class, and Jeremy and the team he was travelling with were offered the seats by a very helpful member of staff.

"Passengers across Britain will have been in similar situations on overcrowded, expensive trains. That is why our policy to bring the trains back into public ownership, as part of a plan to rebuild and transform Britain, is so popular with passengers and rail workers.”

A few testimonies from passengers who had their photos taken with Corbyn on the floor can be found here