Why Tories ought to hate the immigrant health tax

Another week, another bad week to be an immigrant in the UK. With the addition of this so-called preventative measure against "health tourism", the government has put a huge sign on the door of Britain saying foreigners aren't welcome.

This week's knee-jerk policy to appease our grandparents is a £200 a year added to the cost of non-EU migrants visas to cover the costs of their healthcare when inside the UK. Jeremy Hunt, the Tory Minister responsible for the bill, claims this will prevent an epidemic of "health tourism". You'd think Hunt would be more sympathetic to the plight of foreigners likely to need medical care, given his well known love of Australian octogenarian visitors.

That's one of the many ironies of the policy, of course. While it's designed and marketed as dealing with some kind of incredibly rare edge case - someone like Bimbo Ayelebola, the Nigerian single mum of quintuplets, the bulk of the people who will end up paying it are the New York lawyer, the Australian student, the Indian entrepreneur - the kind of immigrants who in theory, we want. As usual with this sort of measure, the largely imaginary people it's designed to stop either won't pay it, or will pay the small levy and be health tourists anyway  - £200 looks pretty cheap compared to the average hospital bill.

It also doesn't do anything to stop the kind of low skilled migration that does apparently worry people on doorsteps and keeps Nigel Farage on Question Time, because a huge amount of that sort of migration comes through the EU, or is illegal anyway.

I mean, obviously, the policy is incredibly stupid on its own terms, even before you go into the maths - in 2011-2012 the NHS spent £33m on treating foreign nationals, of which around £21m was recovered (through directly charging them or via health insurance). The remaining £12m as a proportion of the £109bn NHS budget is almost negligible. It will be interesting to see how this ahem, "giant" £12m subsidy to foreigners can be reconciled with the costs of administering it, not to mention the added costs of untreated foreign nationals walking around with potentially infectious diseases. Still, I suppose Jeremy Hunt can avoid getting TB by hiding in a bush. Of course, it could be designed as a revenue raising exercise in the first place, as there are as many as five million people living here who it will affect.

Earning an extra £200 per person probably sounds pretty tempting, and in theory, it'll pull support from UKIP, and that is probably what motivated the announcement in the first place. My question is, why should these people pay extra? The most ludicrous part of this whole package of measures is that it's predicated on the notion that these foreigners aren't paying their way. Of course, the vast bulk of non-EU foreigners who live in the UK are here on work visas - so they of course pay tax, national insurance, all the rest of it. 

On that note, here's an email I recently received:

Dear friends, family and colleagues, 

As many of you will know, I married Kristina last month, who I met when we were both students at the National Film and Television School. We love each other and want to spend our lives together. 

We both wanted to start out in our respective careers (animation and cinematography) in the UK, but are now coming up against the misguided, cruel and fundamentally stupid new visa rules for the husbands and wives of British citizens. Kristina, who is from the US, may very well be forced to leave the country before 21st April, when her student visa expires - in a week's time - because we don't meet the new financial threshold, which is three times higher than it was before July 2012.

Under the current rules, introduced last July, 47% of employed British citizens would not be able to keep a non-EU spouse in the UK. It's affecting thousands of people, but they are a small part of overall immigration. The government seems to be pandering to extremists by pledging to reduce immigration, and the stringent new rules in the area of marital visas are an attempt to make a small reduction in the figures any which way they can, given the fact that most immigration is from the EU, which they cannot control. Non-EU immigrants have always had their visas stamped 'no recourse to public funds', so the government's argument about wanting to reduce the burden on the state makes no sense. 

But something more fundamental is wrong here: the government is effectively saying that I only really had the right to marry a British or EU citizen, since as it stands, I seem to be penalized for marrying someone of a non-European nationality. Marriage rights have been stratified, plain and simple, and by being under a certain income threshold people are being treated as second class citizens.  

It's a common story - so much for the value of traditional marriage, eh?

While that's all important - and hopefully enough that this silly idea won't survive the eight-week consultation it's due to go through - the thing that strikes me about this policy is how much business leaders hate it. It's the cherry on top of the vast sundae of the other anti-immigration measures that have been proposed and implemented in the last few years - everything from Cleggbonds, to language requirements, to rules about how much people's spouses have to be earning in order to qualify for marital residency. 

Indeed, if you go to most businesses, and ask them for the one supply side reform they'd like, they won't tell they'd like to be able to sack people more easily, or wish they could pay less than the minimum wage, they'll tell you they'd like to make it easier to hire foreigners. Currently, most businesses will reject non-EU nationals as soon as they hear they need a visa because it's too much red tape to sponsor an application. Even if people are willing to put up with the uncertainty of the hire based on a bureaucrat's say-so, then usually firms will only want to go through the shocking incompetence of the UK border authority once.

Even if you can find a firm willing to sponsor you, the fees for the individuals fees are enormous - £600 every six months is not uncommon, especially if you have to renew your contract regularly. £200 a year on top of that perhaps doesn't sound like much to millionaire Jeremy Hunt, and people are bandying around phrases like "it's only £16 a month", but it's not like there's an easy direct debit option to spread your payments. An £800 upfront cost for a Visa, plus a bundle of other red tape, is enough to put off exactly the sort of people we want - skilled, hard-working valuable migrants, like students who have studied here who want to stay on. 

Anyway, as you can see, individually, these measures might almost make sense to your great aunt who "just thinks Britain isn't British anymore". But taken together, they add up to a huge sign on the door of Britain saying foreigners aren't welcome, and they only hurt the kind of law-abiding, hard working migrants the average over 60 on the doorstep professes to like. This is a huge problem - turning the cold shoulder to migrants is costing us billions, and pulling hugely skilled individuals out of the economy. It's about time all those politicians who bang on about kickstarting growth through supply side reform come out from under their rocks and make the case for the benefits of immigration. 

Look, no hands! Health Secretary Jeremy Hunt. Photograph: Getty Images

Willard Foxton is a card-carrying Tory, and in his spare time a freelance television producer, who makes current affairs films for the BBC and Channel 4. Find him on Twitter as @WillardFoxton.

Getty
Show Hide image

Junior doctors’ strikes: the greatest union failure in a generation

The first wave of junior doctor contract impositions began this week. Here’s how the BMA union failed junior doctors.

In Robert Tressell’s novel, The Ragged-Trousered Philanthropists, the author ridicules the notion of work as a virtuous end per se:

“And when you are all dragging out a miserable existence, gasping for breath or dying for want of air, if one of your number suggests smashing a hole in the side of one of the gasometers, you will all fall upon him in the name of law and order.”

Tressell’s characters are subdued and eroded by the daily disgraces of working life; casualised labour, poor working conditions, debt and poverty.

Although the Junior Doctors’ dispute is a far cry from the Edwardian working-poor, the eruption of fervour from Junior Doctors during the dispute channelled similar overtones of dire working standards, systemic abuse, and a spiralling accrual of discontent at the notion of “noble” work as a reward in itself. 

While the days of union activity precipitating governmental collapse are long over, the BMA (British Medical Association) mandate for industrial action occurred in a favourable context that the trade union movement has not witnessed in decades. 

Not only did members vote overwhelmingly for industrial action with the confidence of a wider public, but as a representative of an ostensibly middle-class profession with an irreplaceable skillset, the BMA had the necessary cultural capital to make its case regularly in media print and TV – a privilege routinely denied to almost all other striking workers.

Even the Labour party, which displays parliamentary reluctance in supporting outright strike action, had key members of the leadership join protests in a spectacle inconceivable just a few years earlier under the leadership of “Red Ed”.

Despite these advantageous circumstances, the first wave of contract impositions began this week. The great failures of the BMA are entirely self-inflicted: its deference to conservative narratives, an overestimation of its own method, and woeful ignorance of the difference between a trade dispute and moralising conundrums.

These right-wing discourses have assumed various metamorphoses, but at their core rest charges of immorality and betrayal – to themselves, to the profession, and ultimately to the country. These narratives have been successfully deployed since as far back as the First World War to delegitimise strikes as immoral and “un-British” – something that has remarkably haunted mainstream left-wing and union politics for over 100 years.

Unfortunately, the BMA has inherited this doubt and suspicion. Tellingly, a direct missive from the state machinery that the BMA was “trying to topple the government” helped reinforce the same historic fears of betrayal and unpatriotic behaviour that somehow crossed a sentient threshold.

Often this led to abstract and cynical theorising such as whether doctors would return to work in the face of fantastical terrorist attacks, distracting the BMA from the trade dispute at hand.

In time, with much complicity from the BMA, direct action is slowly substituted for direct inaction with no real purpose and focus ever-shifting from the contract. The health service is superficially lamented as under-resourced and underfunded, yes, but certainly no serious plan or comment on how political factors and ideologies have contributed to its present condition.

There is little to be said by the BMA for how responsibility for welfare provision lay with government rather than individual doctors; virtually nothing on the role of austerity policies; and total silence on how neoliberal policies act as a system of corporate welfare, eliciting government action when in the direct interests of corporatism.

In place of safeguards demanded by the grassroots, there are instead vague quick-fixes. Indeed, there can be no protections for whistleblowers without recourse to definable and tested legal safeguards. There are limited incentives for compliance by employers because of atomised union representation and there can be no exposure of a failing system when workers are treated as passive objects requiring ever-greater regulation.

In many ways, the BMA exists as the archetypal “union for a union’s sake”, whose material and functional interest is largely self-intuitive. The preservation of the union as an entity is an end in itself.

Addressing conflict in a manner consistent with corporate and business frameworks, there remains at all times overarching emphasis on stability (“the BMA is the only union for doctors”), controlled compromise (“this is the best deal we can get”) and appeasement to “greater” interests (“think of the patients”). These are reiterated even when diametrically opposed to its own members or irrelevant to the trade dispute.

With great chutzpah, the BMA often moves from one impasse to the next, framing defeats as somehow in the interests of the membership. Channels of communication between hierarchy and members remain opaque, allowing decisions such as revocation of the democratic mandate for industrial action to be made with frightening informality.

Pointedly, although the BMA often appears to be doing nothing, the hierarchy is in fact continually defining the scope of choice available to members – silence equals facilitation and de facto acceptance of imposition. You don’t get a sense of cumulative unionism ready to inspire its members towards a swift and decisive victory.

The BMA has woefully wasted the potential for direct action. It has encouraged a passive and pessimistic malaise among its remaining membership and presided over the most spectacular failure of union representation in a generation.

Ahmed Wakas Khan is a junior doctor, freelance journalist and editorials lead at The Platform. He tweets @SireAhmed.