Theresa May refuses to "quantify" cost of "health tourism" as she panders to immigration fears

The Home Secretary glossed over the fact that "health tourism" costs just 0.01% of the NHS budget.

Among the measures included in the government's new immigration bill, which is published today, is the introduction of a £200 charge on all temporary migrants, such as overseas students, to use the NHS and a requirement for GPs to check the migration status of new patients. 

Both policies are aimed at solving the alleged problem of "health tourism", whereby migrants travel to the UK to seek free healthcare, 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". The cost of administrating the new system could well outweigh the savings (the chair of the Royal College of GPs, Clare Gerada, estimates that staff costs alone will amount to £500m), while also increasing public health problems such as TB by deterring temporary migrants from seeking treatment when they first fall ill. 

Challenged on this point on the Today programme this morning, Theresa May repeatedly refused to "quantify the problem", instead describing it as "a point of principle" and noting that the public believe "there is an issue out there". In other words, the government is making policy based on fears, rather than facts. 

A dose of sanity was provided by east London GP Paquita de Zulueta, who warned that the bill would make it "considerably harder for vulnerable migrants in considerable need to access healthcare" ("if they can't access primary care or they're too frightened to they'll wait until they're really ill," she said) and pointed out that "we're net exporters of patients". 

But to May, the woman who once warned that the Conservatives were seen as "the nasty party", all of this is irrelevant as where UKIP leads, the Tories follow. 

Theresa May speaks at the Conservative conference in Manchester earlier this month. Photograph: Getty Images.

George Eaton is political editor of the New Statesman.

Getty
Show Hide image

The English left must fall out of love with the SNP

There is a distinction between genuine leftism and empty anti-establishmentarianism.

After a kerfuffle on Twitter the other night, I am all too aware that writing something even mildly questioning of the SNP government is the British equivalent of approaching a lion pride on a kill. Nevertheless, seeing the almost hero-levels of mental gymnastics tweeted by Mhairi Black, in the week of the Hillsborough inquiry whereupon Nicola Sturgeon posed with a copy of The Sun endorsing her re-election, prompted me once more to consider just how spectacular the distance has become between the SNP that stood against Ed Miliband versus the SNP today and in government.

Mhairi tweeted: “So Kezia wants to put up the taxes of Scottish people to subsidise Tory cuts that her party supported in Westminster?”. Confused? So am I.

This follows in a series of SNP revisionism on what austerity is and the excuses the SNP has hidden, not quite so conspicuously, up its sleeve to not act on its new tax powers, so as not to break its bond with Middle Scotland. They insist that Labour’s plans for a penny tax are not progressive, and have framed it in such a way that an anti-austerity plan has now become a subsidy for cuts Labour actually haven’t supported for more than a year now. Just like that, the SNP is a low-tax mimicry of Toryism.

But it isn’t ‘just like that’. The SNP have governed from an economically cautious stance for seven years. For a brief period, they borrowed Ed Miliband’s clothes. But once the Red Wedding had been completed, they returned back to where they started: as successors to New Labour, though that is hardly fair: they are far, far less redistributive.

So why is it, in the 2015 election, and even today, many of us on the left in England still entrust our faith in SNP rhetoric? Still beat the drum for an electoral ‘progressive’ coalition with a party that doesn’t seem very happy to embrace even the concept of higher taxes?

My theory is that the SNP have successfully, indeed more successfully than any party in Britain, adopted the prime hobby of much of the Left: ‘againstism’.

‘Againstism’, clumsy I admit, is to be against everything. This can include a negative framing of being anti-austerity but not pro-anything in its place. But in this instance, it means to be anti-establishment. The latter, the establishment, is what Labour as a party of government always has aspired to be in competing to be the national government in Westminster - which is why elements of the Left will always hate it and will always vote against it. In a way, some of the left is suspicious of governance. This is occasionally healthy, until it prevents real progressivism from ever being elected.

While in government, Labour could be seen as sell-outs, rightly or wrongly, because they became the establishment and had no one but themselves to blame. The SNP are the establishment, in Scotland, but can nevertheless exercise ‘againstism’, even with new tax powers. They always will so long as Westminster exists, and so long as their main motivation is independence. This is why the bogeymans that sustain nationalism are not natural allies of social democracy; to achieve social democracy would be to remove the bogeyman. This means that the Lesser New Labour tradition within which they govern will continue to go unnoticed, nor be doomed to eventual death as New Labour itself suffered, nor be looked back on as an era of neoliberalism. The SNP can just avert attentions back to the Westminster establishment. ‘Againstism’. Paradoxically, the way the SNP have managed to come to exploit this is because of New Labour's devolution. Devolution has created, for the first time, the perfect environment for an establishment in one part of the country to blame the establishment in another. It has allowed for the rise of an incumbent insurgent. The SNP can campaign as insurgents while still being incumbents. It is a spectacular contradiction that they alone can manage.

Insurgency and anti-establishment politics are not, of themselves, a bad thing. We on the Left all dip our toes in it. It is a joy. It is even more fun for us to be successful. Which is why the celebratory mood that surrounded the SNP gains in Scotland, a paradigm shift against one incumbent for another, is, objectively, understandable. But these insurgents are not actually insurgents; they are the illusion of one, and they have had the reigns of power, greater now for the Scotland Bill, for seven years. And they have done little radical with it. The aim of an anti-establishment politics is to replace an establishment with something better. All the SNP have done is inherit an establishment. They are simply in the fortunate position of managing to rhetorically distance itself from it due to the unique nature of devolution.

This is why some of the Left still loves them, despite everything. They can remain ‘againstists’ regardless of their incumbency. They do not have the stench of government as a national Labour government did and inevitable would have. So the English Left still dream.

But now, with this mounting evidence and the SNP’s clumsy revisionism, it is up to the English Left to distinguish between genuine leftism and empty anti-establishmentarianism, and to see the establishment -via governance- as something to define for itself, to reshape as something better, rather than something to be continuously against. This is, after all, what Attlee's government did. The SNP have not defined the establishment, they have continued someone else's. It's up to us to recognise that and fall out of love with the SNP.