Health Bill [HL]

I shall speak also to Amendment 132. I have spent seven Committee sittings in this Room listening—actually, trying to avoid catching my noble friend’s cold and, as Members of the Committee will see, my upper respiratory tract has finally succumbed so I did not succeed. However, I have sat patiently, listening to ways of improving the lives and safety of our citizens, and of improving already good health services for a very privileged population in this part of the world. This amendment is, for me, the most important. It addresses what we do for some of the most oppressed and unfortunate people in the world. I feel passionately about it, and ashamed that, as a privileged nation, we do not do enough. This is a probing amendment, to clarify an unclear, confused and sometimes inhumane policy that has operated since 2004. Since then, there has been no free treatment for refused asylum seekers in hospitals except in emergencies. Ostensibly, this puts people’s lives in danger and requires doctors to consider immigration status before treating a patient. This is difficult for a doctor who simply wants to help the patient. Organisations representing asylum seekers have many examples of patient suffering which they, of course, have given to me. People with non-life-threatening illnesses can be turned away until those illnesses become a life threatening emergency. As a simple example, what happens if you are a diabetic? You cannot access treatment because it is not an emergency, but if you go into a diabetic coma and could die, it is an emergency and you will then be treated. This is extraordinary. Cases are cited where failed asylum seekers who have been admitted to intensive care from accident and emergency departments are charged for further treatment when they leave the intensive care unit. You cannot go straight home, but you have to pay for the rest of the treatment. Some asylum seekers who are too ill to be deported are denied treatment that would make them well enough to return home. GPs often refuse to register failed asylum seekers and refer them to accident and emergency departments instead. There have been examples of pregnant women being denied maternity care or being made to pay enormous fees. Of all these examples, the one that concerns me most is that of people with conditions deemed not an emergency being refused treatment until it becomes one. I cannot imagine a concept that goes against medical ethics more than that; it is quite extraordinary. The extra expense to the NHS, not to mention the suffering of the patient, is just not acceptable. As a Member of the Parliament in the other place whose constituency had its fair share of asylum seekers, because it was very close to Heathrow Airport, I know how long it can take before a failed asylum seeker actually gets returned home. It can be a very long time indeed. Moreover, the UK is signed up to the Convention Relating to the Status of Refugees of 1951, which says that host countries must provide those fleeing tyranny and persecution with access to health services, housing, education and employment. Even at the point of entry, when application is made for asylum, we do not do basic testing that would help the individual and protect our society. Testing for TB, hepatitis and HIV should be routine. If people are being tortured, swift referral to psychotherapy would help them and us—our society. It is terribly important that children should have their vaccination status assessed and be vaccinated against childhood diseases if necessary. Why is that not done? I am well aware of the list of conditions exempt from these regulations. I have them here—I have been sent the list—and I thank the department very much for that. They are all conditions that are relatively obvious and are certainly a great danger to our society as well as the asylum seekers. We take those measures, but the rationale for the current policy was to protect us from health tourism, whereby foreign nationals deliberately come for healthcare. If you cross the continent of Africa and trust yourself to some unseaworthy little boat, are at sea for I do not know how long, finally make land and are accepted as an asylum seeker, apparently you have come deliberately for healthcare treatment and you are a health tourist. I am very sceptical. Many people do come for medical treatment in this country, and they pay for it in the private sector where the healthcare is often world-renowned. Overseas visitors can be distinguished in most cases from asylum seekers, I would contend. Where are the figures for health tourism that you hear about? Is it just the anecdotes of taxi drivers, or is there real, hard evidence? This year the Royal College of General Practitioners concluded: ""There is no evidence that asylum seekers enter the country because they wish to benefit from free health care"." Other doctors have supported this view, and the general opinion is that the psychological and physical health of asylum seekers, especially those who become failed asylum seekers, worsens progressively in the UK asylum system. At this point, I shall briefly address Amendment 132, which would exempt HIV treatment from charges, irrespective of residency status. This would ensure that everyone in the UK, including failed asylum seekers, would be able to access HIV treatment while in the UK. We offer testing and counselling for HIV, which would, one hopes, reduce the risk of HIV being spread by sexual contact—or would it? Might the fact that no treatment is available unless you pay for it make a failed asylum seeker less likely to have the test in the first place? I think that it would. HIV sufferers are not a huge public health hazard in the same way as are the conditions on the exempted list that I mentioned under Amendment 130, but full-blown AIDS is extremely debilitating and might make an individual too sick to be sent home. What is gained then? We discussed the protection of our society from HIV when the Health and Social Care Bill came through this Chamber last year, and vigorously defended the need for some degree of protection for the HIV carrier from discrimination now and in future. This amendment seeks to add the right—and it is a right, I contend, under the convention on refugees—that AIDS sufferers receive treatment so long as they remain in this country. Scotland, Wales and Northern Ireland have chosen not to charge for HIV treatment, so why do we in England? I remind this Committee that it is the only serious communicable disease and the only sexually transmitted infection for which treatment is not provided free of charge, irrespective of residency status. Finally, in April 2008, Mr Justice Mitting ruled that failed asylum seekers should be classed as ordinarily resident in the UK and be entitled to NHS treatment. This judgment is currently being appealed by the Government through, I think, a judicial review. There is great confusion in the system. Vulnerable people are suffering as a result. This country is also probably in breach of an international convention on the status of refugees. We have no reason to be proud or complacent on this issue. I beg to move the amendment.