Health Bill [HL]

My Lords, I support Amendment 71, and speak also to Amendments 73 and 74 in my name and the name of the noble Baroness, Lady Barker, and the noble Lord, Lord Judd. The point I wish to make to enlarge on the remarks of the noble Baroness, Lady Stern, is that her comments dealt with those asylum seekers who have failed the test to stay here but cannot be returned home. There is also another group who can be returned home but have to wait for all sorts of reasons. As I said in Committee, having had a constituency near Heathrow Airport, I know that many such cases were being appealed and the appeals take a long time. It may be years before they are eventually deported. I am incredibly concerned about that group of people. Following the latest court ruling, failed asylum seekers are still not to be considered as residents of the United Kingdom and are liable for charges for all secondary healthcare except emergencies, whatever they may be, and compulsory mental health care and infectious diseases. There is a list of infectious diseases that they must be treated for. This list excludes HIV/AIDS, which I will address later. So we have a situation where they can access primary care but because they are told that they must pay for secondary care, many of them do not dare to access primary care because they think that some terrible thing will happen and they will be revealed to the authorities, or they will be charged even though they were told it was free. So among this group there is a great fear of charges and of being ill. A failed asylum seeker who has diabetes has a chronic condition that can become an emergency at any stage if it is not treated. Are we to say—they are not on the list of infectious diseases—that a diabetic should not be treated except in an emergency? Are they supposed to lurch from diabetic coma into diabetic coma, just being treated as an emergency? Those patients are also susceptible to infections such as TB, which they may contract, which would be a danger to the general community. Diseases such as HIV/AIDS make patients particularly vulnerable. It seems to me extraordinary that we keep people in our community who are a danger to the public health of that community, let alone inflict on them an extremely unkind abuse of their human rights. The current guidance says that it is a clinical decision to treat failed asylum seekers free of charge but, in practice, the doctors often do not know their status. It is all a muddle. The overseas visitors manager in a particular trust dictates whether it is going to take money from that patient or not. It is not a clinical decision, however much we would like to think that it is. I would like to hear tonight whether the Department of Health will insist that it is a clinician’s, not a manager’s, decision in every case as to whether patients are treated free of charge. HIV patients are an even more special case. It is necessary that they are treated as soon as possible with anti-retroviral drugs. The irony is that anti-retroviral drugs make transmission of AIDS less likely. If patients are on these drugs, they are less of a public health hazard than if we leave them off treatment when they stay in the community. Another factor is that we offer them testing free of charge. We say, "Come along, we will test you, it is all free. You can be tested and we will tell you whether you have HIV or not". But who is going to go for a test if they are not going to have any treatment? It is even more likely that these patients will be in the community with HIV, untreated, a danger to themselves and others. The argument has always been that we must make this ruling because of health tourism: that people come specifically to this country and claim to be asylum seekers simply to get free treatment for diseases that would cost a lot of money to treat in their home country. I see no evidence of that. The British Medical Association certainly cannot produce any. It would be helpful if the Minister could point us to the website that tells us just how much health tourism costs this country. I spent many years dealing with international development issues and visiting developing countries and conflict zones. They are not very nice places to live. Are these people criminals to seek a better life, even if they are not genuine asylum seekers but so-called economic migrants? Is that a crime? Would we not seek a better life if we were living in those conditions? Would we not want try to make things better for ourselves and our families? It must be said about this Government—I said it at lunchtime in another context—that the Prime Minister and his allies have done so much for international development. They have been champions of overseas aid and the relief of third world debt, knowing full well that the way to stop asylum seekers and economic migrants is to make those developing countries better and prevent conflict. The Government know that. Yet, when we have not yet succeeded and people come here, we treat them in this appalling way. I urge the Government to reconsider and show true humanity.