Let me deal with those very good points in order. First, health tourism is not new; people may now be coming from Romania, but we have had people coming from the middle eastern states for a long time. I used to live near King’s College hospital, which has a great liver treatment centre, and a significant proportion of its patients at one time were from Arab countries. [Interruption.] They were not paying, that is the point. Of course we have to do something about health tourism, but we also have to be wary of unintended consequences. I mentioned A and E because in London, as the hon. Lady knows, and in some other parts of the country it is acting as a secondary GP service. In a huge, three-hour queue of people coming to A and E to get secondary GP services, I do not know how we distinguish between those born in Britain and those born in Hungary or Romania. There is a great risk of getting this wrong, and the medical profession would not go along with it and be the arbiters. As the hon. Gentleman rightly said, communicable diseases are a problem, irrespective of whether someone is a British citizen or born abroad. They have to be treated differently and separately, but that is not a question of payment or of health tourism; it is a question of getting it right.
This morning, the Health Secretary talked on the radio about the pull factor, characterising medical care as such. That is the case for a health tourist, and we can do something about it, but we could not do something about the half a million Polish immigrants that there were at one point. The pull factor for most of the Romanians and Bulgarians will not be health care, welfare or housing; it will be simple economics, because the average income in Romania and Bulgaria is approximately one third of our minimum wage. Most
Romanians and Bulgarian could treble their standard of living simply by coming to the UK and doing almost any job.
We have to face up to that fact, which also faces Germany and all the European countries closer by. One would have thought that if we really did have a working European Union, we would by now have been able to say to each other, “When we devised the rules about the freedom of movement of people, they were not devised for an organisation of states that had a tenfold difference in average incomes.” Let me say that I am a free marketeer, so I think those things are terrific and I am a believer in the free movement of people, but we have to think of a better way of dealing with this matter, because these people will not be the last ones who come along—and they are coming in January next year.