I appreciate the Minister’s intervention, but the fact is that there is no clarity in the Bill—it leaves that fear for communities seeking primary care. If they believe they will be kicked out of the country for going to the doctor, they might not go and therefore might not be tested.
Public health experts agree that increasing the offer of HIV testing to a wide range of facilities is key to tackling the UK epidemic in all communities. In addition, the purpose of primary care is to assess the broadest range of health needs and identify how best to meet them. Anything that delays or prevents anyone with an infectious disease from seeking medical advice denies them the opportunity to be diagnosed and increases the chance of them passing on the infection to someone else. Someone on HIV treatment is 96% less likely to transmit it to others. Therefore, the Bill clearly risks unlimited and unintended consequences to UK public health.
The Bill may increase the risk that we will fail to tackle HIV in our communities, and it may also be costly. According to the Department of Health’s review of overseas visitors charging policy, referred to in the explanatory notes, a comparison of the administration costs of the current system with the amount actually recovered showed that it barely broke even. The Home Secretary failed to address that point, and I hope that the Minister will do so in his closing remarks. The new system may not be cheaper and we may fail to reclaim any money.
According to the review, in order to recoup the money and achieve the Government’s aims, the NHS structure would need to be radically changed. It said:
“Only a fundamentally different system and supporting processes would enable significant new revenue to be realised.”
I would be grateful if the Minister provided more clarity about the administration of the proposals and the collection of the money from those who have entered the country.
I am also concerned about the effect that the proposals will have on reciprocal arrangements with other countries, which has not really been mentioned today. The Bill refers to our EEA partners, but we have arrangements with 27 countries that are not in the EEA, including
Australia and New Zealand. Many of our students go backpacking in those countries or to work on short-term visas, and they access health care free of charge, like the people who come here from those countries. Can the Minister clarify how the Bill will affect reciprocal arrangements? Has he had discussions with representatives of those countries? Will we have new reciprocal agreements, or will they not be affected?
The final area of concern is the devolved aspects of the Bill, which I mentioned in an intervention earlier. I am surprised by how vague this issue is in the Bill. There is no detail on how charges for devolved public services will be made, or on how landlord checks will work in the devolved nations.