My Lords, we have no current plans to do so. The Immigration Bill that is before the House in Committee requires temporary migrants coming to study, work or join family members for more than six months to pay a health surcharge to ensure that they make a fair and proportionate contribution to the NHS commensurate with their immigration status. Overseas visitors will continue to be liable for NHS treatment charges.
My Lords, I thank my noble friend the Minister. Does he agree with me that while the health service surcharge is welcome, at £200 it is a little inadequate, given that the National Health Service itself has calculated that the cost of providing services, even to people aged 15 to 44, is £700? More importantly, the proposed health service charge takes no account of a person’s illness, whereas if they were required to obtain insurance before they came to this country, that illness could be assessed and properly and fully costed. I am sure my noble friend will agree that it is no coincidence that out of 30 countries that provide comparable health insurance to the United Kingdom, only the UK and Ireland do not require certain migrants to have health insurance, which goes some way to explain the estimated health tourism bill of £2 billion.
My Lords, my noble friend to some degree misunderstands the reason for the surcharge, which is, as I have said, to ensure that temporary migrants pay a fair contribution towards the health service. It is not intended to be a full cost recovery but, none the less, it will raise in the region of £2 billion over 10 years. Visitors are not covered by this scheme and they will be liable for full cost recovery, which they may indeed choose to insure against.
My Lords, I suspect that health insurance for visa applicants would be extremely complicated to administer. Does my noble friend think that there might be something to be said for it if the Government go down the route recently recommended by the Migration Advisory Committee of auctioning about 100 visas a year, with a reserve price of £2.5 million, to get accelerated settlement in the UK? I sincerely hope that they will not go down that route.
My noble friend is tempting me to elaborate a policy into a direction in which the Government have no intention of moving at the present time. There is a review of health service charges going on. Currently the recovery of health service charges is a problem. The health service is not getting the income that it should be getting from health service charges, but my noble friend is right to say that the merit of this scheme covering temporary migrants is that it makes a significant contribution and is very simple to administer.
Is the Minister aware that an inquiry is taking place at the moment under the auspices of the Science and Technology Committee to look at the dramatic drop in the number of overseas students engaged in science, technology and engineering subjects, and that one factor that has become quite clearly significant is the intimidatory character of the application of immigration rules, in particular this latest suggestion that there will have to be, over and above a very sizeable visa charge, a charge for health? This is having a deleterious effect on the number of PhD students, whom we desperately need in our institutions and who will make a continuing contribution to the British economy. It is a highly unsatisfactory way of trying to control inflation by imposing unnecessary and, as I say, intimidatory charges on a group of very attractive immigrants for Britain.
We have missed the noble Lord from our debates on these issues on the Immigration Bill. I assure him that the points he is making have been well made but the Government are quite clear that this does not put us in an uncompetitive position. Even the basic health insurance for a student going to Harvard is $958 and he might expect to pay $2,190 a year more if he wants full health cover. In Australia the annual payment would be £300; in New Zealand £325; in Canada £300. The actual cost of students in this respect is estimated by the Department of Health at £700 a year. This is not putting us at a disadvantage in the world market. We have the most excellent institutions here and I wish people would stop talking down our attractiveness as a place to study.
On two occasions now the Minister has quoted the figure that a student would have to pay as £700. In reality, is it not true that we do not know the level of usage of the health service by students, and that the Department of Health is conducting an audit right now that will determine it?
I have some figures here in front of me. I respect the noble Lord and I think he would agree that we have had some good debates on this issue. The figures say that non-EEA students cost the NHS around £430 million per year, with an average cost per head to the NHS of more than £700 per year. Those are the figures that I am giving the House, and I am assured that they are authoritative.
Is my noble friend aware that these proposals are very broadly welcomed? Will he reassure the House that a proper monitoring system will be set up so that we do not reach the situation 12 or 24 months hence where we do not actually know what has happened?