Health visitors

It is customary for the government to use the Christmas slump in news to announce new ‘crackdowns’. This year’s offering was an attack on so-called ‘health tourists’ accused of draining precious resources from Britain’s National Health Service (NHS).

Apparently, heavily pregnant women are queuing to enter the country so that they can have their baby free on the NHS. Business visitors often bring their sick wives and children with the aim of getting them seen to. Government officials estimate that this costs the UK £200million per year. Foreigners are ‘effectively stealing treatment from the people of this country’, said health secretary John Reid (1).

The government was soon forced to back down on its crackdown. It turns out that there is no evidence for the extent of health tourism – the £200million figure seems to have been plucked out of the air. One health minister, John Hutton, was left calling for action ‘irrespective of the size of the problem’. It seems unlikely that people are clamouring to queue in Britain’s overcrowded hospitals. After all, this is the country forced to send patients to France and Germany for treatment. And the fact that a special term had to be invented to describe the problem should raise suspicions.

‘Tourism’ sounds frivolous, as if foreigners sit down with a map of the world to decide where they want to have their baby. The real-life prospect of doctors turning away sick, poor visitors has been less easy to defend. Ministers were forced into contortions trying to separate deserving patients from undeserving. ‘I am not talking about emergency treatment, matters of life and death’, said John Reid. These restrictions would only apply for ‘routine’ cases, he assured. It is proposed that failed asylum seekers would be allowed to finish existing courses of treatment, but not to begin another.

Asking doctors to decide who is entitled to treatment would be unworkable as well as undesirable. Dr Edwin Borman, chairman of the British Medical Association’s international committee, said: ‘The medical profession is not willing to become a state agent, and police a system which…might interfere with what we see as an ethical doctor-patient relationship. I have a responsibility to any patient to treat their illness, and care for them as much as possible.’ (2)

While the policy is murky, the motivations behind it are fairly clear. This is another attempt by the government to key into what it imagines to be popular prejudices and fears. Reid’s announcement read like a Daily Mail editorial. ‘It is not fair’, he said: ‘we are not mugs. We will not allow people in this country to be taken for a ride.’ (3) This is an appeal to rally round and protect our precious health service from Johnny foreigner. The government is displacing blame for the parlous state of the NHS on to others, explaining away all those delays and shortages.

There is also perhaps an attempt to make the NHS experience more meaningful. Excluding foreigners makes the treatment received by British citizens appear special, rather than routine. ‘It’s not for anyone, you know!’ is the message. But whatever their aims, the government’s health tourist crackdown has spectacularly backfired. Condemnation has come from all sides, including Labour MPs, GPs, the press and asylum organisations. Government ministers are probably by now wishing that they had left the foreigners to their free births – and the British public to its holiday.

(1) Medics balk at NHS tourism plan, BBC News, 29 December 2003

(2) Medics balk at NHS tourism plan, BBC News, 29 December 2003

(3) Reid announces crackdown on foreigners taking NHS ‘for a ride’, Independent, 29 December 2003