Wednesday, 10 February 2016

EU migrants are NOT 'bleeding dry' the NHS

Yesterday's Daily Express front page shouted that Britain should ‘Quit the EU to save our NHS’.

Being part of the EU, the paper claimed, puts an “intolerable strain on the NHS” and it “could collapse completely.”

The same story appeared in an inside feature article of the Daily Mail with the headline, ‘Migrants are pushing NHS to breaking point..’

Both newspapers quoted a top cancer doctor – UKIP candidate, Professor Angus Dalgleish – stating that the NHS was being ‘bled dry’ by European migrants coming here ‘to use Britain’s free health service’. 

The Mail claimed that, “The NHS has been left ‘on its knees’ by uncontrolled migration from the EU” and added that, “the NHS is being bled dry of resources by health tourists denied care at home.”

The Mail continued, “Cancer treatment can cost £200,000 and, under Brussels rules, Britain has to offer it to all EU nationals.”

The Express stated, “In 2013 the annual cost of health tourism to the UK was estimated by the government to be £2 billion.”

Stated Professor Dalgleish, who stood as a UKIP candidate at last year’s General Election:
“Our membership of the EU is putting an intolerable strain on our NHS. The NHS is on its knees and could collapse completely.
“Britain is attracting thousands of health tourists from across the EU who cannot get certain drugs or treatments in their home country so come to Britain and demand them as EU citizens.”
The papers were quoting from a speech that the Professor is due to give today at a conference called, ‘The Good Life After Brexit’, which will claim that Britain will be safer leaving the EU. 

The problem with both stories by the Daily Express and the Daily Mail is that neither quote any verifiable statistics or evidence to support their claims that EU migrants are bringing the NHS to breaking point. 

That’s not really surprising, as there is no evidence that EU migrants are responsible for ‘bleeding dry’ the NHS. 

For one thing, EU migrants coming to live in the UK are mostly young, fit and less likely to use our NHS than native Britons. 

That was the conclusion of a study by Nuffield Trust which indicated that immigrants use hospital care at around half the rate of English-born people of the same age and sex:
“People who are seriously ill tend not to want to up sticks and move to another country looking for work. As a result, migrants are generally healthier than average – and so less likely to turn up in hospital.”
Another study by the Nuffield Trust found that up to 40% of the increased use of Accident and Emergency Departments come from the over-85s, who are 10 times more likely to end up in A&E than people in their 20s, 30s and 40s (the age group of most immigrants).

This was confirmed by a research study commissioned by the Department of Health which concluded, “The high average cost per head for older people means that most health costs are associated with the older age groups, especially the over 65s. 

"In contrast, in the migrant population there are few people in these older age groups, so most of the cost for visitors and migrants is associated with much lower cost per head age groups.”

The report added, “In general terms non-UK born people report better levels of health, particularly for the age group that most migrants belong to.”

Furthermore, most of those coming to Britain for NHS treatment were from outside of Europe. Confirmed the report:
“We now have a cost for the use of the NHS by visitors and temporary migrants of about £1.8bn, of which almost £1.5bn is attributable to people from non-EEA countries and about £305m to people from the EEA.
“Visitors from the Middle East account for more than 50% of spending by visitors who come to Britain for medical treatment.” 
It can also be argued that immigrants to the UK put far more into the NHS than they take out. 

Around 26% of NHS doctors and about 11% of all NHS staff are from abroad, according to latest research by the Health and Social Care Information Centre.  It’s actually these foreign workers who are preventing the NHS coming to a standstill, rather than foreign patients bringing the NHS to the point of collapse.

(For example, there are over 4,000 doctors, dentists and nurses from Romania working for our NHS)

The British Medical Association observed that without the contribution of non-British staff, "many NHS services would struggle to provide effective care to their patients".

In addition, many Polish immigrants - for example - prefer to pay to visit private Polish health clinics than use the NHS. Since 2007, such private clinics have mushroomed throughout the UK, with at least 20 in London. It's also been reported that many EU migrants living in Britain prefer to fly home for treatment rather than to use our NHS.

But there is something more seriously wrong with the stories by the Mail and the Express. They mix up categories of migrants, as they often do. 

The Mail claimed:
“Cancer treatment can cost £200,000 and, under Brussels rules, Britain has to offer it to all EU nationals.”
Well, for one thing, cancer treatment shouldn’t be offered to people who don’t have cancer – and that applies to the vast majority of young, fit, migrants who mostly come to Britain for work, not for treatment. 

Secondly, EU temporary visitors here can only receive basic and emergency care, not long-term cancer treatment.

And thirdly, temporary visitors from other European countries to Britain shouldn't cost the NHS at all.

That’s because EU/EEA visitors here can use their EHIC card to obtain health treatment, and these costs are then recoverable by the NHS from the home country of the visitor. 

In the same way, British temporary visitors and holidaymakers to most other European countries can also obtain necessary health care whilst abroad, and the cost is then claimed back from our NHS.

In fact, British visitors to the rest of Europe cost health services abroad far more than visitors to Britain from the rest of Europe.

Official figures showed that the cost of treating British people who become ill while travelling in Europe is five times higher than the cost of treating ill visitors from other European countries in the UK.

The Department of Health data, obtained under the Freedom of Information Act and reported by The Guardian newspaper, showed that it cost £30 million in 2013-14 to meet the costs of European visitors using the National Health Service.

This is less than one-fifth of the £155 million cost to other states in the European single market for treating ill British tourists.

Giles Goodall, the chair of the Brussels and European Liberal Democrats, said:
“These figures are further evidence that free movement is a two-way street from which the UK benefits as much as – and in some cases more than – anyone else. 
"They also puncture a big hole in claims that Britain is submerged by ‘health tourists’ – if anything, it seems to be the other way around.
“With 42 million visits by Brits to other EU countries every year, it is clear that we are one of the biggest users of the right to travel freely in Europe – a benefit of our EU membership that the Tories and Ukip would put at risk."

An EU spokesperson added:
“First, EU law certainly does not make the UK a safe haven for EU citizens who would like to come to get healthcare at the expense of UK taxpayers. Those who come for short periods, for example on holiday, can receive basic and emergency care, by using the European Health Insurance Card (EHIC – formerly known as an E111).
"However, under the EHIC system, that care is ultimately paid for by their own Member State of residence. Such visitors are in general not entitled to non-urgent treatment for existing medical conditions and neither are they entitled to come to the UK specifically to obtain NHS treatment.”
EU/EEA migrants permanently resident in the UK are entitled to use our NHS without charge. However, most of these migrants are in full and gainful employment, and according to various studies, making a net contribution to the British Treasury. In other words, they put in more than they take out.

The Department of Health advised me today that they don’t collate specific statistics on the cost of treating EU migrants permanently resident in the UK (which means that the Daily Express and Daily Mail cannot calculate those statistics either).

However, it does work both ways. For example, according to research published by the TUC, it costs the Spanish government £249 million a year to provide health care services to the approximately one million British residents in Spain (net, after insurance and UK charges) - many of them pensioners, rather than young, fit migrants.. 

Furthermore, although the Mail and Express referred to ‘medical tourism’ as a drain on the NHS, such tourism actually generates millions of pounds for our health service. 

According to researchers from the London School of Hygiene and Tropical Medicine and York University, 18 British hospitals earned £42 million from foreign patients (2010 figures, now likely to be higher). Furthermore, medical tourists spent an estimated £219 million on hotels, restaurants, shopping and transport in the UK.

It’s true that hospitals are overstretched; but it’s disingenuous, mean and nasty to blame EU migrants for that. 

The reason hospitals are struggling is because of lack of investment to meet demand, especially from the growing number of older patients (rather than migrants, who are more likely to be treating patients than being patients).

The Daily Express, the Daily Mail, including the cancer doctor they quoted, appear to have made the wrong diagnosis. So, would it be wise to accept their treatment plan (for Britain to leave the EU to save the NHS)?

Further reading:


Related articles by Jon Danzig:

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