New Clause 8
Health Bill [Lords]
2:45 pm
Sandra Gidley (Romsey, Liberal Democrat)
I do not have that information, but if the hon. Gentleman is interested we can table a question to the Home Office and it will provide the answer.
In May 2009, the committee on economic, social and cultural rights voiced its concern over the low level of support for and difficult access to health care for rejected asylum seekers. The charging structure also runs counter to other Government policy objectives on public health, social exclusion, combating HIV/AIDS and TB, and the Every Child Matters agenda.
Restoring refused asylum seekers’ access to free secondary health care would ensure more efficient use of NHS resources. Treatment that prevents or cures illnesses is obviously more efficient and effective than waiting for a condition to deteriorate until it reaches the thresholds of immediately necessary or urgent treatment, which cannot wait until the person is expected to return home. That conclusion was also reached by the Joint Committee on Human Rights, which repeated a previous recommendation that
“free primary and secondary healthcare be provided for all those who have made a claim for asylum or under the ECHR whilst they are in the UK, in order to comply with the laws of common humanity and the UK’s international human rights obligations, and to protect the health of the nation”.
It also stressed the very difficult position of refused asylum seekers who cannot be returned and recommended that the Government issue guidance to set out clearly their entitlement to free health care while they remain in the UK.
If the Department of Health issues further guidance before that has been done, it should help to ensure the proper implementation of existing guidance and relieve some of the burden on health care professionals by specifically stating that the decision whether to treat somebody rests entirely with the commission. That was confirmed in another place by Baroness Thornton on 6 May 2009.
Refused asylum seekers on section 4 should be exempt from charges as the grant of section 4 support means that the Government accept that those people are temporarily unable to return home and would otherwise be destitute. All HIV treatment should be considered immediately necessary. That has been recommended by the British HIV Association and there is clearly a public health implication here. The Government should also take steps to reimburse hospitals in areas where large numbers of asylum seekers are grouped so they do not have to bear an unreasonable extra cost from properly implementing the guidelines. There would obviously be a disproportionate impact on those areas.
Earlier, a comment was made from a sedentary position about how much all this would cost. The more important question is, how much less would it cost if we treated early? Community-based health care is cheaper than secondary health care. Seeing a nurse at a GP’s practice costs £33 an hour. Seeing the GP costs £116 per hour of patient contact. Prompt referrals to hospitals for care that is required can be very cost-effective. For example, seeing a doctor who is a medical consultant based in a hospital costs £163 per patient-related hour and out-patient attendance at a hospital for a face-to-face meeting, non-consultant led, would cost £55 for first attendance and £71 for the follow-up.
Compare that to the cost of treating someone whose condition is allowed to deteriorate until care is absolutely necessary. The average cost for a journey in an emergency ambulance is £263, or £344 in a paramedic unit. If surgery is required, the cost for a surgical consultant to perform an operation is £388 per hour. Similar arguments can be extended to mental health issues. In short— [Interruption.]
The hon. Member for Eddisbury has spoken at length on a number of amendments. The first one I speak at length on, he seeks to mock me. He is being rather churlish.