My Lords, migrants from high tuberculosis risk countries intending to stay in the United Kingdom for more than six months are currently tested for tuberculosis on arrival, as are people applying for asylum at ports and airports in the UK. As we announced in Controlling Our Borders, our five-year immigration and asylum strategy (Cm 6472) published on
HIV, as a non-airborne infection, poses a lower immediate risk to public health, but the case for extending compulsory health checks to that and other infections is being kept under review.
My Lords, I do not have an answer to that. I have nothing in my briefing that says that the testing procedure is not up to scratch. Under the testing procedures at Gatwick and Heathrow, 185,000 people a year are tested, and people are found to have the infection. The recent increase in TB in this country is a cause for concern, given that the number of people suffering from the disease was stable, although the disease had not been eradicated. In the mid-1980s, 5,500 people a year were reported with the disease. That has risen to about 7,000 people, so there has not been a dramatic drop. Two-thirds of that number is discovered in people not born in this country. However, if, as the noble Baroness says, our procedures are not meeting international standards, that point will be taken up forthwith.
My Lords, does the Minister agree that concern is properly expressed about this issue, in relation not simply to the potential spread of infection of tuberculosis and HIV in the United Kingdom but also to the potential burden that such individuals may impose on the National Health Service in relation to their treatment? Is there not a case to be made for requiring legal immigrants wishing to come to this country to undergo screening for these conditions in their native countries, so that those who are infected can be refused visas?
My Lords, the short answer to that is yes—although I probably did not make that clear because of the short answers that one is required to give. I did say that we had published our five-year plan in February this year, which made it clear that we intend to take the next stage of the process of requiring TB screening at entry clearance stage—that is, in the country of application. Therefore, if screened and found to have TB, people would be required to undergo treatment before a visa was issued.
My Lords, although the Question includes both TB and HIV—and I am certainly not criticising that—the public health risks are somewhat different. TB is airborne and HIV is not, so a different procedure is used. Lots of advice, treatment and screening are available for HIV, and the idea that we are doing nothing is not the case.
The matter is highly sensitive. On the one hand, we do not want people to resist coming forward because of possible stigmatisation; on the other hand, they need to know that early treatments are available. But the two issues are slightly different, simply because the risk to public health is much greater with airborne TB than with HIV.
My Lords, I regret that I do not have a specific answer to that, but I shall obtain one and write to the noble Baroness.
No, my Lords; I do not. Again, that is a question that I cannot answer. I shall see whether I can get an answer, but I am not so sure that it will be possible to put an actual, precise figure on it. We know the approximate figures. There is a worldwide problem with TB: some 9 million people a year are contracting the disease and 2 million to 3 million die from it. So it is a serious disease, which has certainly not been eradicated; indeed, that is long overdue.
My Lords, while recognising the purpose of this Question and appreciating the answers—particularly in the case of HIV—does the Minister agree that to avoid the necessity of some of the testing that might be required for asylum seekers, especially those from Africa, we should do more to ensure that protected sex is taking place in those countries?
My Lords, the Department for International Development has large programmes, details of which I am quite happy to share with the House, on a range of issues relating to what we are trying to do to improve health in those countries. In some ways, both these conditions, though not necessarily in equal measure, are diseases of poverty and ignorance—and outright prejudice, in some respects. But the programmes that the Department for International Development has in various countries, and through the World Health Organisation, seek to meet the issues that lie behind my noble friend's question.
My Lords, what happens to those who test positive for tuberculosis? Are they treated or simply not allowed entry and sent back?
My Lords, people who are found to have TB here are treated, whatever their status. There is no argument about that. Their immigration status is irrelevant in that regard. They will be treated as, for a start, it is a public health issue. If they are known to have TB before entering the country, they will not gain entry. As I say, screening processes need to be stepped up to screen people before they leave their own countries, particularly where there is a high risk of TB. If people show signs of ill health or mention ill health at ports of entry to this country, under the immigration procedures put in place in 1971 Immigration Service officials can ask them to undergo screening there and then. As I say, at the present time 185,000 screenings take place a year at Heathrow and Gatwick.