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13 Dec 2007 : Column 169WH—continued
The hon. Gentleman also referred to the Christian view of these things. My experience of working in my constituency with faith-based organisations is that they share my view. In fact, every faith-based organisation shares my view, not his, that this is an inhumane policy and not simply a matter of running the system and policies a little better. We ought to pay tribute to the work that those organisations do, but also recognise that if one is going to suggest that we run the country and our policies on Christian lines—I understand his point—we ought to seek the view of the voluntary organisations on the policies, as many of them have to pick up the pieces of the destitution.
Health has been mentioned again by hon. Members. It is the clearest example of how the system is not only inhumane, but counter-productive. The report goes on at great length, with plenty of evidence—albeit in many cases anecdotal—on the effect of the health care rules. I wish to discuss a couple of examples.
The first example is the assertion that there is health tourism in the UK. As the hon. Member for Walthamstow said, there is not good evidence that there is a significant amount of health tourism. In any event, that description is insulting, and I am sorry that some of the mainstream media use it. If we are going to talk about people coming from outside the country to access our health service, we need to take a balanced view and net off the impact that poaching our health service has on the health care resources of other countries.
Despite the Government’s recognition of the problem and attempts to limit it, we still take health care professionals from countries that have far fewer health care professionals per head of population than we do and far greater burdens of ill health. Because of the way international labour flows, whether deliberately or not—I hope the Government accept that I am not claiming that they seek to do this deliberately—we are responsible for undermining the health care systems of many countries from which migrants and asylum seekers, some of whom are unsuccessful in their claims, come.
For us to argue that people coming here from a health care system that is worse because the doctors and nurses whom it has trained up and whose training we may have contributed to are now working in this country are in some way stealing our health service resources, when they may well be being treated by people from their own country who have come to work here, is a bit of a cheek at least, and an extremely unfair and unfortunate allegation at worst.
Mr. Stewart Jackson: I do not think that it does a debate on transparency in immigration and asylum a lot of good to disregard, in effect, the real stresses and strains on the delivery of public services that EU migration, for instance, has caused. Such migration is not pertinent to this debate, but we are not talking about necessarily sophisticated media. There is a strain, and the by-product of that strain is that genuine asylum seekers and refugees are held accountable for the fact that there has not been planning for EU migration, for instance, which may not be health tourism, but which certainly involves accessing local facilities that are not adequately resourced to cope.
Dr. Harris: I thank the hon. Gentleman for raising that interesting question, because it is important to discuss it. Any group of people coming to this country may have higher than average health problems and lower than average wealth-generating potential than others, but we know that the EU migrants, who are generally younger and here for work purposes, are usually net contributors in terms of tax versus welfare, and that they use the health care system much less than average because of their age. Therefore, even if they were not filling health care posts, which they have done for a considerable period, it is extremely difficult to make a logical case that EU migration is a net drain on our resources for that reason.
The people who are a net drain, although I would not use that term, on our resources are the elderly people in this country, but they are entitled to health care resources that are far greater than what they contribute now—not only because they contributed in the past through their working lives, but because that is the right and proper thing to do.
If the NHS is stressed, it is wrong to try to blame any group of people. It is an emotive thing to do, and the real risk of talking the language of migrants being a drain on the health service is that people think that their grandmother cannot get a hip replacement because of the foreigners—they might say “foreign-looking people”—who are somehow ahead in the queue. It is extremely difficult to access health care services if one is not permanently resident in this country, so the argument that migrants jump the queue in any way is absolutely wrong. It is incumbent on all politicians in all parties, in local government and central Government, to ensure that we argue the case for a civilised debate on the matter and do not seek, to coin a phrase, to blame the scapegoat.
On HIV/AIDS, it is bizarre that the Government—in particular, the Prime Minister—have a long-standing commitment to ensuring universal treatment in the developing world but not in this country. That defies belief. It is not a rational approach, particularly given the fact that it is not sensible in economic terms not to invest in HIV treatment to keep viral load down. There are dangers of infection if the viral load goes up and, therefore, more cases present as an emergency, and also because people are more infectious—usually through sexual contact, of course—when they are not under treatment for HIV/AIDS. The policy does not make sense in terms of health care either.
It seems wrong that we have shifted the question of whether people should be treated on to health care workers who find it ethically difficult to deny treatment to people who need it, even though it is not immediately necessary in the language of the regulations. As the hon. Member for Hendon said, infectious diseases have real public health implications. If the idea is that people will now not be allowed primary care but will have to rely on presenting to accident and emergency, that will undermine completely any pretence the Government have to running a rational health care system. Yes, a good way of generating accident and emergency admissions is by not treating diabetics until they present as emergencies, but the suggestion is ridiculous even in terms of health care economics.
I hope that the Department of Health view prevails if, as we believe, there is an argument between the Department of Health and the Home Office. It will be difficult for the Government to escape criticism from health care professionals and human rights groups if it does not.
There is a responsibility on Opposition politicians to ensure that if the Government produce a sensible policy on asylum seekers that is not draconian, it is not criticised. I hope that the Opposition will accept that.
It is important to recognise the impact of Government policy on children. Whatever one says about the motives of people who claim asylum—I do not accept that a large number make applications in bad faith—children should not be victims of decisions and processes initiated by other people. The report makes lengthy recommendations on how children should be looked after, but the Government responded positively to only a few. It would be extremely useful if they at least made a statement, even if they are not prepared to drop their reservation about the convention on the rights of the child and asylum-seeking children having the same rights as other children under domestic legislation. I hope that that is not too much for the Government to say yes to.
I hope that the Joint Committee returns to the matter, because there have been a number of responses to the Government’s response, and the Government gave a number of commitments on more consultation, more regulations and returning to some of these matters. I fear that there will always be an immigration Bill, although the Government will be asked to change their policy and the law. I hope that the Committee presses the Government on these issues.
The Government should be ashamed of their policy and their inadequate response to the criticism of it. I have spoken without commenting on Home Office efficiency and the Border and Immigration Agency, because the Government have at least recognised that reform is necessary. They have a new asylum model—I am not criticising that—but their performance on the recommendations of the report of the all-party Committee of both Houses has been dreadful, and their response inadequate. I hope that the Minister, who is more than capable of providing a better response to the report, gives us the answers we want.
4.42 pm
Damian Green (Ashford) (Con): This has been a fascinating debate on an important report, but I want to make a procedural point. In an era when the subject of welcome topical debates is decided each week in the main Chamber, it is faintly absurd that an interesting and controversial report is published in March, the Government publish their response in June and the Chamber debates it in December Surely we can do better than that in procedural terms, so that such reports can have more impact than even this one. It is absurd that it takes so long for such a report to be debated.
Mr. Dismore: I agree, but it was open to the Opposition to select the matter for debate on an Opposition day. I would have welcomed the opportunity to debate it earlier.
Damian Green: I am sure that is so, but the hon. Member for Hendon (Mr. Dismore) will understand that there are many important matters that we want to debate, especially concerning the Home Office, but we have only a limited number of Opposition days on which to do so. Sadly, this matter has fallen through the net so far.
Turning to the substance of the report, during my 10 years in this place, I have not heard a more devastating attack on the Government in a Select Committee report than that made by the hon. Gentleman. He said—I do not think I am paraphrasing him unfairly—that current Government policy is not just illegal because it breaks our international treaty conventions, but is immoral because it reduces some of the most vulnerable people in this country to destitution, and achieves that not because of incompetence in the delivery of policy, but as the specific aim of the policy. I cannot imagine a more devastating critique of any Government policy. I noted carefully what he said in his cogent introduction, and that seemed to be the thrust of his comments and of the report. It is clear that times are slightly out of joint for the Government when the most supportive remark to the Minister comes from my hon. Friend the Member for Peterborough (Mr. Jackson) about a detail of the policy as it has affected his constituents.
Mr. Stewart Jackson: My hon. Friend may get me into trouble with our Whips. My point is that the Government’s policy is probably completely incompetent and immoral, but not systematic. It is more cock-up than conspiracy, but it is still disastrous.
Damian Green: I am grateful for that clarification, but I suspect that the Minister may not be. I agree with my hon. Friend, and I do not ascribe malign motives to the Government in this area. It is just one more area in which things are going badly wrong. I have some sympathy for the Minister because, as several hon. Members on both sides of the Chamber have said, the tone of the debate is important. I agree, and Conservative Members seek always to deal with asylum and wider immigration matters in a measured and reasonable tone. In pursuing a proper balance, it is important not to assume that the Government have evil motives or that everyone involved in the asylum process is necessarily a victim.
We can and do have arguments about individual cases on behalf of our constituents, but there is a danger that as the tabloid press tend to sensationalise in one direction, we tend to tip over in the other direction and assume that everyone who applies for asylum is genuine and that they are all victims. My modicum of sympathy for the Minister is that anyone operating the system must do so fairly, and allow genuine refugees to lead a reasonable life in this country, but they must also decide that some people are not genuine refugees and try to run a system that does not attract to this country people who are not genuine refugees. To that extent, I have some sympathy with him, but such sympathy has not been expressed by any Labour Member.
Mr. Dismore: I made it clear in the first paragraph of my speech that the Committee accepts that some asylum seekers are not genuine and must be removed. The question is whether it is right to starve them into submission or to remove them humanely.
Damian Green: That is a reasonable point, and I was about to say that one indictment of the current system is that it is not effective, efficient or quick. The human effects of that incompetence are, as the hon. Gentleman said and as all reasonable people admit, to have destitution as the effect of public policy, even if it is not the cause, and that is clearly unacceptable.
Dr. Evan Harris: I understand the hon. Gentleman’s point, but support under section 4 of the Immigration and Asylum Act 1999 applies to people who cannot be removed, so it is not a question of Home Office delay in dealing with their cases or removing them. Does he believe that current policies on section 4, and specifically the use of vouchers, which are probably not the most efficient way of delivering support, are appropriate in such circumstances, given that that cannot be blamed on slowness or inefficiency, because people are trapped here?
Damian Green: I do not object in principle to the use of vouchers although, having spoken to many of the organisations that work in this area, I agree that the application of the system under section 4 is clearly unsatisfactory.
The issue of children is clearly one of the most sensitive subsets of the many sensitive areas dealt with in the report. The Minister will be aware, as he and I enjoyed many debates during the passage of the Bill that became the UK Borders Act 2007, that Opposition Members feel that the Government are not doing enough to protect asylum-seeking children. I was interested in paragraph 190 of the report, in which the Committee states:
“We are concerned about the detrimental consequences of providing inadequate and inappropriate support and accommodation to separated asylum seeking children.”
The Minister will know that we welcomed the concessions that the Government made during the passage of the 2007 Act. A good deal of useful work was done by the Refugee Children’s Consortium. However, one question that I shall put to him to add to the enormous pile of questions that he has to deal with when he responds is whether he will look again at applying section 11 of the Children Act 2004 to the Border and Immigration Agency.
In paragraph 191 of the report, the Committee noted
“the difficulties local authorities face in providing an appropriate package of accommodation and support to separated asylum seeking children”
“the lack of additional resources”.
That is an important point. It is more than just a standard local authority battle with central Government about funding, because this particular financial and organisational burden falls disproportionately on a relatively small number of local authorities. As it happens, my local authority in Kent is one of them, but it goes much wider than that to include, obviously, Hillingdon, Slough and so on. Indeed, local authorities across the political spectrum in terms of control have joined together to make the point to the Minister that that is a genuine area of concern. Will he therefore address the grant formula and say whether he believes that the authorities that need most support so that they can provide adequate facilities and support for unaccompanied asylum-seeking children are now receiving it?
There was much discussion, notably by the hon. Member for Oxford, West and Abingdon (Dr. Harris), about the effect on the health service of the various problems in this sphere. Again, the Committee said that the Government had not produced any evidence to show the extent of health tourism. That is a genuinely interesting debate in which evidence is all-important. The concept of health tourism is now out there and frequently appears in the media, and no doubt many people in this country take it as a given. If health tourism is not happening, it is clearly in everyone’s interest for that to be shown, and if it is happening on any large scale, the Government need to take effective action on it.
Mr. Dismore: This is an important point and one that the Committee raised. It is very difficult to prove that something is not happening, but if there is evidence that it is, surely it is the Government’s responsibility to prove that there is such a thing as health tourism. When we investigated that with Health Ministers, we found no evidence to support the assertion that it is happening. No statistics at all were available to give any indication one way or the other. On that question, the Government have not made their case. Moreover, in relation to charging asylum seekers, there was no evidence at all about how much was being charged, how many were being charged or how much had been recovered from those who had been sent the bills.
Damian Green: Those are all cogent questions and I look forward to the Minister addressing them.
One issue that has not been discussed in the health sphere is screening of those coming to this country. I know that this slightly stretches the terms of this debate on the Committee’s report, Mr. Bercow, but given the recent very important report by charities involved with hepatitis B and their criticism of the lack of screening, will the Minister address that issue as well?
Another key area is obviously detention and removal—again, particularly in relation to children. Many hon. Members expressed their unease about the detention of families and children, particularly at Yarl’s Wood detention centre. Like many others, I have visited Yarl’s Wood. I thought that the authorities there were doing their best. I do not think that the centre is badly run, but clearly the sight of children being locked up behind what looked like prison doors made me extremely uncomfortable, as it would everyone.
I know particularly well that the Minister is about to experiment with different models, because he is going to do so in my constituency. I obviously hope that that succeeds, but it would be interesting to know whether he thinks that, without compromising the ability of the authorities to remove families, it is possible to move to a situation in which detention of families is not regarded as the norm. We heard examples of cases in which it is fairly routine for children to be detained for more than 28 days, and in some cases children have been detained for three months and more. As long as there are the current delays in the system, I am sure that the Minister will feel as uneasy as many of the rest of us do about the humanitarian effects of that type of policy.
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