Draft Immigration (Health Charge) (amendment) Order 2023 (First sitting)
Debate between Meg Hillier and Tom Pursglove(3 months, 2 weeks ago)
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Tom Pursglove
Let me start by expressing my gratitude for the scrutiny of this statutory instrument and for what I think is an indication from the Opposition that they will support this change to the level of the surcharge.
Before I address some of the issues and questions that have been raised, I want to make the general point that those who move to a new country expect to pay towards healthcare and that countries around the world have a range of systems in place for them to do that, in line with individual healthcare models. It is worth saying as well that since its inception the health charge has generated more than £5.1 billion for the NHS. The funds generated are shared between the health administrations in England, Scotland, Wales and Northern Ireland, using the now familiar formula devised by Lord Barnett. We think that it is right that individuals pay a contribution towards being able to access the NHS and the care that is provided. As I said, that is comparable to the level of financial contribution that others make elsewhere—perhaps through different approaches, but in terms of making contributions towards healthcare, that is what happens. We think that this is comparable and an appropriate way of going about obtaining these funds in order to support the NHS and to ensure that it is sustainable.
There were a few points that I wanted to pick up on—first, about the calculation. The shadow Minister, the hon. Member for Aberavon, asked about that specifically. As the Chief Secretary to the Treasury set out on 13 July, the health charge rates have remained unchanged for the last three years, despite high inflation and the wider pressures facing the healthcare system. The increases to the charge reflect the higher costs of healthcare provision and increases to healthcare budgets since 2020. Additionally, the assumptions on how intensively charge payers use healthcare services in different settings have been revised to use more recent and representative data, with the intention of better reflecting migrants’ use of these NHS services. Although the health charge is increasing, it is still considerably lower than the comparable average cost per capita of providing healthcare for the average UK resident, which stands at about £2,700 per person.
Dame Meg Hillier
The Minister talks about the average per UK resident. That was unclear from the impact assessment; I thought it referred to the average for the applicants paying the surcharge. However, the evidence is very clear, particularly for people such as students, the younger population, that they have very little purchase on the NHS when they are here, because generally they are a healthier population. Migrants tend to be younger. Therefore, has the Minister done an analysis of what the cost has been of providing healthcare to the cohort in question—that is, those who have been paying the health surcharge?
Tom Pursglove
What I will say to the Chairman of the Public Accounts Committee is that I am very happy to take away the various very involved, technical points that she is making and provide an update to the Committee. She will recognise that I have been in this role since the start of December. She has asked whether I have reviewed certain alternative approaches. These are all things that I am very willing and keen to have a look at. In fact, I thought that the shadow Minister made a valid point about regular review of the appropriateness of the level of charging. That is something that I would quite like to have a careful look at to consider whether there are further steps that we can take on that. I am very happy to provide a thorough update to the Public Accounts Committee about these very involved points that have been raised in the course of this debate.
Dame Meg Hillier
On a point of order, Mr Pritchard. We are in the middle of scrutinising a statutory instrument that will be passed or—looking at the numbers—might well be passed this afternoon, yet the Minister is unable to provide me with information and answers from what is a detailed and thoroughly worked up impact assessment. Officials are in the room. I am a patient woman: I do not need the answers this minute, but perhaps in the next 10 minutes—they were not difficult questions that I asked. They are questions that I think the Minister needs to answer before we agree an SI. I would appreciate your guidance, Mr Pritchard, on whether we can leave questions to be answered after a statutory instrument is passed. This is all from the impact assessment document.
The Chair
I am grateful to the hon. Lady for her kind comments. It is a difficult one for the Chair, to be quite frank about it. I do not know whether it is the right approach, but I note what she says. More importantly, I am sure the Government have noted what the hon. Lady has said, and we all know that she will continue to pursue her point.
Tom Pursglove
Of course, I have not finished answering many of these points, so it is important to note that too. I have set out the position on how the charge has been calculated, and I think it is most definitely worth the Committee having an understanding of that and being able to clarify it. It is also worth saying that when it comes to the use of healthcare—I note the point that the Chair of the Public Accounts Committee made about this—evidence suggests that migrants’ use of healthcare is lower than the UK population. Differences in NHS usage are largely due to migrants tending to be younger and healthier. The modelling adjusts for the age and gender profile of migrants compared to the general population. It is also worth saying that the IHS is charged at a flat rate. We think that is fairer to all and that it takes account of the use of services. That is the basis on which historically the charge has been calculated.
Colleagues across the Committee have quite rightly raised questions about fee waivers and the ability of people to access them when they are needed. It is recognised that, in some instances, people who are required to pay the health charge may not be able to afford it. In those instances, particularly on family and human rights immigration routes, and where backed by clear and compelling evidence provided by the individual, the health charge may be waived. Where a fee waiver application is successful, the application fee and the health charge will be waived. Migrants who are granted a partial fee waiver are required to pay the application fee only; the health charge is waived in full. Evidence suggests that migrants are aware of the fee waiver process, due to the volumes of migrants on eligible routes utilising fee waiver applications. In the year ending September 2023, there were over 46,000 fee waiver applications.
The Chair of the PAC also raised a question about the modelling. She will recognise that the Home Secretary set out on 4 December the initial announcement on the net migration changes we are seeking to advance as a Government. We believe that those will, in their totality, reduce net migration to this country by 300,000 when taken together. That is the basis on which we are taking forward those proposals. However, I will very happily take away the Hansard report of this debate, and if there are outstanding points, I would be very glad to write to her to provide some additional detail.
Dame Meg Hillier
I thank the Minister for that helpful comment. It is helpful to get the timetable clear. This impact assessment was signed off in October, so presumably the figures—I will say this for Hansard, so that it can be picked up—reflect the situation in October, and not the policy announcement as of 4 December. That makes me ask: what will the impact assessment be now, after that policy announcement in December? It would be very helpful if the Minister provided me with updated figures.
Tom Pursglove
I am very happy to take that request and roll it into the update that I would like to provide. Colleagues across the House know that I am always keen to be as helpful as possible to colleagues during the course of our proceedings and in the work that we do, particularly to facilitate scrutiny by Select Committees.
In conclusion, our NHS was founded to care for every citizen in their time of need. We as a Government, and, I think, all Members of this House, feel that that principle must be cherished and preserved. Equally, it is right that migrants granted temporary permission to be in the UK make a financial contribution to the running of NHS services available to them during their stay—that is a matter of fairness. On that basis, I commend the order to the Committee.
Question put and agreed to.
Rwanda Plan Cost and Asylum System
Debate between Meg Hillier and Tom Pursglove
Tom Pursglove
My right hon. Friend recognises that the plan is one part of the overarching strategy we are taking forward to address the issue. Let us not forget that if we had taken the advice of Members on the Opposition Benches, who have voted against so many of the measures we have put in place to try to address the issue, we would not have seen crossings down by a third, Albanian arrivals dropping by 90% or hotels being closed. It is fortunate that we did not take their advice—I dread to think what the situation would be had we done so.
Tom Pursglove
It is worth the hon. Gentleman reflecting on the fact that the small boats phenomenon was not an issue in 2010. He is yet another Labour Member who has voted repeatedly against the various efforts we have sought to make that have started to deliver the progress that I believe the British people want to see. The instincts of my constituents, and no doubt of his constituents, lend themselves to getting on and getting to grips with the issue. That is a fact, and the record speaks to that fact. We will continue not to take the advice of those who would do very little, if anything, to address this issue, and we will get on with delivering on this plan.
The plan recognises that illegal migration is a highly complex challenge, requiring innovative solutions. In the Rwanda partnership, we have just such a solution. We are sending the crystal clear message to those thinking about crossing the channel to get to the UK that they will not be able to stay. Let us not forget that, as I have said repeatedly, all those people are leaving what are fundamentally safe countries to make those crossings, which have been organised by criminal fraternities.
Of course it is true that the creation and implementation of a novel approach such as this comes with an expected cost. To date, £240 million has been paid to Rwanda, and those figures have been provided to Parliament. The funding arrangement is boosting the economy of Rwanda, which will benefit both host communities and those relocated there, and will go to areas such as agriculture, jobs and infrastructure. We have also provided an up-front credit to pay for start-up costs in advance of flights.
Although we do not agree with all of the Supreme Court’s conclusions, we respect the Court. Last month, the Home Secretary signed a new internationally legally binding treaty to address the Supreme Court’s conclusions. Crucially, the treaty removes the risk of refoulement and provides for an excellent standard of care for all those relocated. Both countries’ adherence to their obligations will be robustly monitored. The High Court and the Court of Appeal have already confirmed that the principle of the partnership—to remove those with no right to be here to a safe third country—is lawful and compliant with the refugee convention.
Tom Pursglove
I will gladly give way to the Chair of the Public Accounts Committee.
Dame Meg Hillier
I thank the Minister for finally giving way to me. He skipped over the costs of the Rwanda scheme. Yes, we know about the £240 million and the £50 million next year, but only because, as my right hon. Friend the Member for Normanton, Pontefract and Castleford (Yvette Cooper) said, it was leaked—it emerged from the Rwandan Government. That is being investigated. Can he not just share with the House the total cost of the scheme? There is no reason not to do so. It is a flagship scheme of the Government. The Minister, from what he has said, is clearly proud of it, so why can he not share with us the total cost committed in the treaty?
Tom Pursglove
It is slightly uncharacteristic of the hon. Lady to be mean-spirited. It is fair to say that we are having a good debate, and both Front Benchers have taken many interventions. The Government have provided those costings to Parliament, and we will continue to report the costs in the annual report and accounts in a way that is perfectly normal, perfectly reasonable and perfectly respectable.
Oral Answers to Questions
Debate between Meg Hillier and Tom Pursglove(2 years, 7 months ago)
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Tom Pursglove
I am mindful of the point that the hon. Lady makes. She will appreciate the fact that I am new in role in the Department and that I am getting up to speed with the Bill. We began taking evidence in the Bill Committee yesterday, and the line-by-line scrutiny will begin after the recess. I take on board the point that she raises, but what is crucial in taking forward the measures in the Bill is how we operationalise those plans, and I would fully expect that we will be sympathetic in taking proper account of the issue that she raises.
Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)