Should migrant workers pay a bit more for the NHS?

I read there is a debate about the way the UK asks recently arrived workers to pay a charge for use of the NHS.  Some say as they have recently arrived it is sensible to ask them to pay some extra money for all the established facilities and staff on payroll they get access to. Others say they are paying taxes like the rest of us, so maybe that covers it.

This issue is a small part of a much wider question – how much does it cost the host country to accommodate and support new migrant workers? In most of the analyses undertaken people just look at the revenue costs and tax coming in. We need to look at the capital costs as well.

The EU once seemed to give us an answer. When they were looking at the way a few countries in the EU seemed to end up with a large share of the total economic migrants into the area, they suggested that countries not taking their share should have to pay Euro 250,000 for each one going somewhere else up to an appropriate quota for them. This apparently large sum was a capital cost, and presumably reflects the fact that each new  migrant needs a home, and capacity in public services.

When a country has pretty full employment and a housing shortage, each new arrival means the need to build a new home, to provide additional classroom capacity in schools, extra surgery and hospital space for health provision, more roadspace and train capacity and so on. In the case of the UK accepting around 250,000 extra people every year it is not possible to squeeze them all in to the homes, schools and surgeries already built, so there is a capital cost in provision.

The argument about the NHS annual charge is a smaller number than this question of the set up costs for new migrants. It is perhaps this bigger issue which needs more of our attention, especially given the difficult politics of speeding up housebuilding and expanding schools.

 

136 Comments

  1. Peter
    May 14, 2018

    It should be part of a more comprehensive scheme to identify citizens of the UK and those who are not.

    Health tourists should definitely be denied free treatment.

    With EU citizens there is a wider debate to be had.

    1. tick tock
      May 14, 2018

      Why “With EU citizens there is a wider debate to be had” ? Are they members of some super race?

      1. Peter
        May 15, 2018

        1. As long as British citizens have EHIC cards offering some free medical treatment in Europe then some form of reciprocal arrangement for EU citizens in the UK would need to be provided.

        2. If EU citizens are legally living and working in the UK, then why should they be denied treatment?

        1. a-tracy
          May 15, 2018

          Other EU countries don’t pay for our health care though do they, they bill it back to the NHS, the NHS are just very poor at billing back work we do.

          “The UK pays more than £670m to EU countries for Britons’ healthcare abroad, while claiming back less than £50m from the EU.”In what one MP described as a “scandalous failure”, it has emerged that the UK pays more than £670m to EU countries for Brits’ healthcare abroad, while claiming back less than £50m from the EU, even though there are significantly more EU citizens in the UK than UK citizens in the EU.

          Under the European Health Insurance Card (EHIC) – countries can claim back health costs from other EU countries if their citizens use medical services abroad.” Google Sky News

        2. tick tock
          May 17, 2018

          Peter
          I understand what you write in your points 1 and 2 . I really do. Though there is a misunderstanding about “reciprocal” medical treatment in the EU. I have experienced it personally. To put it diplomatically: quality of health infrastructure in EU states is patchy.
          If there is a best place to get ill, it is here and merely a handful of other EU states. I short, we get a poor deal indeed in “reciprocal” health care. Therefore, EU citizens should pay upfront.

    2. Iain Gill
      May 14, 2018

      for a lot of cases its not as black and white as health tourists

      its simply a higher proportion coming here with more expensive than average medical history and likely medical needs while here changes the financial equation

      with the practical problem that our system is capacity constrained, and that is how we ration care, so allowing a higher than average proportion of people who will need care does actively reduce the capacity for everyone else

  2. Mark B
    May 14, 2018

    Good morning

    You cannot have a free at the point of service healthcare and welfare service and MASS immigration at the same time. UK taxpayers are effectively subsidising corporations imported workers. If a company wishes to bring someone into this country then the costs of their healthcare and support for their families should be borne by them. That way they would have to actively seek a UK citizen before going for the cheap option.

    1. Lifelogic
      May 14, 2018

      Exactly and this should have been blindingly obvious to any government or civil service at the time they agreed to have open borders to all of the EU plus their relatives.

    2. tick tock
      May 14, 2018

      The companies should pay the healthcare costs of immigrants, plus housing and child benefits plus administration costs to the government. Should their worker-migrants get into trouble with the law they should pay the legal fees and costs of imprisonment. Plus fees for probation officers afterwards. And a fine for importing bad people into our country.

    3. Iain Gill
      May 14, 2018

      they should be taxed at least as much as local workers

      and they should not be coming in on work visas with skills already in oversupply

      these are the basics that the government doesnt seem able to sort out

  3. Old Albion
    May 14, 2018

    No one coming to this country should have any right to the NHS until they have paid into the system for a minimum of (say) 5 years. They should arrive with insurance cover for any accidental injury.

    1. lojolondon
      May 14, 2018

      EXACTLY! – As we do when travelling to the USA, for example, or anywhere in the world, really.

      You can have a welfare state or you can have open borders, but never both.

    2. Rien Huizer
      May 14, 2018

      Australians too? Then what about the Brits in Australia?

      1. John
        May 14, 2018

        Travel insurance dear. Its a really good industry that also provides substantial tax revenues.

        Those that can’t afford to pay for travel insurance, injury etc get hit with large bills if they do. Brilliant idea!

        What a great system. I could say all outside of the EU but when I go climbing in the Alps I also pay for private insurance.

        What an amazing idea insurance is Rein. The ability to buy cover discounted because so many use/buy it.

        1. John
          May 14, 2018

          That’s right, I’m covered in the French and Italian Alps but also in the Swiss Alps non EU.

        2. Rien Huizer
          May 15, 2018

          I was referring to UK citizens living in Australia. You seem to be confusing visitors and migrants. There are thousands of UK retirees living in Australia (adn many more in EU countries who receive local health cover via reciprocal arrangements with the NHS. For some rason the NHS lacks the capacity to charge foreign healt funds/schemes to the same extent the foreigners charge the NHS. Or maybe Brits abroad are sicker than foreigners in Britain.

          Of course in the future, once the UK would have become a third country effectively and absent arrangements with EU health funds to replace existing ones, one should expect the NHS become financially competent, because eg Spain will require payment from patients rather than reimbursement.

          But once again, the problem Mr Redwood refers to is not the use of NHS services by visitors (tourists, business travelers, etc) but people residing in the UK, either legally (like EU citizens or long term visa holders) or illegally (like many of the people who travel to the UK from countries like Nigeria claiming to be refugees and once in France, attempting to cross to the UK. In France they would be picked up very quickly (ID cards and residence reporting system) but much less easily in the UK. I do not think that these illegals should receive free treatment (although hospitals may be obliged to treat emergency patients regardless of status before billing them), like migrants covered under reciprocal schemes. If the NHS fails to collect those reciprocal receivables, that is a problem for the NHS, not the migrant or his home country.

    3. Iain Gill
      May 14, 2018

      wouldnt work. for example :- Brit marries a foreigner, the female gets pregnant soon after the marriage, you are looking at a new child 9 months after that, and the child will be British too. do you really want such couples to have no medical care during the maternity? there are many more examples…

  4. Lifelogic.
    May 14, 2018

    Indeed this is why we need quality control on immigration and a points based system not open door immigration to people, many of whom, will be paying in less Tax than they get back in immediate benefits. May has ruled out a points based system. Meanwhile people like Roman Abramovich are, it seems, probably being driven out of the country by Hammond.

    T May in her letter in the Sunday Times says she will take back control of the borders. These one assumes are the same borders that she foolishly assured us in the referendum we had control of (even while in the EU) by being out of Schengen. Also control of Taxation – fine but we do not want it under the control of highest and most absurd taxes for 40 years Philip Hammond. She makes no mention of control fishing waters.

    The people making the much needed investment in new housing are being deterred from doing so by absurd new and grossly unfair taxation from Hammond.

    May asked us to trust her, but why given her performance so far, would you trust her even to deliver a bunch of bananas. Farage suggests she is thinking of another election. Surely she cannot ever be allowed to lead us into another election? We need a real Conservative who is a low tax at heart, real brexiteer with leadership vision and who is a real Conservative. Not a lefty, high taxing, dithering interventionist and visionless left wing dope.

  5. alan jutson
    May 14, 2018

    Pay a lump sum up front to get full cover of the NHS and Benefits, or wait a few years before you get full benefits and NHS cover seem to be the two sensible options.

    Why we allow new people recently arrived to claim full benefits, and get the full range of NHS treatment for free, is simply mad.

    Perhaps start off after a year with 10% entitlement, rising each year until full entitlement after 5-10 years of contributions.

    Likewise holiday health tourists, when we go abroad we have already paid holiday insurance to cover the cost of at least repatriation as well as treatment, if you have failed take out insurance then be sure you have a credit card, because that is what is asked for immediately after your name and address.

  6. Lifelogic.
    May 14, 2018

    The NHS would work far better if all who can paid something for it at the point of use. Also if far more people were encouraged to go privately with tax breaks a fair system that does not make you pay four times over if you do. Currently it is killing thousands.

    1. Lifelogic
      May 14, 2018

      Jeremy Hunt announces £40 million for brain cancer research. Policy determined by what will get you on the news today after the recent sad death of Tessa Jowell. This rather than what produces the best return for each £1 of R&D spent. The NHS is killing thousands and has some of the worse cancer recovery rates in Europe.

      They cannot even run a competent breast screening programme as we have seen recently. Please spend the money where it produces the best return and not where it gets Hunt some political propaganda and TV coverage.

      Yet another Oxford PPE I note PR & spin over substance every time. Just like Cameron.

      1. Iain Gill
        May 14, 2018

        Correct. And the announcement is just “money tree” politics. A good Conservative government should be making clear that money thrown at something does not necessarily improve the quality or quantity of outcome.

  7. Anonymous
    May 14, 2018

    They should have valid insurance – or their employers should provide it at least.

    ‘Cheap’ migrant labour has been subsidised by the hard pressed taxpayer. No wonder UK employers and landlords love it so much.

    1. Anonymous
      May 14, 2018

      250,000 people is nearly three Wembley stadia full.

      All of those need another roof… every year.

  8. gregory martin
    May 14, 2018

    So a qualifying payment makes it Ok?. How about a capital refund to depart to somewhere else? How much is it worth to emigrate?
    Given the money, many Britains may find this an attractive option to escape the currently disintegrating Nation.

  9. Narrow Shoulders
    May 14, 2018

    When a country has pretty full employment and a housing shortage

    Thank you for addressing an issue that is too often countered with siren calls of racism and little Englander.

    The passage above states the heart of the matter. We need immigrants due to a skills shortage apparently yet we have full employment. Who therefore benefits from extra people and new homes? Not the existing population who are displaced by the incomers to accommodate whom local authorities seem to bend over backwards. Not the existing population whose school funding is targeted at those with English as an additional language. Not the existing population whose training opportunities disappear as employers take on cheaper experienced staff from overseas. Not the existing population whose public services receive no extra funds to cope with the additional numbers.

    Follow the money said deep throat. Business and government are the ones who benefit by increasing the size of the market and the taxable population. The path of least resistance for increased revenues rather than increasing productivity.

    Cease!

    1. Iain Gill
      May 14, 2018

      we dont have full employment.

      some industries such as info tech have big unemployment problem as influx of cheap labour has been used to displace Brits from the workforce

      and we have many sink social housing estates far beyond travelling distance to any jobs market of sufficient quantity for the numbers of residents, so we have people in the wrong parts of the country and a housing system which does not support people moving closer to jobs

      and we have overcrowding in other parts of the country where jobs are most available

      1. libertarian
        May 14, 2018

        Iain Gill

        Not for the first time I’m having to point out that this is total drivel.

        We have a massive shortage of skilled IT and digital people , there are 36,000 unfilled IT jobs at the moment.

        Anyone in IT who can’t get a job needs to upgrade their skills or their attitude or both , oh and the average salary in IT in the UK is £52,5oo

        Just because you work for an organisation that has an outsourced provider doesn’t mean that everyone else does too. CWjobs is your friend

        1. Iain Gill
          May 15, 2018

          Simply wrong.
          I am fairly senior in the IT business, and have been inside the major outsourcers, and large corporate IT depts, and consultancies. I have a large network that knows exactly what is going on in the business far and wide.
          The most obvious thing to say to your comment is that the governments own migration advisory committee does not agree. And that IT jobs are not on the shortage occupation list they produce. Which is why intra company transfer visas are used in such large numbers, because those visas uniquely are exempt from considering amongst other things if the skill is in shortage or not.
          There is a shortage of people prepared to work for the low pay business wants to pay, there is no shortage of people at the right money.

          1. libertarian
            May 15, 2018

            Iain Gill

            No you are wrong

            I’ve worked in IT over 40 years at the most senior corporate levels. I own and run a software company that is a data analytics operation collecting data on the job market in the UK , I provide job market data for corporates, recruiters and the government . I also previously owned one of the UK’s largest IT contracting agencies

            There was a total of 93,000 tier 2 visas issued in the UK, across all industries . 49% of them being in the Health and ancillary sectors, i.e. Doctors, nurses, dentists and other medical specialists

            UK IT currently employs 1,317,337 people which means that less than 0.5% of IT workers are on tier 2 visas . There are currently 36,000 unfilled IT jobs

            Not sure what you think you’re saying about low pay

            I already told you the average IT salary in the UK is £52,500

            The rules on intra company transfer say

            You need to be paid at least the minimum salary for your type of visa or the appropriate rate for the job you’re offered – whichever is higher.

            The minimum salary is:

            £41,500 for permanent Staff
            £23,000 for Graduate Trainee

            Heres a handy article that will show you just how wrong you are

            Titled The UK IT Skills Crisis its in Computer Weekly this a report from 2009

            https://www.computerweekly.com/feature/The-UK-IT-skills-crisis-Essential-Guide

            Here is a report from 2018

            https://www.channelweb.co.uk/crn-uk/news/3027078/it-execs-alarmed-by-uks-skills-shortage

            Heres a direct quote

            With employer demand for tech talent routinely outstripping supply, the year ahead will force more organisations to rethink their approaches to recruiting, training and talent management,” said Graham Hunter, CompTIA’s vice president for skills certification in Europe and the Middle East.

          2. libertarian
            May 15, 2018

            Sorry typo less than 2.5% are tier 2 visa workers

          3. Iain Gill
            May 16, 2018

            This is like discussing the earth with those who think its flat…
            The problem with the supposed papers, and data, on this matter is that overwhelmingly those that are incentivised to push for more open doors, who are those producing the papers and briefing politicians, are those making money on the back of cheap imported labour, so hardly impartial.
            I think you are living in cloud cuckoo land. Cutting back on visas will only increase the incentive to train, hire and promote Brits which is no bad thing, and market rates will rise, again no bad thing. There is a large excess capacity of labour already able to take up the slack if projects are prepared to pay.

      2. libertarian
        May 17, 2018

        Ian Gill

        The trouble with debating you is you lack facts and dont like them

        I, thats me and my company collect data on this field. I am independent and have no vested interest. You’re wrong , end of. Oh and by the way the government just turned down 1,600 T2 IT visa requests as the cap has been reached as it has with Doctors and Nurses too

        Fact, There is NO trained execess of Labour 36,000 unfilled IT jobs

        Fact , there are no low wages in IT the average is more than £52k

        Fact , overseas visas are not the problem, our education system is the problem

        Fact As I showed you T2 Visas require that a minimum wage of £41k is paid, there is no low wage cheap imported labour in IT

        1. APL
          May 17, 2018

          libertarian: “our education system is the problem ”

          Now there I can completely agree with you.

        2. anon
          May 19, 2018

          What is the average pay of the unfilled vacancies and where are the vacancies distributed in the UK? Are they advertised in the UK? directly by employers (not agents).

  10. Sakara Gold
    May 14, 2018

    The short answer is no. Foreigners are attracted to this country because of the universal free high-quality healthcare, low levels of crime compared to their countries of origin, safety on the streets, they admire the British way of doing things, there is plenty of work etc

    If they are employed and paying taxes, they are contributing to national development – with the possible exception of foreign students who have overstayed their visas

  11. Bryan Harris
    May 14, 2018

    It would be one thing if all migrants actually worked, but I fear there is a great percentage that have no interest in paying their share, demand large houses for their 10 offsprings and multiple wives, and help to drain our funds.
    It would be good if a contract was established with migrants, such that they were legally obliged to be in paying work within 3 months, and contributing, otherwise they would be presented with a hospitality bill.

    Can’t you just hear labour screaming at the unfairness of that – But something like that is required!

    1. Lifelogic
      May 14, 2018

      Even if they do work on a low wage they might pay only two or three thousand in NI and tax yet get ten times that back in housing benefit, schooling for children, health care for themselves and elderly relatives and all the rest.

      1. L Jones
        May 14, 2018

        So the comment regarding the employers’ responsibility is a valid one.
        If companies wish to bring in, say, seasonal labour, then they should expect to pay for the health care (or insurance) for those employees.
        Any reason why not?
        We have to take out insurance when we leave these shores, even to go to EU countries – why shouldn’t we expect the same from visitors to ours?

        1. Bryan Harris
          May 15, 2018

          Very good points …. The government should take notes

  12. Sir Joe Soap
    May 14, 2018

    An unusually naive posting.

    Houses are neither here nor there; with a work permit system, immigrants would pay rent or buy houses.
    Health- immigrants would of course pay through insurance or by some other method a cost for treatment which would include a capital cost. I don’t pay a capital cost for the supermarket when I buy food – the cost of the food includes an element of capital cost.
    Education- we’d expect new arrivals to pay a contribution to costs unless they were relatively high earners/taxpayers, although of course that could be taken account of in the work permit system.

    Where are we with that work permit system by the way?

  13. JimS
    May 14, 2018

    Wouldn’t it be easier to actually control immigration? We, the people, have been telling you, the politicians, this for decades, why won’t you listen and do what we tell you?

    1. Timaction
      May 14, 2018

      Nail on the head. Politicos know this but refuse to do what the English people want! That’s one of many reasons politics and our voting system needs radical reform. FPTP is unfit for purpose in the 21st Century and leaves little or no choice for the increasing disinfranchised as they are all the same. Morgan, Soubery, Clarke, Hesiltine all share the same platform as the discredited Clegg(what EU military plans!) and by Labour!
      There is no will to stop mass migration the destruction of our culture and obviously shrinking health, education and housing for English people. When are we getting our own devolved assembly like the Scots or Welsh or Irish???
      No chance I,d vote for any of the blue, red or yellow by Labour.

  14. mark riley
    May 14, 2018

    are they and their familes still allowed to use UK issued EHIC cards in their native countries?

    1. Iain Gill
      May 14, 2018

      currently anyone who can prove UK residency, and who is entitled to indefinite leave to remain here, can have an EHIC card to charge care to the UK taxpayer, regardless of the card holders nationality.

  15. Ian wragg
    May 14, 2018

    Immigration is the original Ponzi scheme. We now import immigrants to build houses for immigrants. We have immigrants employed as teaching assistants to translate for immigrants. The NHS maternity units are importing staff to cater for the immigrant baby boom.
    They open their own shops and add to the balance of payments problem.
    GDP rises but per capita doesn’t.
    What’s in it for us.

    1. Timaction
      May 14, 2018

      Nothing!!!

    2. Lifelogic
      May 14, 2018

      GDP rises but per capita (and indeed living standards) actually fall significantly.

    3. Iain Gill
      May 14, 2018

      sadly I agree

  16. Iain Moore
    May 14, 2018

    When my family worked abroad on a work visa they didn’t get access to health services, they had to pay for it. They didn’t get access to education they had to pay for it. They did get to pay loads of taxation to that nation’s Government. They also never had the option of turning a work visa into a right to remain status. In addition they had to take care not to blot their copybook while there otherwise their work visa would have been cancelled and they had to leave. Their work visa was also tied to a company.

    This I would suggest is the terms most British people working aboard accept , and the British Government also accepts, for I have never heard a British Government seek to represent them and change it. The British Government thinks it just fine for British people to work under these terms. Its seen as a bargain they struck with the nation issuing the visa, and terms they have to accept if they want to work there. As such I would suggest it is the British state which is the soft headed odd one out, who believes public services should be offered to any foreign national who rocks up here on a work visa , work visas aren’t tied to the company offering the work, and British nationality should come with a few years of staying here.

    The result is that foreign nations get high skilled high earning British expats who pay their way, while the British state gets low income foreign nationals, who load costs on the public services.

  17. Lahdedah
    May 14, 2018

    First thing to say is that migrant workers is in general they are young and fit and in good health, so except in the case of an accident they are very unlikely to be looking for help from the NHS at least in the short term.

    Secondly, politics is the art of the possible, I’m sure it’s not beyond the ingenuity of man to work out with the EU and others some kind of method of slowing down the numbers coming in- various examples have been mentioned in this diary in the past.

    If we crash out of the EU March 2019 then there will be no problem for us- all we have to do then is put up the border controls- 20 foot high walls as mentioned yesterday

    If we make a new agreement with the EU we should build in whatever solution is necessary to stem the flow- all talk about asking migrants to pay more is superflous as presumably they will be paying taxes and NI etc just like the rest of us?

    1. Lifelogic
      May 14, 2018

      Migrant workers may often be young and fit but they often bring elderly relatives needing treatment. As indeed I would in their position if I thought the treatment better here.

    2. Iain Gill
      May 14, 2018

      Re ” migrant workers is in general they are young and fit and in good health” sadly not factually correct, especially when many bring in other family members

    3. mancunius
      May 14, 2018

      “migrant workers is in general they are young and fit and in good health”
      in which case they are capable of bringing in spouses and children, and having children while here.
      Since many work manually, they are also at heightened risk of accident.

      True NHS costs (from Pharmaceutical Journal / NHS England /Maternity Action):
      GP – £45 per appointment
      Prescriptions – £42 per prescription
      A&E – £80.55 per visit

      Antenatal care £1590-£4233,
      Birth £2244-£3282 (plus additional payments longer stay in hospital needed)
      Caesarean section £3781
      Postnatal care £355.50-£1207.50
      IVF: £3435

      However ‘fit’ and ‘young’ they may be, does a ‘self-employed’ manual worker or bartender on little more than minimum wage, declaring only small annual profits for tax and thus claiming the NIC exemption, pay back what they get out of public services, including the NHS? I doubt it.

      1. a-tracy
        May 15, 2018

        How on earth is a birth £2244 to £3282? Half a day to a full day for most women with a shared midwife, usually working between four women now, no overnight care anymore, I didn’t even get a sandwich!

    4. Narrow Shoulders
      May 14, 2018

      Have you been to A and E or your local GP surgery recently?

      I can testify that when i have attended as a proportion of the whole population those not speaking English to each other are over represented. Of course it may just be that the English’s foreign language skills have improved and they are practicing

  18. agricola
    May 14, 2018

    For European citizens there is the European Health Insurance Card which along with a passport identifies one as entitled to health care wherever you are in the EU. I assume that the country giving the care is reimbursed by the patients country of origin.

    For longer stays, buying property etc , here in Spain one is required to register on the DNI national register. All achieved at a designated police station. This is not citizenship, but a lesser form of it so that the Spanish government knows who is in the country. Spanish citizens are also registered. This entitles one to a SIP registration number and card of the Sistema Nacional de Salut, ie. your entitlement to health care which in my case is paid for by HMG.

    The failing if any is in the UK system or lack of it due to no known system of national registration. You have no idea who is in the country legally or illegally. The NHS is a medical service dedicated to the care of the sick. It is not a cross between an immigration service and the treasury. The failure is in government and specifically the Home Office for not insisting on a system of national registration. With such there would have been no Windrush catastrophe.

    None EU citizens should only be permitted to enter the UK with valid health insurance. If it is their intention to stay as retirees or workers after a six month sabbatical, they should register, pay their taxes and be entitled to health care.

    National registration would be a quick way of sorting the legal from the illegals, but I doubt the bleeding heart brigade or MPs with a large immigrant electorate would allow you to take such a step. The mayor of London would be the first to object.

    1. agricola
      May 15, 2018

      How come you can moderate 6 Lifelogic to 0 Agricola. It makes an utter nonsense of your oft repeated terms of publication. I find it bizarre.

  19. Rien Huizer
    May 14, 2018

    It depends on what their status is. Under -still applicable- Eu rules, the treatment of EU citizens living in the UK is determined. With other countries (eg Australia) there are reciprocal arrangements. That the NHS is not organised to collect fees for services rendered is a problem for the NHS.

    So the “should” is not really the problem. Of course their should be compensation for what a UK state agency does, either via taxes or fees. Nothing to so with a moralistic “should”. If it comes to morals: there may be two cases: illegal immigrants (the ones that clean and do other things no one else wants to do and who are employed by criminals) and legal immigrants, especially EU citizens. Legal immigrants treatment is designed to be reciprocal to the treatment of UK citizens abroad. Would you prefer 50 drunken youngsters having a “party” in Amsterdam (and vandalising along the way) not to be treated in a Dutch hospital (that would claim NHS compensation afterwards)?

  20. B Cleer
    May 14, 2018

    We must do our sums.
    John Migrant arrives to pick carrots ( retail price with packaging on supermarket shelves, not when he picks them =60p per kg ). He requires a major operation costing £15,000, plus benefits to his wife and children, free school dinners Hmmmm
    No, a migrant should not pay a bit more for the NHS, He should not be here.

    1. Iain Gill
      May 14, 2018

      Well if they allowed social housing residents in the North of England to leave their house unoccupied for a few summer months while they traveled South to pick crops, and didnt make it so hard to sign on after having a temporary job for a few months, there would be a lot more of Brits doing it.

      It is only because the politicians have made it so hard for Brits to do these jobs, and so easy for foreign labour, that it works like that currently.

  21. BOF
    May 14, 2018

    They most definitely should be charged. But it also has an adverse effect on the indigenous population when they have treatment delayed and have to wait weeks for an appointment with their GP. And how about the visitors to this country being required to pay for treatment, like my brother from Australia (who wanted to pay but could not!).

    Does it not demonstrate the stupendous folly of an ‘immigration policy’ that allows such huge numbers of immigrants into the country in the first instance?

  22. Denis Cooper
    May 14, 2018

    I look forward to the day when our national immigration policies meet with something approaching universal approval among the established body of UK citizens, unlike the deplorable situation of the past two or three decades when a substantial majority have increasingly felt that they are having excessively high numbers of not necessarily very desirable immigrants forced upon them. Then there will be much less concern about issues such as jobs being taken and homes being occupied and services being used by the immigrants. I do not say we will ever get to the point where everybody in the established UK population would be perfectly content with the numbers and types of foreign people who were being allowed to join them as new citizens sharing their country and would be prepared to give them an proactively warm welcome, but we could surely get beyond the present situation where it is only a small and mainly rather weird minority who will be prepared to go out of their way to help newcomers settle in. I emphasise here that I am not talking about tourists, short term visitors, people on fixed term secondments or students, but only about those who are expected to stay here longer term and with the prospect that they will wish to acquire UK citizenship.

  23. Peter Parsons
    May 14, 2018
    1. tick tock
      May 14, 2018

      I listened and watched but never got to the bit on the video you are talking about…just a long list of astrological statements, this will go up , that will go up without the person speaking having any inside information whatsoever and as we all are, incapable of knowing what the outcome of negotiations will be with the EU and cheap food producers Africa and Latin America.
      Why are NHS staff being charged what? If you visit and work in a foreign country in a factory producing smartphones you do not automatically expect a free smartphone…and if you do, by our taxation, you would have to pay tax on it, so what are you asking? Are those staff by the way desperately needed in their countries of origin? If not why not? Do they eat spinach or come from the planet Krypton?

      1. Peter Parsons
        May 14, 2018

        Try reading the article. Non-EU NHS staff are currently being charged £200 per family member, the charge will up to £400 later this year and the Conservative manifesto committed to raising it to £600.

        As for your smartphone example, under the UK taxation system, if it was something available to every employee it is not taxable. That’s why, for example, tea, coffee and snacks provided for all (as some employers do) are not a taxable benefit.

        What I am asking is why people who we want and need to come here to work in the NHS are then also being asked to pay additional charges over and above the income tax and NI they pay in order to access the service that they, themselves, provide.

    2. mancunius
      May 14, 2018

      Because they and the dependent families who arrive with them use the NHS like everyone else – and have not yet paid a penny towards it. The real total costs of family healthcare (children included) can far outweigh any individual low or average salary.
      A Registered nurse arriving in Germany and earning a salary of £32,500 will the usual ca. 15.5% i.e. just over £5000 per year for the standard public health insurance cover – a far larger amount than £600 per year.
      Germany’s obligatory insurance system is therefore not likely to be targeted by anyone seeking a cheap solution to all their family’s health problems by working there.
      The salary scale for a nurse in Germany’s public healthcare system and a nurse in the UK NHS is the same or comparable.
      Our free-to-all, free-at-point-of-service, free-to-everyone-except-future-indebted-UK-generations health system is suffering grave abuse – and not just from migrants. As soon as we institute our own competitive, tiered insurance systems, the abuse will cease and mutual trust will improve.
      NIC is not an insurance scheme – though it could become one, if Mr Hammond the Treasury can only be persuaded to release it from their rapacious their infinitely capacious maw.

  24. Adam
    May 14, 2018

    Those who cause expense & consume services should pay the cost, or be paid for personally by those willing to support them.

  25. stred
    May 14, 2018

    https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/682491/nino-registrations-adult-overseas-nationals-december-2017-summary.pdf

    Last year, a reduced number of NI cards were issued to inward migrants. It was down to 685k. This number would not include non-working or cash working and dependent family members. The passenger survey figures are obtained by asking selected incoming passengers whether they intend to stay for over one year. The survey mainly takes place at main airports and not the cheap European flight airports such as Stansted.

    What is the typical EU passenger going to answer? Probably they intend to go home to see the family for Christmas or perhaps more often. Perhaps they would rather say no in order to avoid officialdom. The ONS say that the passenger survey provides more reliable statistics. Just one question. Where are all of these uncounted migrants, not staying for over a year and perhaps coming and going for more than a year, going to find housing, transport, education, welfare and tax rebates, council services and health.

    Of course the residents who have been paying NI for many years before and decide to leave for better health, paid for by the UK Treasury, and climate should be netted off the overall figure. But how much does the taxpayer save when they leave?

    1. mancunius
      May 14, 2018

      “how much does the taxpayer save when they leave?”
      My bet is: not a lot. Few with a known life-threatening condition or one dependent on expensive medicines are going to blithely leave for somewhere they’ll have to pay for their healthcare, unless they are extremely wealthy – in which case the UK would lose their assets and purchasing power.
      Also, many retain a UK shell address for the very purpose of getting health treatment as and when. As we have no joined-up public registration system, it is difficult to prove they are not resident.

  26. tick tock
    May 14, 2018

    What does a human being here cost us? Any human being? From birth to death at say 70 years old..assuming they never engage in productive work? What is the cost of pre-established infrastructure and its present availability, used or not?
    Mr Barnier says “If you join a club, there is a price which must be paid.” The NHS is a club, is it not? Migrants should continue to pay into the NHS after they leave the UK. The clock is ticking

  27. ChrisK
    May 14, 2018

    We don’t have a housing shortage. We’ve got too many immigrants. The doors should be closed, pure and simple, to those coming here with no proper jobs….relatives, extended families, every man, dog and hanger-on is being given clearance to come here…..and this is not counting the illegals.
    I don’t buy the notion that we need them when we still have many of our own people unemployed….pretty full employment you say, I beg to differ, with three young people in my circle still job-hunting and still without futures. Acres of green countryside are being covered in bricks, in a desperate bid to solve this non-existent housing crisis. Britain does not exist to house or educate the world at our own taxpayers’ expense, nor are we here to provide healthcare for the world. Sorry if people find that harsh but that’s the general view of the ordinary man. One day this government might put the real British first, but I won’t hold my breath.

  28. David
    May 14, 2018

    The easiest way to do this, rather than create a new tax would be stop giving new workers so much in benefits. (It would also not harm/deter higher paid migrants who already pay enough taxes).
    A relative recently arrived in the UK from the EU, as he has 2 children he will only have to pay £50 pcm rent!!
    I am glad that the EU is now saying immigration has a cost, perhaps we can get 250K Euro for each EU immigrant who comes here.

  29. DrakeB
    May 14, 2018

    Hope you were listening to Nick Clegg..he was talking about you and your egghead pals leading us to the cliff

    1. Denis Cooper
      May 14, 2018

      You really think we’re silly enough to listen to Mr “7%” Nick Clegg?

      http://openeuropeblog.blogspot.co.uk/2014/05/so-nick-how-many-laws-come-from-brussels.html

      “So, Nick, how many laws come from Brussels?”

      It’s amazing how with just a few laws the EU has so entangled us that now we’re told it will be an impossibly long and hard struggle to free ourselves …

    2. tick tock
      May 14, 2018

      He visits Mexico

    3. Beecee
      May 14, 2018

      That would be the Mr Clegg who depends on his EU Pension and accordingly is mandated to say nice things about the EU!

      That would be the same Mr Clegg who, with his Remain friends, are now, again, screaming that the public was mislead because they were not told in a clear way that Brexit meant leaving the Single Market yet on a Question Time he, himself, made it clear that it did!

      Mr Clegg has nothing to say which is worth listening to.

      Unless you like Fake News?

      1. APL
        May 18, 2018

        Beecee: “That would be the Mr Clegg who depends on his EU Pension ”

        Yes, about those EU pensions, I recall, not so long ago, they were the first thing on the EU agenda.

        Has the administration you support Mr Redwood, caved on that too?

    4. Mike Wilson
      May 14, 2018

      Hope you were listening to Nick Clegg..he was talking about you and your egghead pals leading us to the cliff

      Why would you take note of anything Clegg has to say. I remember the leaflet where he was making the case for a referendum on the Lisbon Treaty …

      It’s been over thirty years since the British people last had a vote on Britain’s membership of the European Union.

      That’s why the Liberal Democrats want a real referendum on Europe. Only a real referendum on Britain’s membership of the EU will let the people decide our country’s future.

      But Labour don’t want the people to have their say.

      The Conservatives only support a limited referendum on the Lisbon Treaty. Why won’t they give the people a say in a real referendum?

      The above is from a leaflet with Clegg’s face on it. /eu-referendum-leaflet-will-haunt-clegg-today

      I’ve heard him argue since that he was only talking about the Lisbon Treaty. But these words …

      Only a real referendum on Britain’s membership of the EU will let the people decide our country’s future.

      don’t mention a treaty, they mention ‘Britain’s membership of the EU’.

      So, we’ve had our referendum. But he doesn’t like how we voted. I’ve heard him say, when the last referendum was in full swing, that we should only have a referendum next time there is a treaty change. Why? What would he do if we voted against a future treaty and were then out of step with the rest of the EU? And the next treaty after that?

      As for this cliff we are being led to … not ‘white cliffs’ by any chance? ‘Of Dover?’

      Do you think it is impossible for this country to work without being a member of the EU? If so, why?

    5. mancunius
      May 14, 2018

      No one young or old listens to Nick Clegg. Except maybe his Clegghead pals.

  30. ian
    May 14, 2018

    Good article by Peter Lilley today, on con party home site.

    1. Iain Gill
      May 14, 2018

      Con home site is like a Blairite Labour site these days, it wants much more immigration than the British people, it want much more tax than the British people, it wants state workers to have control over far too many aspects of individuals life and in far more detail than any of the British people

      It is frankly embarrassing, and doesn’t tolerate people who point out how out of touch they are from the main stream view of British people outside the political bubble

    2. mancunius
      May 14, 2018

      Thanks for the tip, it is well worth reading.
      So btw is the interview with Alexander Downer, Australia’s retiring High Commissioner, in this week’s Speactator online. ‘Your fate when you leave the EU will depend much more on the domestic policies you pursue than the fact you’re not in the EU. You will do well if you open your markets and you embrace free trade; there was never a country that embraced free trade that was poor as a result…The more the public understands that remaining in the customs union means that other people make all of your trade policy for you, they would regard that as completely unacceptable…if you were a really effective politician, you could make a very strong point on this.’

  31. Newmania
    May 14, 2018

    PS on Housing -The rate of house building has exceeded population growth since the 60s so if the number of people in the country were the significant factor the cost of a house would be about one decent salary , say £50,000 ( in the South East )
    In fact it is ten times that
    Hereis another veiled slur which is to blame EU worker for housing costs to which they self-evidently contribute virtually nothing as he would know for the House of Lords Report.

    In fact there is so much wrong with this post its hard to know where to begin , were the work of anyone else I would simply call it stupid

    I sense panic

    1. Narrow Shoulders
      May 14, 2018

      Ok @NM I’ll bite.

      Have you a (credible) citation for that house building claim.

      1. Mark
        May 14, 2018

        It’s more or less true. Look up DCLG Table 101 for the housing stock and ONS for population data. The biggest push on house prices has been the expansion of the size of mortgage granted – this correlates extremely well with prices, and accounts for e.g. the 20+% fall after the financial crisis, when all the other supposed factors such as net migration or the rate of building might have suggested rising prices.

        In recent years, housebuilding has barely kept pace with population rise, in contrast with running comfortably ahead of it from the 1950s- 1970s. But we have just 2.3 people per dwelling, compared with 3.5 in 1951, 2.6 in 1980, and 2.4 in 1997.

        1. Narrow Shoulders
          May 15, 2018

          I don’t deny that monetary expansion is a primary cause of price increases in housing but driven by demand. You write yourself that the housing stock has not kept pace with arrivals since the 80s which makes the original post specious.

    2. Edward2
      May 14, 2018

      That’s nonsense.
      House building has never kept up with demand for many years.

    3. Anonymous
      May 14, 2018

      It only needs 2 bidders for each home to get a x10 outcome.

  32. PaulW
    May 14, 2018

    More’s the point..how is the NHS going to manage with the extra great influx of old people returning home from the continent post brexit? also how are councils going to manage in getting them accomodation? Am afraid that this is going to be the real problem not the young able bodied european migrants who will be abld to get work in Germany and other places.

    1. fedupsoutherner
      May 14, 2018

      PaulW. You are being ridiculous. I have lived in Spain and can tell you that all the people we knew there and were elderly have come back anyway. They just do regardless of Brexit. It’s to do with the fact that there are no nursing homes in Spain as there are in the UK. Brits are ok abroad until they get old and they have no family around them to take care of them and then they tend to sell up and come back. As they normally own their homes abroad they sell them and then buy something when they return or move into property they own which they have been renting out. Don’t tell me this isn’t the case when I know it is. Brexit has nothing to do with it.

  33. JoolsB
    May 14, 2018

    Visitors to this country whether permanent or temporary should be made to take out medical insurance before they are allowed into the country but it seems socialists May and Hammond would rather tax the English more instead to pay for what has become the International Health Service.

  34. Iain Gill
    May 14, 2018

    Well if people come in with broadly average chance of needing medical care that is one thing. Perhaps some modest small admin charge is in order for adding them to the system, then broadly what the rest of us pay via tax.
    If a worker (or a family member they bring with them) already has pre-existing conditions, or is arriving already in need of expensive medical treatment, then nothing we charge now or propose to charge is anywhere near enough to cover our costs. This is the real problem, because people who know they will need expensive treatment have an extra incentive to come here, especially if treatment would be very expensive in their home country or elsewhere, this is the underlying reason many of our London hospitals are stretched by such people.
    Similar with people planning to have children, they often plan to give birth while here on visas, as it simply the cheapest way for them to get maternity care anywhere in the world.
    I would add, as I have said before, though, that we do need to make much better provision, and put in place competitive downwards pressure on prices if we propose to charge for care that is pretty much an NHS monopoly in much of the country. So, for instance diabetics have got to be able to travel here, and get access to insulin (and here that means docs for prescriptions), to be able to come here at all, and the costs of this need to be broadly competitive with a diabetic travelling around any other developed country. So we need to take care how we price care.

    1. Iain Gill
      May 15, 2018

      The point about some groups coming in disproportionately when they need expensive medical treatment is an important one. Any contribution they make is only reasonable if their chance of needing expensive care are broadly the same as existing residents. As soon as we allow people to come here precisely when they need expensive treatment (as their cheapest option to get the treatment worldwide) then naturally the fiances will not balance.

  35. Javelin
    May 14, 2018

    The true cost of migration is shrouded in secrecy by the Gov. who I presume dont want to publicise the figures.

    I did the calculations about 6 months ago based on the UCL and migration watch figures and figured out non EU and eastern EU migration diluted the tax spend by about 5%, with Western EU immigration bringing that down to 3%. Recently the Government let the cat out the bag by saying skilled migration salaries needed to start at 60k, an admission that the tax cost of non skilled immigrants is very high.

    Whilst Labour like to talk about Austerity I think the key phrase that no one uses is TAX-DILUTION.

  36. APL
    May 14, 2018

    JR: “Should migrant workers pay a bit more for the NHS? ”

    No. They should pay the whole cost of the NHS.

    Do you know what the initials NHS stand for? It doesn’t stand for ‘International Health Service’!

    1. L Jones
      May 14, 2018

      Well said, APL. I must say the words ”a BIT more” don’t sit well with many people commenting here!

  37. Alison
    May 14, 2018

    The Telegraph is reporting that all backbench Tory MPs are being brought in to no 10 about the lunatic Customs Partnership idea and the MaxFac option. Indeed, our host has presumably also been invited to a session. Why are they not also covering No Deal, with accurate information about border control, technology ..?
    The Remain literature and campaigning during the 2016 referendum stated categorically that leaving the EU would mean leaving the Single Market (hurray) and leaving the Customs Union (hurray). This should not be under debate, full stop.

    I passed a message indirectly this weekend about this to my Conservative MP, a Freer (also was fin director for Stronger In). I worry about him. I did point out to him last year that his Stronger In literature had hugely understated figures for the amount that the UK pays to the EU, and he genuinely didn’t know (should have known). I think the figure they gave was between £6bn and £7bn.

  38. backofanenvelope
    May 14, 2018

    My immigration policy would be quite simple.

    Any foreigner may enter the UK to work – if he or she has a job lined up. Any foreigner may enter to study, provided they have an approved course to go to. Any foreigner may enter the UK on holiday, providing they have travel and health insurance.

    No foreign national is allowed to enjoy taxpayer funded services or benefits, with the sole exception of emergency medical care.

    There is NO right of settlement.

    1. Narrow Shoulders
      May 14, 2018

      Emergency care is a broad brush and includes childbirth.

      How does schooling for offspring fit into your model? I assume they would not be allowed to bring children.

  39. Chris
    May 14, 2018

    The businesses that want to hire migrant workers should pay their basic health insurance. That would be factoring in the true health cost of using an immigrant work force as opposed to a UK work force. Once that cost is recognised and the scale of it i.e. it is huge, then the true cost of mass immigration to this country can at least be calculated with slightly more accuracy. Furthermore, it will encourage firms to first look for UK workers. However, health care is only one of the costs to this country of mass immigration, as others have commented.

    1. Narrow Shoulders
      May 14, 2018

      Quite. Increased employers NI percentage contributions for non UK worker and no lower earnings threshold for the employer contributions.

  40. British Spy
    May 14, 2018

    Why’s being a British citizen in the UK more advantageous than being a EU citizen in the UK?
    Is it because in the event of national catastrophe I can conscripted into our army to fight to the death and they can’t?

    1. PaulW
      May 14, 2018

      British Spy..am afraid that there won’t be many young british available to be conscripted in the case of an emergency as with the obesity problem in the country very few would pass the army physical

      1. British Spy
        May 14, 2018

        I have thought it before, but I feel I shall use a professional ghost writer to write the book(s) I have been trying to write for over half a century..and I shall emigrate to America . I cannot make myself understood here.

        1. Dennis Zoff
          May 15, 2018

          British Spy

          “I cannot make myself understood here.”

          Perhaps if you tidied up your grammar, it might help?

          ………..”I can conscripted into our army to fight”……….

  41. Gordon Hetherington
    May 14, 2018

    Why not require all those coming to the UK to have medical insurance? NHS “free at the point of delivery” should be for UK residents only.

  42. Denis Cooper
    May 14, 2018

    Off-topic, will any Tory backbencher point out that there could be other options?

    https://www.telegraph.co.uk/politics/2018/05/14/theresa-may-meeting-every-tory-backbencher-today-find-way-brexit/

    “Theresa May is today meeting nearly every Conservative backbench MP to head off a rebellion over her plans for a customs deal with the European Union.

    Scores of Tory MPs are heading into 10 Downing Street for briefings with Mrs May, Julian Smith, her chief whip, and Gavin Barwell, her chief of staff, about Brexit.

    Mr Barwell is presenting a series of slides setting out the pros and cons of the two options for Britain’s trading arrangements with the European Union after March next year like a “price comparison website”, one insider said.”

    So who says there are only two possible options? Civil servants, like those who have rigged their economic models to falsify the effects of leaving the customs union?

    https://brexitcentral.com/civil-service-misled-us-costs-brexit-customs-union/

    “How the Civil Service has misled us about the costs of Brexit and the Customs Union”

    I have always viewed Patrick Minford’s calculations with some caution, thinking that they probably exaggerated the economic benefits of leaving the EU, but the difference between his cheery forecasts and the doomladen predictions of the civil servants would raise very serious questions about the latter’s impartiability and reliability if we didn’t already know that they have none, they are generally pro-EU and will always slant their predictions and their advice in that direction.

    “Using credible and sensible assumptions turns the Civil Service analysis on its head. Where the Civil Service analysis says a Customs Union with the EU will be beneficial to the UK, to the tune of 1.2-6.2% of GDP, and so we should not leave it, the report – if based on correct assumptions – would say that remaining in the Customs Union is damaging to the UK, to the tune of 3-4% of GDP, and we should leave it.”

    And my MP, Theresa May, pretends that she does want us to leave the Customs Union, while secretly working to effectively keep us in it.

  43. Chris
    May 14, 2018

    I am sorry this is off topic, but it is so important for the country. It seems as though we are going to be betrayed with a customs partnership. As Juliet Samuels has written in the Telegraph, Theresa May laid the grounds for this sellout in December, as was recognised by Charles Moore when he referred to the December agreement as a “complete capitulation”. This is not acceptable, Mr Redwood.
    From D Tel:
    “…At the heart of this weakness (of the Brexiteers) is the agreement that Mrs May struck in December. Few Brexiteers except Mr Gove seem to realise it, but that was the moment when the Prime Minister gave up on everything they want. Her policy since then has been to drift until confronted, and then make a “strong statement” to convince the Eurosceptics that she’s still on board. Surprisingly, this seems to be working…”

    1. Denis Cooper
      May 14, 2018

      Why the hell should we have to go to the Irish media to find out that our Prime Minister and her negotiators have been stabbing us in the back?

      https://www.rte.ie/news/2018/0505/960472-how-the-eurosceptics-have-blown-the-brexit-talks-open/

      What do you think about that, JR?

      1. Dennis Zoff
        May 15, 2018

        Denis Cooper

        Have no fear…we are all (17.4 Million) waiting in the wings patiently for Friday, 29 March 2019 at 11 pm to arrive. Until then Mrs. May et al can waffle and obfuscate but she/they cannot hide forever…..cometh the moment “March 2019” and with no appropriate deal negotiated, we immediately move to WTO or…cometh the disappointment, anger/rage, retribution and political revenge will ensue?

        Generally speaking, British people suck it up politically and just get on with their lives, but this time there is real simmering anger at the way Brexit has been handled and how the will of the people has been so appallingly and arrogantly dismissed by the establishment. If Brexit is a failure, sedition will break out, of that, I have no doubt!

    2. Peter D Gardner
      May 14, 2018

      JRM has since written in the Telegraph. It seems to me that JRM really wants to remain a backbench MP and he also judges that a leadership challenge wold not be helpful. It is normal to change negotiators at particular stages in the process and it would solve a lot of Mrs May’s problems were she to place JRM in a senior position in the negotiating team, if not actually as David Davis’s right hand man.

  44. margaret
    May 14, 2018

    I am glad to read your unemotional post now. Today I am angry and am looking back at the undermining , mistakes and belittling I have suffered in the NHS ( not usually by the patients who I serve) but by the people who employ, manage and lie. It is like a trigger which makes my blood boil and as I am quite practised at anger management can continue.

    I would like if possible opinions on this topic of infection control.

    Nurse practitioners come into contact with patients who have diseases , infections and conditions which require clean clothes which can be boil washed at the end of the day.

    GP’s in the same buildings come into contact with the same patients who have diseases, infections and conditions which should require clean clothes which can be boil washed every day.

    GP’s now unfortunately hold the purse strings and wear their day clothes all week , go to meetings, public places and other venues still in the same clothes. They then ask Nurses to wear uniforms for infection control purposes( but don’t often buy enough to change clothing every day ) .

    Why do virus’s , infections and other diseases have a preference for Nurses rather than the MD . Why do they say’ lets infect the Nurse , we won’t bother with the MD. ‘Why do they say’ this Nurse will pass on all the disease that is on her uniform to the public and yet they say ,’ no we laud and honour the MD so we will be kind and commit suicide so as not to infect any other?

    1. Dennis Zoff
      May 15, 2018

      margaret

      Your comment is logical, heartfelt and clearly practical….most European Hospital staff, including Consultants/Doctors, wear white/Green “daily changeable” clothing for the very reasons you point out; to avoid contamination and inhibit disease spreading! (though it comes with an additional cost)

      When my wife came to the UK from Germany “Medical Practitioner” she was deeply surprised to see Consultants and Doctors walking around the wards in normal clothing and asked was this normal procedure…yes came the answer, and why, was the next question….answer, it has always been thus so and came with a shrug of the shoulders?

      Many medical practitioners share my wife’s concern, but the medically ignorant administrative authorities (Trusts) run the show, not the medical professionals….a bit like our Government!

      1. margaret
        May 16, 2018

        Thank you for your response .In primary care the GP’s are now the managers of their own businesses. They hold the purse strings , so in effect do not have administrative authorities to deal with.
        Uniforms are worn for hygiene purposes but some now see a demarcation for a Master/ Slave relationship;.You wear the uniform to mark that you are not as important as I am. I wear the suit because I am distinguished.’
        There are a lot of double standards, for instance I take 6 surgeries a week , but the claims are that they are the Dr’s surgery even though I have been there since 2003 .I am afraid that the Medics around Manchester do not acknowledge my profession and in fact their own of past years.

        I am glad your wife can see past a false sense on self importance.

        1. margaret
          May 16, 2018

          ie ‘of’

  45. Dennis
    May 14, 2018

    Yes, there is certainly a housing problem – too many houses. As there are 50 million too many people in this country which makes it unlivable in a sane manner where is the user friendly thinking to get to a population of 10 -15 million in user friendly time.

    One way which would allow in really needed immigrants (100,000 too!) would be to receive 100,000 which is around half the number which leave each year. So in 10 years 1 million fewer people here. User friendly enough?

    10 – 15 million would still make the UK more populated than Switzerland, Norway, Denmark, Sweden, Iceland etc., etc.

    1. L Jones
      May 14, 2018

      Housing crisis + transport crisis + schools crisis + NHS crisis = population crisis.

  46. David Price
    May 14, 2018

    Migrant workers should pay for insurance to cover medical expenses which should be charged at a premium rate to reflect the unplanned load on the NHS. If they are immigrants then that is a different question, these I feel should contribute for a number of years before getting any benefits during which they should have insurance.

    How do other countries address the issue of migrant access to benefits …

    1. Iain Moore
      May 14, 2018

      They deny access to public services, and expect British people to pay for their health etc themselves.

  47. The Prangwizard
    May 14, 2018

    Your leader is deaf to all this, Mr Redwood.

  48. Blue and Gold
    May 14, 2018

    As usual Mr Redwood, you haven’t put my comment on for 2 reasons:

    1. You know that what I said is absolutely true.
    2. You are against free speech and the fact that you Brexiteers are losing the argument over EU withdrawal.

    1. Dennis Zoff
      May 15, 2018

      Blue and Gold

      Just maybe, John is politely trying to ignore your sophistic nonsense and saving us the trouble of ignoring it too?

    2. David Price
      May 16, 2018

      Free speech means you are free to set up your own platform, share your background and offer your opinions to others.

      Don’t expect everyone or even anyone to agree with you, much less give you a platform for free.

  49. VotedOut
    May 14, 2018

    If you are earning less than 10K per year you are not paying much tax to cover your costs.

    Time and again businesses hire foreign workers because its easier than training up local labour. As Mr Trump says: “That’s OK, you go ahead and hire them, but when I’m in office your gonna pay more corporation taxes to cover the costs. The days of taking Americans for a free ride are over”.

    There really is no excuse for training local people.

    Its not racist to put our children and culture first. Its what everyone else does – but us. Pretty soon we won’t have any home culture left. For us Brits, this is the only place in the world we call home and we would prefer to be asked before its given away to somebody else.

  50. John
    May 14, 2018

    I assume that 250k euro set up cost estimate is an EU average. Therefore its about maybe £500k per person.

  51. Peter D Gardner
    May 14, 2018

    Those who promote mass migration are not interested in the costs, whether capital or operating. Of course they will quote any figures purporting to show a benefit of mass migration. Like human caused climate change it is an article of faith that mass migration is good and attempts to control it are immoral. underlying this is the belief that nation states are inherently bad because they are exclusive clubs and compete with each other. Are we not all equal? should we not share everything on the planet or the good of all? What gives you the right to claim this bit of the planet as yours just because you got here first (unless you are Palestinian)?
    It is not just naive immature idealistic or bonkers youth who believe such nonsense. The late Peter Sutherland, UN Special Representative for International Migration, believed it passionately. George Soros believes it and he has more money invested in promoting it than the GDP of some countries. Even within the protectionist and highly exclusive club of the EU, which itself aims to become the exclusive nation state of Europe, the subjugation of the existing nation states (nationalism being the root cause of all the evil in the world) is a central aim.
    For such people, the cost sof the NHS and who pays is immaterial. It should belong to everyone and the fact that UK is a rich country means that people from poor countries (not their fault they are poor, it’s the result of British imperialism and/or Western oppression) should be paid for by you.
    And by the way, where is that US$200bn you Westerners promised us poor people to reduce our carbon emissions? NHS? Peanuts. Gimme.

  52. Original Richard
    May 14, 2018

    Eventually we’re going to realise that we need ID cards to access services such as healthcare and benefits and to prevent some types of voting fraud.

    What other major country in the world doesn’t require its citizens to hold ID cards ?

  53. Simon Platt
    May 14, 2018

    Of course migrant workers ought to pay more. The NHS ought to be paid out of National Insurance, and the rates ought to be lower for British citizens.

  54. Mark
    May 14, 2018

    Many migrant workers impose little burden on the NHS, because they are young and fit: the visa contribution paid by e.g. students is sufficient to cover these risks – and supposedly we get reimbursement from EU countries anyway (cough, cough – if we only had a better claim system in the NHS). Older migrant workers tend to be professionals who are likely to take out additional medical insurance anyway (or have their employer pay for it as part of their contract). The burdens on the health service come in the early years of life (and as a consequence of pregnancy) and the end of it for the most part, and the biggest burden from the migrant population is for early years care and pregnancy, since few have attained old age, and most of those who have settled here a career ago.

    Those who bring families should be subject to medicals that evaluate whether there are pre-existing conditions likely to give rise to extra costs which they should cover, and until they qualify for settlement, they should also insure against or pay for the costs of pregnancy and neonatal/paediatric care: we should be prepared to contribute the modest cost of reliable contraception methods should they opt for them. Perhaps we should also evaluate the medical risks of those who come here for cousin marriage, which often results in a very significant health and education and welfare burden on any children produced. Epidemiology may suggest other particular risks of high cost care: countries with high rates of AIDS infection for example.

    We should be prepared to issue medical treatment visas for those whose full medical costs are indemnified by their home government, their insurers, or their own cash contributions. This would presume treatment outside the NHS, so as not to burden its resources.

  55. GilesB
    May 15, 2018

    I don’t know where the EU got the number of EUR250k from.

    The value of physical infrastructure in the U.K. is nearer to STG1million per head.

    Immigration has significantly depressed productivity in the U.K. for the last thirty years as investments in infrastructure for the population increase has squeezed out investments in the workplace.

  56. nigel seymour
    May 15, 2018

    Everyone that is fortunate enough to gain access to this country and be allowed to work should be paying the same as any Brit working in this country whether it be tax or NI. If they feel hard done by then they can easily return to their own country and get the benefits it offers. Why is it that born nationals in this country often seem to be subsidising others?. The ‘perception’ is that non UK born nationals, working or otherwise, are treated better and gain advantages?…

  57. Dennis Zoff
    May 15, 2018

    John

    “Should migrant workers pay a bit more for the NHS?”

    First point: From a business perspective, I have yet to see how importing low skilled workers en masse has had a beneficial effect for UK citizens?

    Second point: Leaving NHS/Housing/GPs/Dental care/Schooling and all other important issues aside, and regardless of the many reasons for bringing economically low skilled migrants into the UK? I thought the main “original” objective for bringing in a net 250,000 migrants annually to the UK was simply to enable Labour to gain additional votes…or am I just being cynical?

  58. a-tracy
    May 15, 2018

    Just get the NHS to do what every other Country manages to do and rebill back the EHIC and those that don’t even have the card (unlike we get treated in Spain!) treatments.

  59. Ron Olden
    May 16, 2018

    This all boils down to how we see the terms on which migrants come to live here.

    If someone wants to come here to work, that’s fine but that doesn’t mean they should be automatically entitled to all the public services and benefits on the same terms as people who are born here.

    That’s not the deal we can, or should, offer.

    The fact that someone comes and lives here and pays the same amount of tax as someone on the same income already living here, does not mean that he is paying his way.

    The majority of people born here don’t pay their way in terms of tax paid in relation to benefits and services received, either.

    And as, on average, migrants are in the lowest paid jobs, and are therefore paying the least tax, they are the least good net revenue prospects.

    Rather than have a complicated system of charging in the NHS, Schools, etc, the simplest thing to do would be to make an entry charge into the UK for every person who comes here, with a charge on top for each dependent.

    And make it clear to them that they will never be entitled to any State Benefits or Social Housing, and charge them, and their employer a higher rate of National Insurance Contribution than British Citizens pay.

    If they’re willing to come on those terms good luck to them. And the most skilled, able, and enterprising, will.

    The issue of excessive low skilled migration would be solved overnight and we wouldn’t need all these quotas and permits people are talking about.

  60. anon
    May 19, 2018

    Yes.

    Maybe we should have a non-citizen resident (extra % tax) and no personal allowances.

    Pathways to citizenship should be offered to those who are here legally.Dual citizenship should not be allowed.

    Should not the EU be funding us £250,000 per net EU migrant?

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