Charging   Migrants for NHS;thin end of the wedge?

Women and babies suffer first from health service cuts, so Save Liverpool Women’s Hospital Campaign is very concerned about cuts and about charges. A real life case brought this to life in our campaign meeting.

The  plans to introduce direct charging to patients is one of the most feared aspects of the Government plans for the NHS.We are seeing the early steps in this and need to say NO!

The National Health Service is funded directly from  the tax ordinary people pay, be it income tax, VAT or one of the myriad of other taxes.

The NHS was founded in 1948, in the debris of war. It was founded to be free at the point of need, funded by taxation, not for profit,  a universal service providing the best available care

We do pay personally for prescriptions and for dentistry and for opticians, costs that once were included in the NHS. We also have the mixed up mess of  paying for care for the elderly, sometimes even if they are too unwell to care for themselves. Social care remains a part private responsibility, part social services, and part NHS mess. Social care for the elderly can  be personally very costly. We need a similar funding system to the NHS.

However no-one using the NHS is asked to fork out tens of thousands for Cancer care or for transplants or complex care for  very poorly babies Medical treatment is still free at the point of need

We are not alone in being concerned at this.  Many doctors  are concerned at charging being  brought in

So in 2017, we see that some services have been transferred to the private sector and  we find ourselves having to pay for some services. This was from earlier waves of privatisation. A huge wave of privatisation is growing in the NHS which will be described in a different  posting. But worry about  privatisation pales against the time when we may be forced to pay for treatment or go without treatment, if we cannot afford to pay

Our service is very different from the US model. It is not a service to sell, or an insurance based system. It is a universal service funded by taxation.

In some other countries most notably the USA people get health care according to how much health insurance they or their employers buy. No insurance, no treatment, or treatment at huge cost. Sometimes  the insurance refuses to pay and people lose their homes and cars to pay for it, or, rather than risk their family becoming homeless, people accept a preventable death or long-term damage. The insurance system operates a de-facto rationing system for care.

Charging some people has been in the NHS for some years but the system has just changed

It started with  charging Migrant women for maternity, hence the link with our campaign.This has been damaging to pregnant women  as described in the British Medical Journal article linked here.  Lots of articles were put in the press to support the government claims of rampant health tourism but the statistics do not back this up. Now the government is  spreading the net.

It is simply not true that Health Tourism is a big cost to the NHS.The most reliable estimate is 0.38% of the budget. Compare that to the cost of PFI hospitals where the profit on one hospital is more than 10 times the cost (see earlier article)  and it’s a tiny amount. Collecting the fees will cost more than the  treatment so no extra money will feed back into the NHS.

It is a smokescreen and a dangerous one. It is laying the groundwork for charging more and more groups of people. Women and babies suffer first from health service cuts so Save Liverpool Women’s Hospital Campaign is very concerned about both cuts and charging.The  plans to introduce direct charging to patients is one of the most feared aspects of the Government plans for the NHS.

So in 2017 we see that some services have been transferred to the private sector and  we find ourselves having to pay for some services. This was from earlier waves of privatisation. A huge wave of privatisation is growing in the NHS which will be described in a different  posting. But the many forms of privatisation pale in insignificance against the time when we may be forced to pay for treatment or go without treatment, if we cannot afford to pay

Our service is very different from the US model. It is not a service to sell, or an insurance based system. It is a universal service funded by taxation.

In some other countries most notably the USA people get health care according to how much health insurance they or their employers buy. No insurance no treatment, or treatment and then a bill which the insurance refuses to pay and people lose their homes and cars to pay for it, or, rather than risk their family becoming homeless, people accept a preventable death or long-term damage

Charging some people has been in the NHS for some years but the system has  recently changed

 

Migration

Migration means to move to a different country for  one of many different reasons. It is not tourism where people come for a holiday. During the  misnamed Irish Famine huge numbers of Irish  people moved to Liverpool and beyond. Whole Welsh communities moved to Liverpool too. A community of Welsh miners migrated to Patagonia where the Welsh language survives there still.. When the Scots were forcibly driven from the Highlands  to make room for sheep farming, the Highland clearances,  whole communities moved to England, Canada, the US and Australia. More recently tens of thousands of UK people moved to Australia and New Zealand

A Migrant is someone who lives here. Not a visitor. Some are mega rich and live in million pound pads in London but most are working people, doctors, nurses, carers,  engineers, social workers, hotel staff, scientists,cleaners. Some migrants have full legal status here. Some have interim leave to remain and some are still applying. Some are from Europe, some are not. They are needed in large numbers in the NHS and the care sector.

The poorest are the most likely to have difficulties with their papers and migrant women are amongst the poorest.

Someone working and paying taxes here in the UK should not be charged additionally for health care. Health care is paid for through  general taxation

If they end up with an outstanding bill for health care on their records, getting their papers or citizenship can be much harder and the threat of deportation hangs over them.

The NHS is funded directly from taxation and provides a universal service, that is a service for everyone.The NHS is recognised as a wonderful public service across the world and its seventieth birthday next year will be celebrated across the world. It is the most cost efficient  health service in the world https://www.theguardian.com/society/2017/jul/14/nhs-holds-on-to-top-spot-in-healthcare-survey

Taxes

Taxes in the UK come not just from income tax but from indirect taxes like VAT. Indirect taxes raise more money than income tax.Everyone who buys anything except food and children’s clothes pays VAT and other taxes

Other health care systems spend huge amounts of money recouping money from patients but the NHS does not need to do this because it is funded from taxation. Employing people to chase other people to get payments or to refuse to pay out on an insurance policy or to tell people they are not eligible for treatment, really does help to curing sickness or protecting health.

Health in the UK is delivered to all people just as our beaches and open spaces, roads and street lighting  are open to all.This public  health provision system is cheap in comparison to other countries and is efficient, both in money-saving and in saving lives and promoting health.

Sick or infectious people who are NOT treated are a cost to themselves, their families, their community, people they meet and the wider society. A country functions better with  universal health care.It manages epidemics more efficiently and it allows research that leads to better health outcomes. More people keep fit and healthy and able to be employed or to study or to take care of others.

Wasteful use of resources. Damaging to health.

Employing people to chase up charges is not an efficient use of resources.The USA is a fine example, they pay much more of their National wealth on health care, its one of the biggest bills families face, yet their health care outcomes are not as good as the publicly funded NHS and it costs much more

It makes more sense to  train those people as doctors nurses or some other useful role in the NHS.

Any sick person with an untreated illness is eventually costly to society. Any infectious disease not treated a threat to the whole society. TB used to be a real threat to the health of this city. Universal health care has turned it into a rare illness, or at least not a dangerous epidemic, here in Liverpool

But this is much more so for pregnant women. Denying care in this situation  damages two people who can be hurt the baby and the mum, and the rest of the family can suffer too.We are only two generations away from the time when more women died in childbirth, than men died in the mines. We are only two generations away from women losing many babies in childbirth.

The NHS has a long way to go before it is really good at saving babies but t is a world better than generations past and a lot better than the USA.

This government and the previous one have been following some unpleasant policies and ones that damage health and health care.

It appears to be true that we are moving towards an US style  health system where people might have to pay directly according to the treatment, they need which raises the question what of those who can’t pay.

Let’s nail some of their propaganda on this

• A payment system is not  more efficient. It is wasteful and inefficient.
• It pays the money to  insurance companies and to admin which should go to the treatment of ill-health and protection of good health.
• It puts people off seeking early and therefore cheaper treatment
• The UK is not poor. It is very rich. It can well afford to spend 11% of its GDP on the  health service.
• The US spends much more for much worse outcomes because it wastes money on the charging and rationing system it uses.

 

Some of the very rich don’t pay their taxes.

This government’s policies have resulted in real wages falling more than any other country except Greece  since 2008. This government operates as a global economy  more answerable to global corporations than to its own poor. Meanwhile the very rich are taking huge profit from the NHS. The wealthy in this country hide their money in many offshore accounts and invest massively abroad.

The Government should put more money into the NHS. Much of the money which it  pays in now is wasted in privatisation projects.

Many people who have come here to work, work in the NHS. The migrant workforce in the NHS is not replaceable.

The UK should have trained more doctors and should be training more nurses, midwives and related professions, but instead  they have cancelled bursaries for nurses and midwives which shuts those professions off from older women and those from less well off families. Their planning for doctor numbers is a full failure.

Many people who live here either as workers or as carers within families  have to pay a premium on their visa to cover NHS care. They also pay just as the rest of us do through taxation.The new charging system could affect some people who have lived here for many years as we have seen in other home office blunders threatening to deport  and even deporting Grandmothers who have children and grandchildren here and have lived here their adult lives

Migrants tend to be younger and healthier than the average UK resident.

Some migrants can be here totally legitimately, yet not have the correct paper work because of delays in the home office. Migrant women living here need maternity services yet some women were the first to be denied  free NHS Care.The results of this are best described by the Royal College and Maternity Action reports attached. It we made posts of some of their reports, we doubt that we would be believed, so please take it from them, instead.These are the reports by the Maternity Action and the Royal College of Midwives. 

Claiming medical care

Medical records are  crucial to safe treatment. The  standard booking in procedure at a hospital  pulls up the patient’s record, if they have one. Very healthy people, people who are not registered with a GP or people whose records cannot be found are those who will be challenged.

At this point it is not just eligibility for treatment but what happens if they are deemed ineligible and what happens if they can’t pay.

The decision on delivering the treatment or not should still be that of the doctor treating the patient based on need, not an admin person from the hospital. Unless admin respect this, these mistakes will be costly in terms of health as people put off going to the hospital until they are really ill. It will also be expensive in terms of administration and litigation problems  which are going to occur for everyone. And then there are the bailiffs going after some of the poorest people in the country because they went to hospital Many UK families do not have Thousands of pounds  in the bank.

Liverpool Royal Broadgreen Hospital Trust posted on our Facebook page a link to their charging forms

Our campaign, along with many other NHS defence campaigns, across the country want a return to the original NHS  system of a universal service  funded by taxation.

If such a service is restored and continues to thrive other  people in other countries will campaign for a similar service in their own country, as Bernie Sanders and Socialists do in the US.

Just as we have suffered major cuts in service through austerity many countries in Africa and the global south  had forced vicious cuts especially to Maternity  through “restructuring”. This gives a summary of the problem.

Let’s keep campaigning for

• a return to a fully publicly funded NHS
• treatment according to need
• full bursaries for NHS staff in training
• For more doctors to be trained
• For health care to be funded to the same level as other advanced European nations
• For an end to privatisation.
• For the UK to invest in preventing stillbirths and maternal deaths

Save Liverpool Women’s Hospital will cooperate with other health campaigners to stop charging for health care in the NHS service for everyone.