Last week the Daily Mail splashed the headline “Our NHS, Not the World Health Service” across its front page. It was the latest attempt by the Tories and the right wing press to whip up a panic over refugees.
The story claimed Britain is being flooded by asylum seekers carrying infections such as tuberculosis (TB) and HIV.
New Labour’s immigration minister Des Browne was quick to reassure the Daily Mail that health checks on asylum seekers were already being “stepped up”.
Socialist Worker spoke to two doctors who give a very different picture of health and immigration.
You have to realise that the total number of people with TB is very small. Of all the diseases that kill people, this is one of the least significant. It’s less than a tenth of a percent of the fatal disease statistics in Britain.
A GP based in Dover recently revealed that a £250,000 Home Office scheme to screen newly arrived refugees for TB failed to identify a single case, despite screening 4,340 people in six months.
The number of people with TB has gone up slightly, but from a very low starting point. It should be very low on our list of priorities, certainly compared to, say, heart disease.
The increase in TB infection is caused by factors such as poor housing and malnutrition. Wherever there are homeless people, or people living in very crowded conditions, you might see an increase.
The health tourism that the Daily Mail talks about is really an urban myth. The British Medical Association has said there is no evidence for it whatsoever.
I practise in Benwell, a poor area of Newcastle. I do sometimes see refugees and asylum seekers in my practice.
The problems they really have are the effects of torture, post-traumatic stress and gunshot wounds.
You often see their condition get worse as they lose hope, when they find out that they aren’t allowed to work in Britain for example. Many are also faced with the catastrophe of being removed from Britain and sent back.
The asylum seekers we see do not place a huge stress on the health service, especially when you consider what they have been through.
The idea that they are using up all our services is a myth. At one level they should be using us much more than they do because of the trauma they have suffered.
It makes me angry because it’s such an easy issue for the tabloids to try to whip up. However, our patients, who are mainly white, are usually really tolerant of refugees. They mainly see lack of investment in health services as the problem.
Of all the problems facing the NHS, health tourism is about the smallest. Occasionally middle class people might work the NHS on behalf of relatives overseas. But middle class people have always been better at doing this than working class people.
There is no evidence that asylum seekers bring diseases into the country. Surveys of people arriving in Dover show very low levels of infectious disease among them. It’s more likely that people who have gone abroad, on holiday or for other reasons, come back with multi-resistant TB, rather than people healthy enough to make it to Britain as refugees.
The real reason why TB is becoming more common is poverty. TB is a classic social disease — it grows where there is overcrowded, poor quality housing. Good food and decent housing will make it disappear.
Working as a GP in Edmonton, north London, I often see people arriving in Britain who have physical or mental health problems. But these are usually common problems, such as asthma or high blood pressure.
People fleeing to Britain sometimes have gunshot wounds or symptoms of torture. Post-traumatic stress is another huge problem. But none of these things present a risk to the health of the local population.
I have not seen any evidence backing up the Daily Mail’s claim that “GP’s complain that one in ten of their patients should not qualify for free NHS treatment”. If such a report had been produced, I probably would have seen it.
The reason this issue is being raised now is because of the looming general election. Socialist Worker is right when it says that the main parties are trying to outbid each other on this issue. I’m amazed at just how bad Labour ministers have been.
Asylum seekers already have limited entitlement to secondary health care. If they need NHS treatment in hospital, they have to face an “overseas visitor officer” who interviews them, or their family, to decide whether they qualify or not.
Now the government is talking about extending these measures to primary health care. Asylum seekers whose applications to stay in Britain have been refused will be forced to go private.
Every time we put restrictions in front of people, or make them wary of contacting the authorities, means that any illnesses they do have will get worse. This just costs the NHS more in the long run.
It wouldn’t surprise me to find that asylum seekers get ill after they arrive in Britain considering their treatment. Mental and physical health are linked, after all.
Many GPs in poverty stricken areas are now retiring, and many of the gaps will be filled by people from other European Union countries. If you look at our hospitals, they are packed full of workers from overseas doing low paid jobs. We owe them a huge debt.
Gerard Reissmann works as a GP in Newcastle. Ron Singer is a London GP and president of the Medical Practitioners Union.