The news that hospitals will be required to check the immigration status of patients seeking care is a radical new departure for the NHS. For nearly 70 years, the NHS has been free at the point of use, helping to make it one of the most efficient health systems in the world. In an act of pandering dressed as policy, health secretary Jeremy Hunt plans to change that.
How exactly does Mr. Hunt think this is going to work? Are NHS staff going to be required to assess whether someone has a foreign sounding surname? Or foreign looking face? It is palpably absurd. NHS staff are clinicians not immigration officials.
There can be little doubt that Mr Hunt has concluded that he will be attacked by the liberal left in his pursuit of undocumented migrants. Yet he is radically underestimating the implications of the changes that he proposes.
In practice, the only way for the change to be implemented is to require identification from every single person receiving hospital care. The NHS sees or treats one million people every 36 hours. Around nine out of ten British people will use the NHS in any given year. Is Mr Hunt really ready for the backlash from every part of the country when people who are already worried or in distress are scrambling around for the right identification for their outpatient appointments?
What will happen when 83 year-old Gladys arrives at her appointment without her passport and a recent gas bill? Is she going to be sent home? It won't take long for every MP to be flooded with disgruntled constituents. Have Mr Hunt's colleagues really scrutinised what this means?
Hunt argues that our European counterparts collect much more from British nationals using health services on the continent than we do from European nationals living in Britain. When critically examined, this argument begins to fall apart rapidly.
One of the reasons that the NHS is much more efficient than most other health systems is precisely because it does not spend enormous sums of money administering a health insurance system. Has Mr Hunt undertaken a cost-benefit analysis of the costs of collection versus the revenue that could be raised? Will the Department of Health have the courage or confidence to publish it?
Most other European countries either have ID cards - meaning that checking eligibility is straightforward and routine - or insurance-based health systems that are geared up to collect this information. That is the main reason that they are more successful in collecting charges than we are in Britain.
Another reason for the difference might be the different profile between European nationals in Britain and British nationals in continental Europe. The Department of Health has avoided any serious analysis of the discrepancy in funds collected here versus those by European countries. If this was about policy rather than politics, the Department might have furnished us with some of these facts. Alas not.
Many British people living in continental Europe, especially in Spain and France, are retired - and elderly people typically use more healthcare than they contribute in taxes. In contrast, most European nationals living in Britain are of working age, meaning that they are more likely to use low-cost GP care but not costly hospital care.
So at a time when the health service is under enormous strain having been starved of funding and subject to the unprecedentedly idiotic reforms of Mr Hunt's supremely arrogant predecessor, the NHS is going to have to spend millions of pounds of taxpayers' money on building an entire infrastructure to collect identification information at every point of care. Forget more nurses or doctors. Or new high resolution MRI scanners. Or more GP practices.
If Hunt had only recently become Health Secretary, it might be possible to dismiss this as the naïve initiative of a new minister. But he has been in the job longer than any member of the cabinet; and he will have doubtless received advice from officials in the Department of Health and NHS England that this makes no sense. So why do it?
This is misdirection: it is about signalling to the British people that immigrants are the reason the NHS is in a mess, rather than the result of his decisions. What we are seeing in the health service now is the consequences of spending too little as demand rises. Even if every penny of the £500m that Hunt claims could be collected comes in, it would be less than one-sixth of last year's deficit alone. The focus on immigration status is politics dressed up as policy.
After all, the Health Secretary has form - for this is absolutely typical of his scheming ineptitude, no different from an entirely unnecessary and avoidable dispute with talented, hard-working junior doctors. Doing the wrong thing, for the wrong reasons, at the wrong time. Parliament is there for a reason: rather than howling that this is the latest attempt to privatise the NHS, its members would do well to point out that this is just bloody stupid.
Tom Kibasi is Director of IPPR, the progressive policy think tank.Suggest a correction