Politicians in Britain are fond of talking about “tough decisions”. Even on the Left, which is supposed to be the more generous wing, the Labour leader Ed Miliband was happy enough to declare his willingness to tackle “difficult” ones at the leaders’ debate on Thursday.
Why then, was there such a furore over Ukip leader Nigel Farage’s comments over health tourism? Having prefaced his view with the disclaimer that people would be “mortified” that he dare talk about it, Farage said:
“You can come to Britain from anywhere in the world and get diagnosed with HIV and get the retroviral drugs that cost up to £25,000 per year per patient. I know there are some horrible things happening in many parts of the world, but what we need to is put the National Health Service there for British people and families who in many cases have paid into this system for decades.”
A predictable backlash followed, with outrage on Twitter and attacks from the other panellists. At the time Nicola Sturgeon, leader of the Scottish National Party, said: “When someone is diagnosed with a dreadful illness, my instinct is to view them as a human being not consider what country they come from.”
This sounds nice, but it is hard to believe that any of the panel (bar Green leader Natalie Bennett) truly believe in not discriminating against foreigners when it comes to the health service. The alternative would mean offering free health care to all 7 billion people living in the world, which even the Greens would recognise as a bit ambitious.
That doesn’t mean that Farage’s interest in health tourism is not misjudged. In a country open to foreign travel and trade some health tourism is inevitable, or at least would be costly enough to clamp down on that it was not worth the bother. The figures he quoted in regards to HIV (7,000 diagnoses a year, 60% of them accounted for by foreigners) amount to a piffling addition to the health service bill, and the total cost of health tourism is equally piffling.
According to Farage the total cost of health tourism £2bn, a figure that is based on this research commissioned by the coalition. As George Eaton of the (leftwing) New Statesman pointed out at the time, this is not really true:
The £2bn figure refers to the total cost of treating foreign visitors and temporary migrants (such as students and seasonal workers), many of whom are eligible for free treatment and pay tax, not “health tourists”.
The report actually estimates the cost of health tourism at £70m. In the fiscal year 2013/14 the total bill for the NHS was £109.721bn, according to the NHS Confederation, a trade body.
In the end the controversy over Farage’s comment shows both sides posturing. The Left does not really believe that Britain should pay for the world’s healthcare, and the Right are not so bloody minded that they will pursue fraud at any cost.