HL Deb 08 June 1982 vol 431 cc98-100

2.46 p.m.

Lord Kilmarnock

My Lords, I beg leave to ask the second Question which stands in my name on the Order Paper.

The Question was as follows:

To ask Her Majesty's Government whether they have considered requiring overseas visitors, who have no right to free health service treatment, to take out temporary national insurance cover for the period of their stay, including an element for the administration of such a scheme; and if not, why not.

Lord Trefgarne

Yes, my Lords. The Government did consider such an arrangement, but it was ruled out on a number of grounds; not least the lack of the necessary statutory powers. It would furthermore have required the processing of all arriving passengers at the port of entry and the issue of 4 or 5 million documents per annum. The effects of such a scheme at Heathrow in mid-summer, for example, I leave to your Lordships' imagination.

Lord Kilmarnock

My Lords, may I thank the noble Lord for that reply. May I ask him whether he is aware that the past Secretary of State, Mr. Jenkin, and the present Secretary of State, Mr. Fowler, suggested at various times in speeches in another place that foreign visitors should simply take out insurance in their own countries against health risks? While this might seem to be a reasonable proposal, may I ask whether the Government have thought about the difficulty of recovering charges from people who may be running out of money and will want to refer the matter to their insurers before paying? Has the Minister thought of the likelihood of bad debts and the considerable administrative costs that could arise from these?

Lord Trefgarne

My Lords, it is the case that the bulk of the visitors to this country come not from the third world, a s is sometimes imagined, but from developed countries where insurance arrangements are in many cases well advanced and highly sophisticated. It is for that reason that we think that insurance is the best policy. As for bad debts, I suppose that it is true to say that anyone who actually sets out to cheat the health service, even when he has insurance, may occasionally find a way of doing so. But, in general, those who have insurance will, I am certain, be willing to meet the costs imposed upon them.

Lord Avebury

My Lords, have the British Council accepted the advice that the noble Lord gave that insurance should be taken out in respect of overseas students? If they have not done so, how is the extra £100 cost, which he said would fall on the average student for medical fees, going to be met? Is there going to be an increase in the amount of the grant to the British Council or has this £100 somehow to be found out of the sum already allocated to it for fees and maintenance? How can the sum of £100 be found out of such a vestigial amount that is already available?

Lord Trefgarne

My Lords, I do not accept the view that visitors to this country, be they students or any other, have to be fed with a spoon at every step of their existence from the moment that they step ashore to the moment that they leave again. The costs that would normally be incurred for the insurance that we have been discussing are comparatively small in connection with the total annual costs of staying in this country, including the fees, and I hope will not cause any significant difficulty.

Lord Avebury

My Lords, have the British Council taken the advice?

Lord Trefgarne

My Lords, this is not a matter for the British Council; it is a matter for the students themselves to decide how best to meet the costs that may fall upon them.

Lord Kilmarnock

My Lords, regarding the idea of insurance, has the noble Lord taken into consideration the fact that health stamps, for example, might be sold over Post Office counters for variable periods of time? If he is not attracted to that idea, would it not be something that our own insurance market could take up for the benefit of the insurers in this country rather than overseas?

Lord Trefgarne

My Lords, I hope that British insurance companies will want to take this matter up. I would not rule out the possibility of insurance being available at ports of entry. The Question that I was answering was on the possibility of compulsory insurance being sold at ports of entry, and that presents the administrative difficulties to which I have referred. I see no objection to slot machines at points of arrival where people could purchase appropriate insurance. Indeed, I recall that when one is travelling abroad these days one can purchase insurance on departure for various purposes, in any event.

Lord Wallace of Coslany

My Lords, is the noble Lord aware that we received this morning a lecture on democracy and therefore on this basis every person coming to this country must face up to the fact that they must reach a decision on their own to meet a situation created by this very reactionary Government?

Lord Trefgarne

My Lords. I would put it round the other way. The fact is, of course, that when the health service was established in this country we were the forerunners of a scheme of that kind, and we had hoped that it would attract a wider following in the world at large than it in fact has. If every country had a scheme such as ours then we could doubtless have a reciprocal arrangement with every country and this difficulty would not arise.

Lord Hatch of Lusby

My Lords, is the noble Lord the Minister aware that it is already getting more and more difficult for those of us who have to advise students over the country in they should take their degrees, to advise them to come to this country? Is he further aware that what he has said this afternoon makes it even more difficult to advise them, in comparison with the cost in other countries? Would he at least give us an assurance that he and his Ministry will consider whether students in this country should not be given exemption from this penalty?

Lord Trefgarne

My Lords, I would not describe it as a "penalty". We have certainly given very careful consideration to the position of students and the arrangements are to be as I have described. The fact is that students or others who come to this country seeking a totally free health service are seeking access to a service which is essentially designed and paid for by the resident population.

Lord Harmar-Nicholls

My Lords, is my noble friend aware that if it is the quality of the health service that brings students, there is no other country in the world, even when a scheme is in operation, which is superior to the one we offer to students when they come here?

Lord Trefgarne

My Lords, certainly our health service is something of which we can be rightly proud.