HL Deb 28 November 2002 vol 641 cc903-6

3.15 p.m.

Lord Astor of Hever

asked Her Majesty's Government:

Whether the health needs of asylum seekers who have entered the United Kingdom are being met.

Lord Hunt of Kings Heath

My Lords, people who seek asylum in the United Kingdom are fully entitled to NHS treatment without charge. In England, initiatives such as local development schemes, personal medical pilots and pilot health assessments for newly arrived asylum seekers are geared to meeting their health needs.

Lord Astor of Hever

My Lords, I am grateful to the Minister for that reply. What action are the Government taking to combat the worrying increase in TB among asylum seekers entering this country? In the borough of Newham, 200 out of every 100,000 people now have TB—a higher incidence than in India.

Lord Hunt of Kings Heath

My Lords, the noble Lord is right to draw attention to the problem of TB. The majority of asylum seekers entering the UK via east Kent ports are screened for, and, if appropriate, vaccinated against, TB as part of a Home Office-funded pilot. We shall review the results of that pilot in the new year and, in the light of that, make decisions about the future of screening newly arrived asylum seekers not only in Kent but throughout the United Kingdom.

Lord Greaves

My Lords, asylum seekers access the free health service via form HC2, which they use to apply for help with health costs. Such help, along with their housing and subsistence money, comes via NASS, the National Asylum Support Service. Will the Minister consider the case of those who reach the end of the process in terms of their applications and appeals and who are unsuccessful but who cannot be, and are not, removed from this country because they come from places such as Iraq to which it is currently impossible to send people? Such people lose not only their housing and subsistence payments but also their HC2 help with health costs. How are they supposed to access health services when they need prescriptions, dental treatment, sight tests, or whatever?

Lord Hunt of Kings Heath

My Lords, my understanding is that when applications are refused by the Home Office, asylum seekers often appeal against the decision. While appeals are outstanding, free NHS treatment continues. That is also the case in relation to those whose applications fail but who are given indefinite leave to remain in the UK. As the noble Lord suggested, that is appropriate where it is currently not safe for an asylum seeker to return to his country of origin. Those who do not appeal and who are not given leave to remain may be removed from the UK. While they are waiting for that to happen, they will not he refused any treatment they require before removal.

Earl Ferrers

My Lords, did I hear the Minister aright? Did he say that when asylum seekers arrive in this country and are found to have tuberculosis, they are given a jab and then sent on their way? Is that sensible? Does it not encourage spread of the disease?

Lord Hunt of Kings Heath

My Lords, clearly we need to ensure that health-screening measures are appropriate. I referred to a pilot scheme being undertaken in east Kent. We shall consider the evaluation of that pilot to see how well it works. We are concerned about TB and its potential spread. We are keeping the matter under tight review.

Lord Avebury

My Lords, does the Minister agree that proper records should be maintained of asylum seekers who are pregnant or who have suffered recent miscarriages? In which places of detention does he consider that adequate healthcare facilities are available to such persons?

Lord Hunt of Kings Heath

My Lords, there is a problem with health records, particularly as asylum seekers move around the country. There is no doubt that hand-held patient records are the most appropriate method for dealing with the problem referred to by the noble Lord and for recording health information. The asylum seeker would keep the handheld record and take it to health appointments wherever that may be. Many areas have developed their own hand-held records for issue to asylum seekers. My department is working with front -line staff on the development of a national model.

Lord Roberts of Conwy

My Lords, can the Minister tell the House how the additional costs to the health service of asylum seekers are met? He will be aware that there are signs of stress in the NHS.

Lord Hunt of Kings Heath

My Lords, such costs fall within the NHS budget. We are dealing with that in a number of ways. We are looking to make the funding formula sensitive enough to ensure that primary care trusts receive an appropriate allocation. We have also pursued a number of local initiatives, such as local development schemes, where additional money is allocated by the department to help primary care trusts and GPs in specific areas. The flexibility of the personal medical service pilots in relation to the remuneration of GPs may also be of assistance. I acknowledge that particular areas of the health service are under financial pressure as a result of this situation.

The Earl of Sandwich

My Lords, can the Minister confirm that the full range of health services will be available to asylum seekers in the new accommodation centres and that there will be no discrimination, as there is in education?

Lord Hunt of Kings Heath

My Lords, the intention is that appropriate health services of NHS standard are available.

Earl Russell

My Lords, can the Minister confirm that the remuneration of GPs includes a considerable capitation element for regular performance of routine tasks such as vaccinations? Can he confirm that in the case of the homeless, that has been a deterrent to GPs registering transients? Can he tell the House whether the dispersal policy has made that operate even more in the case of asylum seekers?

Lord Hunt of Kings Heath

My Lords, there have been cases in which GPs were reluctant to accept asylum seekers. There have been one or two cases—we are currently investigating the facts—where a GP had a deliberate policy of not accepting asylum seekers. I cannot support that in any way. The scale of fees and allowances is based on both a basic practice allowance and a capitation allowance, which should ensure that additional patients mean additional financial rewards for a general practitioner. However, I accept that that may not be sensitive enough in the circumstances raised by the noble Earl. We are in discussions with GPs about their national contracts. We also believe that the PMS pilots give greater flexibility to the NHS at local level, which may enable them to deal with the issues raised by the noble Earl.