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Good afternoon. My name is James & I am a member of the Migration & Asylum Justice Forum. For clarity’s sake, I am also a supporter of Fight Racism! Fight Imperialism! or the Revolutionary Communist Group, who have supported & helped to build for our discussion today. The Forum is a fairly broad organisation, with members of various organisations & unaffiliated individuals making up its membership. What is central to the Forum’s politics is an opposition to the intensification of racism by the British state over recent years, a process most clearly expressed in immigration law.
This brings me on to the topic we are to discuss today: health care. The 2014 Immigration Act brought into effect a series of restrictions & charges for migrants attempting to access the NHS (Immigration Act 2014). We will cover this in more detail, but I want to begin by addressing the manner in which this debate is framed by mainstream discourse. The British media has run – & is still running – an entirely racist campaign of lies, explaining the deterioration of NHS services as a symptom of migration. A recent example serves to illustrate this.
On 21 March 2016, The Telegraph ran an article entitled ‘NHS spent £181,000 treating just one illegal immigrant’. The central claim of this piece was that a cancer specialist had claimed, without a shred of evidence, that migration was making the NHS unsustainable. The claim in the article’s headline is based upon an unreferenced article in The Sun (Telegraph Reporters, 2016). The same story was also run by The Mirror, The Daily Mail & The Daily Express. To put this in context, 5 of the 8 most read newspapers in Britain ran this story, potentially reaching around 5.1m people in their print editions alone (Ponsford, 2016).
This process of ideological manipulation is repeated across British society. As part of the Leave campaign, Michael Gove told us that the NHS will become unsustainable by 2030, the influx of migrants from the European Union (EU) crushing it (Mason, 2016). Theresa May – an inveterate racist, Remain campaigner &, in her time as Home Secretary, a sadist – presided over the legislation we’re here to discuss. Her position on immigration as Prime Minister has been made clear. In her own words it is an ‘absolute priority’ to curb net migration (Swinford, 2016). She has retained centralised control over the Home Office – with Amber Rudd, the new Home Secretary, operating at her command. 3 days ago they announced further plans to attack non-EU migrants’ ability to get visas for work, students & family. Iain Duncan Smith commented, presumably wistfully, that ‘She was always held back, by David Cameron and George Osborne. She wanted to be tougher but there were always people pushing against it.’ (Hawkes, 2016).
2 days ago the Institute of Public Policy Research released a report arguing that the 57,000 EU migrants working within the NHS must be given British citizenship for free. These workers make up roughly 5% of all NHS staff &, without them, the health service would collapse (Dathan, 2016). This is an important point. Alongside working as doctors, both EU & non-EU migrants work as nurses & cleaners in the NHS. The Royal College of Nurses predicted that as many as 7,000 nurses would be deported under new immigration laws in June (Spencer, 2016). Aside from the labour that these people provide, the nature of British immigration law has allowed the wages paid out to migrants, particularly to unskilled migrant workers, to be artificially lowered (Vickers, 2016). For those workers that receive wages “appropriate” to their job – doctors, for example – the cost of their education etc has often been borne by another nation. As a lifetime investment, they are therefore cheaper (Chinweizu & Jameson, 2008). Rather than “putting a strain” on the NHS migrants hold the service afloat, both in terms of their concrete labour & in terms of their cost.
It is not migration that is destroying the NHS, it is austerity. This destruction is too complex for me to attempt an explanation in the short time we have today. Instead, I will offer only an exceptionally basic overview.
At the end of the 2015/16 financial year NHS hospital trusts in England registered a deficit of £2.45bn. Overall, 65% of the 240 NHS trusts reported a substantial deficit (Caller & Clough, 2016). This is a logical consequence of the economic process that has been inflicted on the NHS since the 2008 banking crash. Since 2010, the NHS has faced an enormous whittling away of its finances. This will continue until, at earliest, 2020. By this point NHS spending as a proportion of British GDP will have fallen from 8.8% in 2009 to 6.6%. GDP is forecast to grow in real terms by around 15.2% between 2014/15 & 2020/21, but NHS spending will grow by only 5.2%. The annual real-term increase in NHS spending between 2009/2010 and 2020/21 will be a mere 0.9%.
In order to keep up with advances in medical technology & demand, NHS spending in real-terms would need to increase by 4.5% per annum. This leads me to an important. Austerity is not only responsible for the financial destruction of the NHS, it also creates a context in which greater demand is placed on the service. I will take Newcastle as an example. Statistics from June 2015 reveal there are an average 696 hospital stays for self-harm in the city per year – around 2 a day. This rate is 229.7 incidents per 100,000 population worse than the average for England (Public Health England, 2015). In the absence of adequate mental health care, many working class people are turning to alcohol. 2014 saw a 30% increase in the number of alcohol related deaths for Newcastle, placing the rate 64 deaths per 100,000 population. This is 1.4x higher than the national average (Thompson, 2016). Suicide is rising, with the highest rate in the country being for the North East. Wages are falling (Bell, 2016).
With falling resources & rising need, both of which are born from austerity policies, is it any wonder that operations are postponed, waiting lists stretched, A&E in tatters? (Caller & Clough, 2016)
To return to immigration law.
The 2014 Immigration Act brings substantial legislation into power in relation to the access that migrants have to health care (Immigration Act 2014). In order to gain access to health care on the NHS, migrants must now produce their immigration papers at the point of service. Migrants from outside of the European Economic Area (EEA) staying in Britain over 6 months now need to pay an annual surcharge to access health care on the NHS – £200 per annum for most migrants, £150 per annum for students. This is to be paid up front, accounting for each year that the individual plans to stay in the country. Visitors from outside the EEA will need to pay per operation at a rate of 150% of cost. In other words, an operation that costs £100 to perform would cost £150. On top of this, NHS staff are now legally obligated to report migrants without the correct papers to the Home Office. This plays a dual role in aiding the privatisation of the NHS & placing migrants into an ever deepening form of precarity. The racist paranoia that I referenced earlier is a tool utilised in order to justify this.
The 2016 Immigration Act expands these powers into housing, bank accounts & even driving licences (Immigration Act 2016). For example, in regards to driving licences, the police now have a duty to check migrants immigration papers. This essentially gives the police an unlimited power to pull over black & ethnic minority people whenever they please, as racially profiling people is the only way to implement this kind of legislation. For migrants, this equates to living in a constant state of fear. If a migrant attempts to rent a private flat, they need to provide their migration papers. If a migrant wants to open a bank account, they need their papers. If they cannot provide papers at any of these points, they run the risk of being reported to the Home Office & deported. This gives greater powers to the British state to deport people at will. It will likely make it easier to force migrants into poorer working conditions, with poorer pay, as many people will be forced to move underground in order to survive. The mass incarceration of 35 undocumented migrants by Byron Burgers on 4 July stands as a harrowing indication of what British companies can do to workers they have exploited & no longer need (O’Carroll & Jones, 2016).
In order to implement such clearly repressive laws, laws that operate on the scale of everyday life, the British state has brought the borders inside Britain. To ensure this is done coherently, the British state has employed all kinds of coercion to transform everyday workers & citizens into border guards. For example, landlords may now face upto 5 years in jail if they are found to be letting to a migrant with the incorrect papers (Immigration Act 2016). Not only are these workers coerced, they are untrained & fed the racist paranoia produced by the British media. This creates a context of constant precarity, danger & violence for migrants.
We reject absolutely these racist Immigration Acts. We reject absolutely the war on migrants’ access to health care, the destruction of the NHS & the scapegoating of migration by the British media. We say that there is no alternative but to organise.
We will not be border guards!
Decent health care, housing & jobs for all!
Down with the racist Act!
Bell, J. (2016). Newcastle Labour council: Austerity & the Transformation of Local Government. [Blog] Notebook. Available at: http://goo.gl/yE2Ywe [Accessed 26 Aug. 2016].
Caller, H. & Clough, R. (2016). NHS in financial meltdown. Fight Racism! Fight Imperialism!. [online] Available at: http://goo.gl/2VTcdf [Accessed 26 Aug. 2016].
Chinweizu, C. & Jameson, N. (2008). Immigration and the reserve army of labour in Britain. Fight Racism! Fight Imperialism!. [online] Available at: http://goo.gl/6oycrd [Accessed 26 Aug. 2016].
Dathan, M. (2016). All 57,000 EU migrants working in the NHS must be offered FREE British citizenship to stop the health service collapsing after Brexit, thinktank says. The Daily Mail. [online] Available at: http://goo.gl/T9lrqx [Accessed 26 Aug. 2016].
Hawkes, S. (2016). ABOUT RUDDY TIME Theresa May orders Home Secretary Amber Rudd to clampdown on number of non-EU workers and students coming to UK. The Sun. [online] Available at: http://goo.gl/pSKOYl [Accessed 26 Aug. 2016].
Immigration Act 2014, ch. 22. Available at: http://goo.gl/fnZdWZ [Accessed 26 Aug 2016].
Immigration Act 2016. Available at: http: http://goo.gl/1l3ln7 [Accessed 26 Aug 2016].
Mason, R. (2016). Gove: EU immigrant influx will make NHS unsustainable by 2030. The Guardian. [online] Available at: http://goo.gl/Yjj8vj [Accessed 26 Aug. 2016].
O’Carroll, L. & Jones, S. (2016). ‘It was a fake meeting’: Byron Hamburgers staff on immigration raid. The Guardian. [online] Available at: http://goo.gl/iSLOUI [Accessed 26 Aug. 2016].
Ponsford, D. (2016). National press print ABCs for January: Mirror losing ground against cut-price Star ahead of new launch. PressGazette. [online] Available at: http://goo.gl/Fy9ZqA [Accessed 26 Aug. 2016].
Public Health England, (2015). Newcastle upon Tyne: Health Profile 2015. London: The Stationarty Office.
Spencer, B. (2016). With no migrant staff NHS would be ‘on its knees’: Doctors’ union chief says health service has been ‘enriched beyond measure’ by foreign staff. The Daily Mail. [online] Available at: http://goo.gl/6OMf2z [Accessed 26 Aug. 2016].
Swinford, S. (2016). Low skilled migrants would have to apply for work permits under plans being considered by ministers. The Telegraph. [online] Available at: http://goo.gl/rBaoUn [Accessed 26 Aug. 2016].
Telegraph Reporters, (2016). ‘NHS spent £181,000 treating just one illegal immigrant’. The Telegraph. [online] Available at: http://goo.gl/Klp5lV [Accessed 26 Aug. 2016].
Thompson, C. (2016). Alcohol killing more Geordies than ever before as figures rocket on Tyneside. The Chronicle. [online] Available at: http://goo.gl/4CGKtn [Accessed 26 Aug. 2016].
Vickers, T. (2016). Racism and poverty in Britain. Fight Racism! Fight Imperialism!. [online] Available at: http://goo.gl/3sLCb1 [Accessed 26 Aug. 2016].