Health tourism and the moral justification for selfishness

By Bernadette Meaden
October 18, 2013

Have we ever had a government with so little regard for truth or accuracy? The tendency for senior Conservatives to routinely ‘misrepresent’ statistics for their own political ends, or make decisions and statements based on ‘feelings’ has developed apace over the past few years. Iain Duncan Smith has been rebuked by the UK Statistics Authority for this habit, as has Grant Shapps, Conservative Party Chairman.

Now however, this disregard for truth or evidence has reached the Home Office, and plumbed new depths.

The Conservatives seem determined to make immigration, and particularly ‘health tourism’ and ‘benefit tourism’ a major issue at the next election. Hence the new Immigration Bill, which they hope will make them look tougher than UKIP.

As far as benefit tourism is concerned, the government’s disregard for hard facts was embarrassingly highlighted on the international stage. Theresa May said EU migrants claiming benefits were an ‘unacceptable burden’, but the EU pointed out that it had been asking for evidence of this for three years without success A leaked classified Home Office document said, "We consider that these questions place too much emphasis on quantitative evidence" In other words, we’re not going to let the truth get in the way of a useful myth. To his credit Liberal Democrat MEP Chris Davies spoke out, saying, "The Home Secretary is pandering to extremists by making claims about 'benefit tourism' that she cannot justify……It's clear that Theresa May hasn't got a clue whether there is a real problem or not."

Pandering to extremism on immigration issues would be bad enough, but there seems to be another agenda here too, which may be clearer where ‘health tourism’ is concerned

So-called health tourism has been shown to be a very minor issue, with perhaps 0.1%
of the NHS budget affected. Yet again, in interviews Theresa May refused to deal with figures and insisted on the ‘principle’ and public concern She was very indignant about the unfairness of people who have not paid into the NHS, like overseas students or short term migrants, receiving free treatment, and the urgency of the need to make them pay.

Now, if immigrants were the only target here it would be bad enough. But with the NHS in such a state of flux, with so many private providers entering the NHS ‘market’, I suspect there is another agenda.

In a recent Sky News special, 24 hours in A&E, viewers saw hard pressed staff struggling heroically to meet demand. Once the audience had been persuaded that ‘something had to be done’ an apparently reasonable idea was introduced. As some of the patients at A&E were there because they were drunk, should they not be made to pay for their treatment? In the dramatic and emotional context of the programme this sounded reasonable, and not surprisingly in the Sky poll that followed, over 70% of viewers agreed.

But wait: aren’t people with smoking-related diseases, or obesity-related diseases authors of their own misfortune? Perhaps we should make them pay? Once the principle of charging people for NHS treatment has been established, and the mechanisms are in place to process payments, who knows where it will end?

And perhaps this is all part of an even bigger agenda: the desire to introduce a ‘contributory principle’ to benefits and services, where people get out according to what they have paid in. Again, this sounds fair, but how would it work in practice? What about people born with a serious illness or disability which mean they may never be able to contribute much financially into the system. What about someone who lives in an area of high unemployment and is long-term unemployed: will they be entitled to lower benefits and less NHS treatment? If people only get out according to what they have paid in, how does that differ from a private insurance system?

A social security system must be what it says, a ‘social’ system, where people pay in for the good of society, not for just what they can get out of it. If we take the contributory argument to its logical conclusion we will soon have people who aren’t prepared to pay for somebody else’s health care, or for other people’s children to be educated.

Perhaps John Kenneth Galbraith was correct when he said,

‘The modern conservative is engaged in one of man's oldest exercises in moral philosophy; that is, the search for a superior moral justification for selfishness.’


© Bernadette Meaden has written about political, religious and social issues for some years, and is strongly influenced by Christian Socialism, liberation theology and the Catholic Worker movement. She is an Ekklesia associate and regular contributor. You can follow her on Twitter: @BernaMeaden

Keywords:NHS | health tourism
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