As one of the richer industrialised nations we will, when we are able, be generous to those less fortunate than ourselves, but our prime duty should always start at home. It follows that the NHS should, first and foremost, be for the long established people of this country, the ones who pay for it – or so you would think.

The NHS now acts as an HIV screening service for anyone from anywhere in the world. This is the result of a 2012 decision by the Coalition to make it available to all non-British visitors (free to them, of course) regardless of status. Those who test positive join the estimated 7,000 who are newly diagnosed each year. Of those newly diagnosed in 2013, more than 60 per cent were born abroad. And of course it now follows that any attempt to repatriate a migrant or asylum seeker with HIV, or any other life-threatening disease, meets with a claim under the Human Rights Act.

However, according to the United Nations, almost 60 countries refuse entry to people who are HIV-positive. Yet when Nigel Farage said we should exclude those who did not have private medical insurance, the predictable outcry ensued. It seems to be perfectly okay for us to attempt to protect ourselves from Ebola but discriminatory to suggest we in the UK require the same for HIV. Earlier this year 20 Tory backbenchers tried unsuccessfully to amend the Government’s Immigration Bill to make it law that all new immigrants must prove they were not HIV-positive and not suffering from Hepatitis B. This was based on figures that proved most new cases in the UK are diagnosed in people who arrived from abroad. But where was the outcry then?

Ebola is now said to be the most serious health issue facing this country since AIDS in the 1980s and the West African-based epidemic has the potential to become a pandemic. The first duty of any government is to protect its citizens and the UK is now introducing gradual, limited screening for people arriving in this country. Ordinarily, we tend to think of national threats in terms of the uniformed military forces of a foe or the skulking terrorist. The current deadly hazard is microscopic, arbitrary and merciless. (The first positive identification of the virus was in 1976 near the Ebola tributary of the Congo River).

Then there is tuberculosis (shortened to TB and otherwise known as consumption). Mayor Boris Johnson recently and grudgingly confirmed there was a high incidence of it in the east of the city. London has the highest number of sufferers of any western European capital according to Public Health England and is the only one where the number is rising. It accounts for almost 40% of the nation’s cases. Any reluctance to talk about this situation is likely due to the nature of the communities or groups in which it is prevalent. Until recently TB was of historical significance in the UK because, by the1980s, it was considered to be all but eradicated.

Professor Meirion Thomas, an eminent NHS consultant with 44 years experience and who has researched the issue thoroughly, estimates the cost of health tourism to the British taxpayer in the billions of pounds per year, which places a huge strain on staff and resources. Our bloated, ring fenced overseas aid budget, spent in the countries where those conditions are present, should be much more effective than it is. It is expensive to train a doctor in the UK yet, after qualification, an increasing number now seek to take their expertise abroad, the favourite destinations being Australia and New Zealand. It cannot simply be about the weather. Ridiculously, we then have to go overseas to recruit replacements whose proficiency often falls below the standards we expect and whose grasp of English can be poor or, in extreme instances, non-existent. The countries we plunder are likely in more need of their health care professionals than we are; it’s a mad medical merry-go-round.

The NHS does not need more money. What it does need is to stop paying for the healthcare needs of the world. Providing it to strangers who have no connection to these shores necessarily means that the indigenous population is pushed further back in the queue when requiring their own treatment.

This nation of ours currently owes £1,400,000,000,000, the interest payments on which amount to millions of pounds per day. Can we, should we, really be playing doctor and nurse to the world?

Photo by 2E0MCA

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