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Health Check: 'Even the general secretary of the Royal College of Nursing has been accused of health tourism'

Maxine Frith
Monday 04 August 2003 00:00 BST
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Britain is being swamped by tourists - only, according to the Government, they are the wrong kind of tourists.

If you believe some of the more rabid reports, A&E departments are being swamped by asylum seekers injured in drunken fights, and grannies are being denied hip replacement operations because hospitals are having to divert the money to HIV-positive Africans. The reality is somewhat different. Even the Government admits it has no figures on the number of "health tourists" visiting the UK, or how much they cost.

Nevertheless, last week it set out proposals to clamp down on foreigners who use - or abuse - the NHS. But despite this seeming to be an extension of the unwritten political policy of "if in doubt, blame the asylum seekers", the NHS was set up to be free at the point of delivery - and that leaves it open to abuse by people who, at home, have to pay for treatment.

Under the Government's plans, everyone in Britain would be issued with an identity card which they would have to show before seeing a GP or consultant.

People whose asylum applications had failed would receive only emergency care on the NHS, and foreign businessmen would only be eligible for treatment if they were working full-time in Britain. (Currently, they can apply for treatment on the strength of a business visa.)

Even the general secretary of the Royal College of Nursing has been accused of health tourism: the American-born Beverly Malone hit tabloid headlines when her mother had a hysterectomy on the NHS.

Doctors, hospitals and politicians say that the biggest problem with health tourism is the soaring numbers of HIV/Aids patients who travel to Britain specifically for treatment. In some areas, two-thirds of HIV patients are from abroad.

But rather than "clamping down" on so-called health tourists - and imposing identity cards on the rest of us by stealth - the Government should look at the reasons why people travel here for treatment.

It is a bitter irony that the countries most ravaged by HIV are also the ones least able to access and pay for the antiretroviral (ARV) drugs which stave off the onset of full-blown Aids.

That is why people travel from Africa: in their own country they are being condemned to a slow and agonising death, knowing that on the other side of the world there are drugs which could save their life. What would any of us do in that situation?

But consider this: in Britain, HIV drugs cost £15,000 a year. In Africa, the drugs companies (under pressure) now offer the same medicines at cost - £6,000. Yet even at this reduced price, many sub-Saharan countries struggle to find the funds.

It is not just a question of money, either. Botswana has one of the highest HIV rates in the world, but because of its diamonds, and a canny government, it has the money and the aid grants to pay for ARV drugs. Its problem is a shortage of medical staff to diagnose and treat patients. And guess which country has systematically poached Botswana's much-needed health professionals with the offer of higher pay and better conditions? Yep - the UK.

If Britain upped its aid to African countries - and stopped poaching their nurses - they could afford to provide their people with the drugs themselves. Surely then everyone's a winner?

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