How soaring immigration has piled on the pressure for British public services

Look closely at the numbers of people using hospital Accident and Emergency wards and you will see a worrying trend.

Between 1987 and 2003, attendances at A&E remained steady, with around 14 million people each year. Then, in 2004, the numbers jumped by 18 per cent to 16.5 million.

By last year, the figure was 21.7 million — a 50 per cent increase in ten years.

By contrast, European countries such as Sweden have registered a barely negligible rise in attendances over the same period.

Quite rightly, critics point to how changes to GP working hours have piled strain on A&E departments, deluged by patients who can’t see their family doctor at night or at weekends.

But there are other reasons that may explain the rise in demand. Crucially, there are concerns that the extra demands placed upon A&E also stem from a rise in immigration.

From 2001 to 2011, our population rose from 52.4 million to 56.1 million — an increase of 7 per cent and the largest rise in the population since the census began in 1801.

It cannot be a coincidence that 2004 — the year in which A&E attendance jumped so noticeably — was the year that Labour changed GPs’ contracts to let them opt out of out-of-hours care, and also the year that East European countries such as Poland and the Czech Republic acceded to the EU, allowing their people free migration to the UK.

We simply cannot go on discounting the effect that such immigration has had upon our healthcare services.

In 2011, the NHS spent £23 million on translators and interpreters — a rise of 17 per cent since 2007.

The Nuffield Trust, a healthcare research body, has also identified that the number of migrants registering with GPs rose from 550,000 a year in 2003/4 to 625,000 a year by 2005/6.

But a bigger problem is almost certainly with migrants who do not register with a GP. Arriving in this country with no clear understanding of how the NHS works, and not knowing which part of the health service to turn to when they are ill, they may go straight to A&E rather than to a GP.

Dr John Heyworth, president of the College of Emergency Medicine, has spoken of ‘increases in the number of immigrants who tend to visit A&E routinely and not register with family doctors’.

Other organisations report the same trend. A UK Border Agency study into the impact of migration quoted one survey of 700 migrants which found only half had registered with a GP.

As one document prepared by the Sandwell Health Alliance (a consortium of GPs in the West Midlands) in August 2011 admitted, the ‘immigrant population have a lack of understanding of how the health service works, and so use A&E as the norm’.

A further contributing factor may be that since migrants tend to settle in more deprived areas, they may not have rapid access to general practitioners.

The Health Services Journal found in 2011 that in the poorer areas of the country, 31 per cent of patients could not access a GP within two days, compared to 19 per cent in the wealthiest areas.

Unable to seek the advice of a local family doctor, patients in the poorest 10 per cent of areas were 53 per cent more likely to attend A&E in a given year than the wealthiest 10 per cent.

The NHS now receives more funding than ever before: £104 billion, rising to £112 billion by 2015. Yet the system, as A&E admissions prove, is under ever greater strain.

The demand for NHS services continues to rise, our population is rapidly ageing and obesity and other chronic conditions put ever greater strain on the Health Service. It has been estimated that by 2050 the costs of the NHS could reach £250 billion.

Unless we take action about how we want to ensure that healthcare is provided free, regardless of the ability to pay, then in future decades the very future of the NHS could be under threat.

Of course, the NHS has never been ‘free’: it is paid for by taxpayers. And it is the contributory system that we need to restore if people are going to have trust in their public services.

The fact is we cannot sustain a health service that will treat anyone who arrives in the country without a record of contributing or paying into the service.

For too long, so-called ‘health tourists’ who are not eligible for free NHS care have managed to get treatment but then don’t pay the cost. Over the past five years, health tourists are estimated to have cost the country more than £40 million.

And this is likely to have been only the tip of the iceberg, given that several health trusts did not collect data or records of foreign nationals who should have been charged.

Medical professionals who have witnessed this scandalous abuse of the NHS are finally speaking out.

The distinguished Professor J Meirion Thomas, of the Royal Marsden Hospital in London, said the founder of the NHS, Aneurin Bevan, ‘would be outraged by the abuse of his flagship social reform on such a scale’.

He added: ‘The time has come to protect the NHS. British taxpayers should not be funding an International Health Service.’

He estimated that the costs to the NHS from ‘health tourism’ could in fact run to billions of pounds a year.

Of course, no one would deny the benefits to this country of migrants who work tirelessly to make a better life for themselves, including those workers who devote themselves to the NHS itself as doctors, nurses, porters and orderlies.

But we should look at introducing a ‘Green Card’ system similar to the United States, which would allow migrants permission to work but not grant them access to public services until they had paid a minimum of, say, five or ten years in tax contributions.

Until that time, migrants entering the country should be required to take out medical insurance before they are granted a visa.

I realise this will require a substantial renegotiation of the UK’s relationship with the EU over how benefits and welfare are paid. But if we are to save the NHS, then we must act to ensure that everyone who is treated by its doctors and nurses puts into the system before they take something out.

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More immigration blunders by the Australian government

Leftist governments everywhere seem to be soft on illegal immigration -- with many unfortunate results

JULIA Gillard has ordered an investigation into how an al-Qa'ida terrorist was housed for months in low-security immigration detention, as Labor seeks to fend off opposition attacks suggesting the flood of boat arrivals is jeopardising national security.

The Prime Minister caved in yesterday after days of having resisted opposition demands for an inquiry into the case of convicted Egyptian jihadist Maksoud Abdel Latif, who Tony Abbott said was housed behind a "pool fence" in the Adelaide Hills.

Ms Gillard said the Inspector-General of Intelligence and Security would examine the management by government agencies "of persons seeking asylum who present complex security issues" - particularly the case of Latif.

In question time, the Opposition Leader moved to link illegal boat arrivals to security concerns, declaring that 42,000 people had arrived on 700 illegal boats since Labor took power and more than 10,000 had been released into the community without comprehensive ASIO checks.

Senate estimates hearings have been told that last month security agencies faced a backlog of more than 19,000 asylum-seekers yet to be processed.

Australian authorities confirmed yesterday the arrival on Tuesday of two more asylum-seeker boats.

One was intercepted north of Christmas Island, carrying 54 passengers and three crew. A second vessel was detected northwest of Darwin, with 79 people on board and two crew.

Mr Abbott asked Ms Gillard in parliament: "Given that a convicted jihadist terrorist was held at a family facility in the Adelaide Hills for almost a year, through what officials called a clerical error, will the Prime Minister now concede that Labor's policies have made Australia less safe than it was under the former government?"

Ms Gillard said Mr Abbott's question showed the divide between a government that was building and investing for the future and an opposition that was "trading in fear".

The investigation by the nation's top-ranking security watchdog will probe how key agencies such as the Immigration Department and ASIO are conducting security assessments of asylum-seekers.

The government faced immediate demands for a wider investigation.

It was forced to vote against a motion by independent Andrew Wilkie for a parliamentary committee inquiry into the case.

Opposition immigration spokesman Scott Morrison said the inquiry announced by the Prime Minister was not broad enough because it did not address how the Immigration Department allowed the convicted terrorist to "stay behind a pool fence" under the watch of two ministers.

The row was sparked by revelations that Latif, who is accused of being a member of terror group Egyptian Islamic Jihad, had been housed in the low-security Inverbrackie detention facility in the Adelaide Hills for almost a year before being transferred to the Villawood detention centre.

Neil Fergus, chief executive of security company Intelligent Risk and a key adviser to the federal government on security at the Sydney Olympics, said the episode reflected the great difficulty for security agencies of prioritising a mass of cases.

Mr Fergus said one of Osama bin Laden's greatest coups was Egyptian Islamic Jihad, which for decades had been one of the most ruthless and bloodthirsty terrorist groups around. It produced al-Qa'ida current leader, Ayman al-Zawahiri.

He said al-Qa'ida had suffered severe operational reversals but there should be no presumption that the risk had gone away. "When a beast is cornered, it can often be more dangerous," Mr Fergus said. "They are dispersing resources. They are, as you can see from the London attack, telling people over the internet to self-initiate attacks."

He said that did not necessarily relate directly to the Egyptian man now in detention custody.

Immigration Minister Brendan O'Connor revealed before question time yesterday that the Immigration Department sent a submission to his predecessor, Chris Bowen, on September 28 last year on the Latif matter.

The submission was not signed, indicating Mr Bowen did not see the document. The Australian understands it dealt in general terms with how the visa application should be handed in relation to emerging security concerns.

Mr O'Connor said the submission was not provided to him when he was appointed Immigration Minister. No matters were raised with him or his office until April 17. This is when it briefed him on the asylum-seeker's movement from the low-security Inverbrackie to Villawood detention facility. The man had remained in detention since arriving in Australia.

Mr Morrison said the inquiry announced was not broad enough because it did not address how the Immigration Department allowed a convicted terrorist to remain in low-security detention under the watch of two ministers.

He called for a full independent inquiry or for the joint standing committee on intelligence and security to investigate, as pushed for by Mr Wilkie in the parliament.

He said Australia did not owe protection to the asylum-seeker under the refugee convention because he almost certainly posed a threat to national security.

Opposition home affairs spokesman Michael Keenan said the inquiry announced by the Prime Minister also did not look at the role of the Australian Federal Police. The apparent lack of co-operation between Australia's key security agencies was a key opposition concern.

It is understood the Coalition is also considering reviewing the interoperability of national security agencies should it win the September election.

Opposition legal affairs spokesman George Brandis suggested Australia would be unable to return Latif to Egypt because it was a country with the death penalty.

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