A brief note on public opinion and immigration

We are facing the usual glut of headlines about how the public think that immigration is one of the most pressing issues facing the UK today. Aside from the fact that this is entirely based on perception, such polling results require a bit of basic dissection before making conclusions about them.

Let's start with the questions posed.

Most polls of this sort will give respondents a list of issues, preferably in randomised order, and ask them to identify the one/two/three most important issues. The issues from which to choose will vary somewhat over time as issues rise and fall, but many of them are fairly constant. Common issues include:

• Crime
• Economy
• Unemployment
• Housing
• Healthcare
• Immigration
• Education
• Pensions
• Environment
• Etc.

Many of the polls simply ask respondents which are the most pressing issues. However, the better polls ask people to identify the most pressing issues for their country as a whole as well as the most pressing issues for them personally. This then identifies what problems people are facing in their everyday lives separately from what they pick up from news media, rumour, heresay, etc.

This is where the results get interesting.

Let's take the Eurobarometer (May 2013) results. First, let's look at the rankings for the question, 'What do you think are the two most important issues facing the UK at the moment?'



For nationally pressing issues, unemployment and immigration clearly rank as the top issues. But the picture looks distinctly different when we look at answers to the second question, 'And personally, what are the two most important issues you are facing at the moment?'

 

Suddenly, immigration comes in as eighth most important.

What does this mean? A lot of people think immigration is a pressing issue at the national level but isn't for them. This indicates that respondents are picking up on government rhetoric and mass media reports that frame immigration as a pressing problem, but in actuality, the vast majority of people are facing far more pressing issues. It's not possible for something to be a pressing national issue that is a pressing personal issue for so few people.

Thus, whilst we should respond to people's fears about immigration, we should take such polls with a very generous pinch of salt. Our response should be more about education with less focus on perceptions that aren't based on any evidence.

Why an NHS levy for immigrants is wrong

Jeremy Hunt has announced a consultation period for a new policy that would require a proposed bond of £200/year for the first five years for non-EU immigrants to access the NHS. He claims that this is 'fair to British taxpayers'. This policy is neither fair nor evidence-based. Here are some of the reasons why:

1. Immigrants already pay to access the NHS. Not only do they pay a visa fee to come, they then pay National Insurance contributions, just like the 'British taxpayer' to whom Hunt refers. 
2. There is no evidence of 'healthcare tourism' to the UK, despite government discourse. The better-researched estimates are that unpaid treatment for foreigners in the NHS costs £30-50m/year. This is compared with an annual NHS budget of around £104bn, meaning that such costs equate to around 0.15% of the annual budget, which makes the proposed levy seem like using a sledgehammer to crack a walnut.
3. Even with the levy, the NHS would not reach full recovery of unpaid foreign debts, as an increased focus on enforcement will cause higher legal and administrative costs. Debt collection is not free.
4. Limiting immigrants' access to emergency services only will have the undesirable effects of sending people who could be treated easily and affordably by a GP to A&E and of people delaying treatment for conditions until they are much worse. Early treatment is effective and affordable; emergency treatment is not.
5. The government insists that 'Britain is open for business', despite placing ever-greater restrictions on student visas and other deterrent policies in pursuit of the seemingly-arbitrary goal of reducing net migration to 'tens of thousands'. The proposed levy would only apply to non-EU nationals, who already have to prove greater wealth and a secure job in a highly-skilled industry.
6. Despite Hunt's claims to the contrary, such a policy very much turns GPs into border agents, just as universities have been saddled with increasing immigration policing, and there are proposals that landlords should also be responsible for checking the immigration status of tenants. GPs already have to check passports and visas for every new person registering at their surgeries. Doctors now express concerns that this policy could cause conflicts with their Hippocratic oath and that it could lead to outbreaks of epidemics from untreated illnesses.

This is by no means an exhaustive list but provides some of the most glaring errors in the policy proposal.