Immigration Bill

House of Lords, 10 March 2014.

Committee (3rd Day)

Earl of Listowel (Crossbench)

In moving Amendment 48, I will speak to Amendments 55, 63 and 65 and support my noble friend Lord Patel’s Amendment 60. I apologise for not having been able to take part at Second Reading. Perhaps it would be helpful to the Committee if I paused for a moment.

Baroness Anelay of St Johns (Conservative)

My Lords, the noble Earl, Lord Listowel, is trying to introduce his amendment and I would ask that noble Lords leave quietly. That was quite a din. I also remind noble Lords that, when they leave, they should not walk in front of the speaker. It not only drowns him out, it means we cannot even see him.

Earl of Listowel (Crossbench)

I am most grateful for that intervention. Amendment 48 would exempt pregnant women from all charges and penalties associated with Part 3, particularly with regard to health charges and concerns for landlords about having tenants who might not be legal migrants. I want to take pregnant women out of this picture.

I recognise the difficulties that the Government face in terms of immigration. I grew up in Hampstead but I have lived and worked near Bermondsey, and I know that for the people of Bermondsey and other similar areas there can be more challenges due to immigration than in places such as Hampstead, around schooling and access to the health service but particularly around housing. There are real concerns and the shortage of housing can be a cause of social tension.

This, too, is a knotty political question, but if the Government and Opposition could come to some consensus about how to provide enough social housing and affordable housing for our people, many of these tensions might be far less acute than they are today. I know that is a great challenge but it relates to this issue and the concerns of our people about migration.

Perhaps it is helpful to think about how maternity has a certain sacred association. If one wanders around the Sainsbury Wing and looks at the earliest paintings there, one sees paintings from the 13th century of the Madonna and child, and nativity scenes. Respect for

the mother and child during that very important period at the beginning of a family is at the heart of our Christian faith. It is not too surprising that France, Spain and Portugal—some of the Catholic countries—exempt pregnant women from any charges for accessing their health services. It points to the wisdom of the great faiths, as we increasingly realise how vital the very earliest months of a child’s life, from conception through the first two years of life, are to the successful later development of children.

Indeed, the right honourable Iain Duncan Smith did very important work concerning early intervention with families. Graham Allen MP, who worked with him in that endeavour, has set up the Early Intervention Foundation, which aims to raise awareness of the crucial period between conception and two years of age, and perhaps a little bit beyond that. Frank Field MP and Andrea Leadsom MP have set up the All-Party Parliamentary Group for Conception to Age Two—The First 1,001 Days, to really focus our minds on this crucial time in a child’s development. It takes several years for a child to grow into the physical stature of an adult but the brain is developing extremely rapidly in the first months of life and achieves its main development by age four. It is crucial to think carefully about how we treat mothers and their very young children.

I should have said something about newborns in my amendment. I talked only about pregnant women, but I hope that the Government will also think about mothers with newborn children within the first two years of life.

On several occasions I have had the privilege to speak to mothers in temporary accommodation through the Barnardo’s Families in Temporary Accommodation project. What came through particularly from their stories was the sense of isolation that they experienced and how difficult it was because of their temporary accommodation—they may be placed a long way from family or anybody of their ethnic group.

My second amendment, Amendment 55, would exempt pregnant mothers so as to avoid a landlord fearing a penalty should they provide accommodation to a pregnant mother who is an illegal migrant. I spoke recently with a London landlord who has 180 tenants, 120 of whom are foreign. He is a spokesman for landlords and is well respected. He said to me, “Well, talking with my network, many of us will simply stop letting to people who speak with a foreign accent or who look foreign, just to be on the safe side”. My concern is that it will be harder for migrants to get access to accommodation. I think about the difficulties that mothers face when they are pushed into very poor accommodation. The more difficult one makes it to access accommodation, the more concern one might have that they will get the very poorest accommodation. I visited with a health visitor a few years back a mother in a house in multiple occupation in Walthamstow. This was a mother with a two to three month-old son. Her husband had abandoned her. She was from Africa. She had no neighbours or local community; she knew nobody. The only help to her was the local church. We visited for just 15 to

20 minutes. This woman was so vulnerable, so isolated. The health visitor did a tremendous job, but I am concerned that if we are not sensitive to the vulnerability of such women and their children we may isolate them further, make their lives even more difficult and undermine to some degree the very important relationship that they form with their young child.

Amendment 65 is just another way to stop charging from the NHS to pregnant mothers. It is so important that mothers engage early with the health service—I am sure that my noble friend Lord Patel will put this case eloquently. I visited the Albany Midwives service in south London some time ago. It works with mothers from the very earliest stages of their pregnancy. It was outstanding in that there was one midwife to one mother. They developed a relationship with a mother; they provided the antenatal care; and there was a beeper, so that when the mother came to give birth they were there for her and would support her after the birth. This gave rise to much improved breastfeeding rates in mothers and lower levels of surgical intervention. That example just illustrates how important is that ongoing relationship with the health service from an early stage. The concern is that the charges that might arise for them would perhaps undermine that contact with the health service. If there is a perception among mothers that if they approach the health service for help they might be drawn into issues around their nationality and their status of stay here, they may be less prone to do so. Assurances from the Minister on that point would be welcome. I look forward to his response.

Baroness Smith of Basildon (Labour)

My amendment is the second in this group and is the only one that deals with domestic violence. I thought that it would be helpful to include the amendment in this group rather than have a separate debate on domestic violence.

I want first to turn to the housing provisions, which require landlords to check the immigration status of those to whom they let. I said at Second Reading that we have serious concerns about these measures and we have tabled a number of amendments to the relevant part of the Bill. I shall not go into detail here because it is a separate debate for, one hopes, later today.

I want to put on record our concern about the workability and what I will refer to—I hope that this is accurate—as the unintended consequences of the provisions. The Government should be aware of the impact of the proposals on vulnerable persons, such as pregnant women and many others, as the noble Earl, Lord Listowel, highlighted. The amendments in this group highlight the concerns about those issues.

Not everybody in life is well organised, not everybody has all their documentation up to date and not all landlords will be able to fulfil—or, perhaps, even understand—all their obligations under the Bill. People can make mistakes. I think that I am a well organised person, but can I say that I have never forgotten to pay a bill or never missed my MoT date? Of course I cannot; we all make mistakes.

We learnt that when the former Immigration Minister, Mr Mark Harper, had to resign. Even with all his good intentions and integrity, wanting to obey the law

and trying to do so, he still made a mistake. There are great concerns about those whose lifestyles may be a bit more chaotic, or those who are here legally but do not have the right kind of documentation. That could include pregnant women and victims of domestic violence. They might end up being refused accommodation as a result of these measures because landlords do not want to take the risk of making a mistake. The danger is that that could result in them falling into the hands of rogue landlords or becoming homeless.

I hope that the Minister can be clear on whether those issues were considered when discussions were held on including the provisions in the Bill. If they were considered and the Government are aware of all those consequences for vulnerable groups, how will they address them—in particular, under this group of amendments, pregnant women and victims of domestic violence?

Most of the amendments referred to the health charges. There is a lot of confusion about the measures in the Bill and other measures announced by the Government. They must recognise that they must take responsibility for any confusion. The Government’s rhetoric and the sweeping statements that we have heard about what they call health tourism add nothing to the seriousness and quality of the debate. Again, I do not want to go into the wider issues—we will have a wider debate on health charges later, and I will raise the bulk of the questions and concerns that we have then—but I want to ask a few questions on specific issues raised by this group of amendments.

I want to be clear from the outset that we agree with the principle of a one-off health surcharge. It is not unreasonable that those who use the NHS contribute to it. My understanding is that all those who have paid the charge would then have full access to the NHS, but the Government’s consultation document then excludes a few treatments. That is not in the Bill, but it starts to cause confusion. In particular, the consultation document states:

“It may be appropriate to build in a very limited set of excluded treatments for which specific charging should still apply. These might include any or all of the following”.

One of those in the list is services for pre-existing pregnancies. As I said, that is not in the Bill, and that is why I want some clarification. As I read it, that seems to mean that women who have paid the visa charge and come to the UK already pregnant—presumably at whatever stage of pregnancy, whether they know about it or not—will nevertheless have to pay for treatment related to their pregnancy. Is that all treatment or some treatment? We just do not know, and the Bill does not provide any clarity on that. I wonder whether when those women get their visas they get a pregnancy testing kit at the same time to check whether they are pregnant.

A number of groups are to be exempt from paying the health surcharge on humanitarian grounds. We totally support that; it is absolutely right. The Department of Health said that that would include refugees, asylum seekers and victims of human trafficking—presumably, whether or not they are pregnant. I know that victims of trafficking will now be debated in a separate group, but I want to press the Minister on how this will work

in practice, as there will be cases when they will present to the authorities only when they are pregnant. Trafficked women will not, by definition, have paid the charge. The UK Human Trafficking Centre suggested in its 2012 baseline survey that more than half of all trafficked victims were not referred to the relevant authorities for assessment, so how will we know who they are?

Specifically on domestic violence, what will happen to women who are trying to escape a violent relationship and who, in fleeing the home, are left without any evidence of their entitlement and no information on their immigration status? They may be UK citizens or have indefinite leave to remain but do not have the documentation. They have fled their home because of violence and to protect themselves and their children. Women who flee a violent partner often do so at the time of the most extreme circumstances that they can face. They will not have time to pack up their belongings, hunt for their passport, pack it into their bag, fold up their documents and bring those out with them. They are going to flee the home to protect themselves and their children so when they present for housing they will, if they are fortunate, be placed in a hostel or refuge. If I am correct, the Government are quite rightly exempting that. However, others will just run and, having run, will try to find suitable accommodation.

With the financial difficulties being faced by women’s aid groups across the country—I declare an interest in that I am patron of Basildon Women’s Aid—supply cannot always meet demand. What do the Government expect these women to do? How will they find accommodation? Will a sympathetic landlord be forced to turn them away if they do not have their documents and, if they are pregnant, where are they going to give birth if they have been turned away by a landlord? Where will their home be? A number of questions are being asked today, and I think that there will be many more from other noble Lords who have amendments in this group, about the implications of Clauses 33 and 34 for pregnant women and victims of domestic violence.

I have spoken to the Minister about this already, so he is aware of my concerns. However, we need far greater clarity about what is in the scope of the Bill and what has been just government rhetoric or other issues which the Government pretend they will take later. What is going to happen and how will it work in practice? I would find it quite helpful if the Minister could help me understand the position of someone who is here legally but who has not paid the visa surcharge—because they are here at present and that surcharge has not come in—and does not have permanent or indefinite leave to remain. What is their position regarding healthcare? I am assuming that transitional arrangements will make provision for that but I am not clear on how that will work in practice. If the Minister can shed any light on that, it would be extremely helpful.

Baroness Cumberlege (Conservative)

My Lords, I have two amendments in this group—Amendments 59 and 63. I declare my interests, which are in the Lords’ register.

We received a very interesting letter from my noble friend Lord Howe over the weekend. His letter explains that Clauses 33 and 34 are designed to break, or perhaps put a stop to, the activity of health tourism. It is absolutely right that we should do that. Having read his letter, I understand that estimates suggest that between £70 million and £300 million of costs—it seems to be rather a large gap—are attributed to people who deliberately travel to England to get free healthcare because their treatments are so expensive in their country of origin. In no way should we entertain health tourism; it should be detected and the individuals suitably charged. The NHS, as we know, is enormously generous and supported by us all through our taxes. The whole purpose is that we should contribute, through our taxes, to the well-being of our own country’s health.

I have had a long-time interest in maternity services. As the noble Earl, Lord Listowel, indicated in introducing his proposed new pregnancy and maternity clause, there really are few things more important to a woman than bringing a new life into the world. It is a journey of dramatic physical, psychological and social change; of becoming a mother, of redefining family relationships and in taking on the long-term responsibility of caring for and cherishing a newborn child. If the needs of child-bearing women and their babies are ignored, then not only are the physical, social and psychological long-term effects damaging to those concerned but the economic implications for the country are considerable.

As I understand it, the present rules charge women for maternity care if they are not “ordinarily resident”—that is, if they do not have permission to live here permanently. However, they can gain the status of being ordinarily resident immediately or shortly after they enter the country. Women whose status attracts a charge receive an invoice for their care, often early in their pregnancy. If they are unable to pay, though, they should not be refused care. The reason for that is that maternity care is classed as “immediately necessary treatment”, which means that it should not be refused or delayed for any reason. This is because we know that the consequences of delay in extreme circumstances can mean the loss of life or serious damage to the mother, the child or both.

If a woman does not pay, the Home Office may be notified and choose to deny subsequent immigration applications until the debt is paid. While the rules state that women should not be refused care if they are unable to pay, there is evidence of women who are wrongly refused care. There is evidence of women deterred from seeking care because of the charges and the impact of such a debt on subsequent immigration applications. These rules are very poorly understood by migrant women and are very poorly implemented by the NHS. The government research suggests that as many as 30% of the people assessed by NHS trusts are incorrectly classified, resulting in charges being imposed on people entitled to services free of charge.

The research that has been undertaken by both the BMA and Maternity Action highlights the confusion among staff not knowing who is to pay and who

should receive care free at the point of use. Secondary legislation under Clause 33 of the Bill will not solve this problem, as I see it; instead, it could make the situation a lot worse. The clause enables the Secretary of State to introduce a migrant levy as part of applying for a visa, as the noble Earl, Lord Listowel, has said. It will significantly increase the number of migrants who are subject to charging, and it will expand the NHS services that attract a charge.

My concern is that, if charges are introduced, they will create a risk that women will not attend antenatal care or will be denied access to services because of their inability to pay. This could prevent midwives from identifying and treating health conditions early in pregnancy, leading in turn to significantly worse health outcomes for these vulnerable women.

As with every piece of legislation, we must try the “What if?” tests. What if a woman finds herself pregnant after her relationship has broken down? If she was dependent on her husband or partner for her immigration status, is she to be charged for maternity care, GP care, prescriptions and dental care? What if a woman whose asylum claim was refused, and is destitute and living on the streets, becomes pregnant as the result of a sexual assault? Is she to be charged for maternity care, GP care, prescriptions and dental care? What if a woman who is married to a British man and has submitted an immigration application to the Home Office becomes pregnant and gives birth while the application is being assessed? Is she to be charged for maternity care, GP care, prescriptions and dental care? Nationally, 20% of all maternal deaths are to women who started their care late in pregnancy, estimated as after 22 weeks, who have missed more than four antenatal visits or who have had no antenatal care at all.

My Amendment 63—I thank other noble Lords who have put their names to it—addresses the needs of migrant women, who have significantly worse maternal health than the rest of the population and have sicker babies. NICE recognises this. NICE guidance identifies migrants, refugees and asylum seekers as a distinct risk group. It recommends that additional measures to promote their early involvement in maternity care should be followed. Screening during antenatal care enables midwives to identify and treat diseases such as HIV and hepatitis. These diseases can be passed on to the baby. Rubella and syphilis can cause serious abnormalities in the baby. The risks associated with FGM can be averted when it comes to labour and the birth of the baby. Lastly, conditions that might lead to early labour can be assessed, for example, blood pressure, urine infections and multiple pregnancies.

Even under the present system, we have cases of women who have been deterred from seeking care. I want to mention just one. A woman who had experienced problems with her first baby was found to have high blood pressure during her second pregnancy. Her doctor wanted her to be admitted to hospital, but she refused because she was fearful of being charged for maternity services. This woman had been charged for NHS care for her first baby. She attended an appointment with a midwife during her second pregnancy, but refused to go to hospital despite strong recommendations from

the midwife and the doctor. By the end of her pregnancy, she was very ill, and when she gave birth, her baby was very unwell. The woman’s kidneys failed. She was admitted to the intensive care unit and now requires long-term dialysis. The ongoing poor health of the woman and her baby could have been prevented had she received the care that she needed earlier in her pregnancy.

The final costs of deterring women from attending antenatal care can be considerable. The simple process of identifying and treating a common complaint in a pregnant woman, such as a urinary tract infection, can prevent a woman developing an inflection of the kidneys, which can result in a premature birth. The cost of delivering standard care, including treatment of a urinary tract infection is £2,600. The cost of providing care to a woman with kidney failure and her premature baby is £59,000. Diagnosis and treatment of HIV during pregnancy can reduce the risk of HIV transmission to the baby to a negligible level. The cost of providing maternity care and HIV treatment is between £15,000 and £24,000, depending on the treatment, but the lifetime cost of care for a baby born with HIV infection is at least £280,000.

I can understand the wish of the Government to simplify the present system, but they must ensure that the proposed changes will not deter some pregnant women from seeking and accessing maternity care. It is important that these clauses do not have a negative impact on the health of these women and their babies and perversely lead to a need for more medical care at greater cost.

My Amendment 63 is carefully drawn. It identifies women who should not pay charges but does not restrict the Secretary of State adding to the categories, should he wish. It also gives him flexibility through guidance, and it gives discretion to providers of services in identifying whether there are reasonable grounds about whether charges should apply in certain circumstances. My concern is that, in trying to deter pregnant women from health tourism, the ultimate result will be that we will be left with a higher bill to pay nationally and will cause considerable misery on the way. I look forward to my noble friend’s reply.

Lord Patel (Crossbench)

My Lords, I shall speak to Amendment 59, which stands in the name of the noble Baroness, Lady Cumberlege, and to Amendment 60, which stands in my name. I have added my name to Amendment 59. I also strongly support Amendment 63, which stands in the name of the noble Baroness, Lady Cumberlege, and other noble Lords. I would have added my name to it, but another Lord Patel—the noble Lord, Lord Patel of Bradford—beat me to it. I think the priorities were wrong there, but never mind. It just shows that Amendment 63 has wide, cross-party support in the House.

I declare my interests. I am on the specialist register of the General Medical Council as an obstetrician. I also hold the position of professor of obstetrics at the University of Dundee. The noble Baroness, Lady Cumberlege, gave a long list of reasons why pregnant women should be seen early in pregnancy, and I could add another 500 or more, but I do not want to recite a

textbook of obstetrics and antenatal care. It is important that every pregnant woman is seen as early as possible during pregnancy if we are to prevent problems occurring later in pregnancy for her and her child’s well-being. It is important that she is seen early so that problems that are occurring are identified early and can be treated early to prevent serious complications developing later. As the noble Baroness, Lady Cumberlege, said, in maternal mortality reports, it is the women who are seen late in pregnancy who develop the most complications and even die. Hence anything we do that will prohibit or prevent women from being seen early in their pregnancy will be wrong.

As for health tourism, the visitors are not part of this levy or these charges. It is likely that the so-called childbirth tourism occurring here, often referred to by some hospitals as the “Lagos shuttle”, is about visitors and not those seeking to enter this country on different visas. I therefore hope that the Minister will look again at why pregnant women are included in the levy and charges.

My Amendment 60 includes not only persons who are pregnant but also children. To clarify, I included children under 18 because, currently, children under 18 in this country are exempt from NHS charges. Of course, I realise that, in terms of risk, children under five years old are different from children aged five to 12 or, for that matter, 12 to 18. As no other noble Lord is likely to speak about children, although the noble Earl, Lord Listowel, referred to them briefly, I intend to speak at length only to demonstrate how important children are and what harm the levy, or imposing charges on children, could possibly do.

My amendment would exempt children from the migrant health levy when they apply or are included as dependants in an application for leave to enter or remain. The levy is to apply generally to visa applicants who are students, workers or families, but not visitors. Currently, it is intended that payment of the levy will provide the applicant with free access to all NHS services for the duration of his or her visa. As the noble Baroness, Lady Smith, said, we need clarification about whether the levy means that they will get all NHS services free of charge. There is a lot of confusion about that. For instance, Clause 33(4) makes it clear that there is no guarantee that restrictions on access to particular services will not be introduced. Clause 33(3)(e) includes a power for the Secretary of State to make exemptions from the levy. However, it is not clear in the Bill what the consequence of such an exemption would be. Without more, it appears that a charge would be made where a child exempted from the levy needed to access NHS services, save for any services which regulations may exempt from charging.

As to which services charges will apply, the intention is that this will include primary and secondary care services, including accident and emergency services. GP consultations will be free, although it is unclear whether any treatment that may be delivered by or via the GP will be free. Treatment for specified communicable diseases and sexually transmitted infections will be available. It is yet to be decided whether any, or how many, mental health services will remain free. There is a great deal of doubt.

The Department of Health response to last year’s consultation on migrants’ access to NHS services recorded,

“widespread support for exempting all children, not just those in local authority care, from charging”.

However, the Government then concluded:

“We do not intend to establish an exemption for children as we believe this poses a significant risk of abuse by visitors seeking treatment for children … Vulnerable children, such as victims of trafficking, those seeking asylum, and migrant children in local authority care currently receive free healthcare and will continue to do so. We will listen to arguments about how best to cover other vulnerable children who might otherwise be denied treatment”.

Can we know what this group of “other vulnerable children” will be? To me, all children of a certain age are vulnerable.

Therefore there are several problems with the Government’s position. First, the suggestion that exempting children would encourage migration to the UK is mere speculation. Research has found no correlation between accessibility of healthcare to migrants and migration patterns. That some people may abuse that is different, but it does not encourage migration. Secondly, not all children falling within the groups specified as vulnerable are in practice recognised as within those groups. As the Department of Health response acknowledges, victims of human trafficking are exempted from charges only if they have been formally recognised as victims or potential victims, and most do not engage with the formal recognition system. If they do not do so, they are not recognised. Child asylum seekers may also be excluded by reason of disputes as to their age.

Thirdly, the Government’s position fails to have any regard to the effect of greatly extending charges to cover primary care and accident and emergency treatment. While children are not generally exempted from NHS charges now, the consequences of this are less harmful because primary care and accident and emergency treatment are currently provided free. Fourthly, the Government’s position seeks to draw a generally inappropriate distinction between children who are vulnerable and those who are not. While some children face greater risks to their health and well-being than others, all children are vulnerable to such risks by reason of their physical and mental immaturity and their dependency on parents or guardians. That is why we look after our children—because they are vulnerable.

If the Government proceed with their current proposals, children face being effectively excluded from basic primary care and accident and emergency treatment if they or their parent or guardian are deterred because they cannot afford to pay a charge, are worried about the consequences—including immigration consequences—of incurring a debt they cannot afford, or are simply afraid that if they seek healthcare, the Home Office will be informed. Clinical experience shows that individuals and families are already deterred from accessing health treatment they need. The Royal College of General Practitioners said that,

“we are concerned that limiting access to primary care would impact detrimentally on immunisation rates”.

At Second Reading, the noble Lord, Lord Taylor of Holbeach, offered the reassurance that,

“claims that we intend to turn GPs into immigration officers are untrue”.—[ Official Report , 10/2/14; col. 419.]

However, can he comment on the plans expressed by the Home Office Permanent Secretary to extend the Home Office “radar”, as he puts it, into the NHS? The Minister has sought to portray the Bill as making little difference to the accessibility of healthcare. That picture is profoundly flawed. The Bill significantly extends, by Clause 34, those migrants who may be charged for healthcare. The healthcare services for which this wider group of migrants may be charged are also to be greatly extended. To implement this, and the migrant levy in Clause 33, the Department of Health and the Home Office are working on a registration system to be applied throughout the health system. I refer noble Lords to page 18 of the Department of Health’s Visitor and Migrant NHS Cost Recovery Programme: Sustaining Services, Ensuring Fairness in the NHS. Will the Minister comment on whether they are working on such a system and what its purpose is?

The proposals can lead only to an increased public health risk—and I have no doubt that we will deal with that at a later stage. Children’s health and wellbeing will be put at greater risk if a parent or family member is not treated for an infectious disease. The people who will be most at risk are the children. The Department of Health accepts the responsibility to provide healthcare to anybody who needs it, but the proposals in the Bill will play against that. The children’s future will also be put at risk if their mothers do not receive any or timely antenatal care. A physically or mentally ill parent may be unable properly to care for his or her child, with health and other safeguarding consequences. Indeed, when children are not attending healthcare services, the risks that safeguarding concerns are missed will be increased. Hence, the Bill runs counter to the Home Secretary’s duty to safeguard and promote the welfare of children. Nor is it consistent with the UK’s general duty that,

“in all actions concerning children, the best interests of the child shall be a primary consideration”.

That is a reference to the 1989 UN Convention on the Rights of the Child. How do the Government feel that they will fulfil this by introducing the proposals in the Bill?

Imposing the health levy and other NHS charges on children and pregnant women for preventive, acute and emergency care will not fulfil the Government’s legal, moral or ethical responsibility for providing care for children, particularly emergency care. They will fail in their commitments to the UN convention. If we do not care for those vulnerable children, particularly the very young, and pregnant mothers, who do we care for? Is it only those who can afford to pay?

Baroness Barker (Liberal Democrat)

Clause 33 enables the Government to introduce a health levy. The noble Baroness, Lady Smith, said that her Benches support it in principle; on our Benches, we support it as the least worst of a number of options, none of which we particularly favour. We think that a health levy is preferable to requiring people who come to this country to take out forms of private health insurance that do not meet their needs and are considerably more expensive. However, having said that a health levy may be one

way of generating income for the NHS that we can support, like other Peers we have considerable reservations about what the effect will be in practice—and, in particular, what the deterrent effect will be on people who require health services. We will go on in later groups of amendments to discuss that in greater detail, but in this group noble Lords have focused first and foremost, perhaps not surprisingly, on pregnant women and children.

The noble Earl, Lord Listowel, in his introduction was almost biblical in his references to our consideration for expectant mothers and children. I am not as spiritual as he is—I am much more practical. I would say that one of the haunting images of last year was that of the asylum seeker who drowned in the boat off Lampedusa in southern Italy, who was found to be giving birth at the time. When I listen to people talking about maternity and health tourism, time and again I go back to that woman and what must have been going through her mind, and what her life must have been like, to be pregnant and in that position. That is just my disposition towards our general discussion.

The noble Baroness, Lady Cumberlege, introduced her amendment in her characteristically thoughtful and well researched way. She, too, referred to the letter of the noble Earl, Lord Howe, of 6 March, in which he explained the thinking behind this Bill from the point of view of the Department of Health. I, too, wanted to focus noble Lords’ attention on the statement that he made. He said that there was “widespread evidence” and,

“a cost of between £70 million and £300 million from people who deliberately travel to England to get free NHS treatment—so-called ‘health tourists’”,

of which those seeking maternity treatment were most prominent. There is some difference between £70 million and £300 million. My first question to the Minister is: can he explain the range? Even if he can, £300 million in terms of the overall NHS budget is minuscule. Consequently, when we are doing our job in this House as we should, which is to consider not just the immediate cost but the overall impact of a charge, we have to do it in recognition of that fact.

I should like the Minister to explain exactly how the Department of Health arrived at that estimate, particularly as the small charity, Médecins du Monde—Doctors of the World—conducted research across the European Union and discovered that there is no higher rate of migration to this country under our current system of charges than to places such as Germany. I simply repeat, as I did at Second Reading, that I have no problem with our making a fundamental change to our health policy provided that we do so on the basis of proper evidence and not the cynical opinion of newspapers.

Amendment 64A in this group stands in my name. Other amendments in the group, which I support, refer to pregnant women. Mine refers to women who are pregnant or require postnatal treatment. We afford postnatal services to those who are ordinarily resident. We do so routinely for women who do not have problems, who also have access to health visitors to ensure that they and their children are functioning well in the first few weeks of the children’s lives. We

afford these services to women who have problems which may not be very significant but which we know are important in the development of their children—for example, women who are having trouble breastfeeding or women who are suffering from postnatal depression. We also extend treatment to women who have suffered traumatic deliveries and need surgery following deliveries that have not gone well. That is what we do for our own people because it is the right and decent thing to do. I should like to think that in future, no matter who a woman is or what her financial status is, she, too, will be afforded such treatment.

Finally, I thoroughly support the amendment of the noble Lord, Lord Patel, which mentions children. I pay my taxes to live in a country where the first question that a doctor asks concerns what is wrong with a child and what treatment they need, not who their parents are. Our wish is to retain that as far as we possibly can.

Baroness Lister of Burtersett (Labour)

My Lords, I support the amendment on domestic violence in the name of my noble friend Lady Smith of Basildon. She has made the case for it, so I will not repeat that, other than to point out that this amendment is totally consistent with the Government’s own action plan on domestic violence and builds on the destitute domestic violence concession. It is a very modest amendment, which would simply guarantee a period of safety, with access to services and benefits, after the breakdown of a relationship because of domestic violence. I hope I am not being naive when I say that I am confident that the Government will support this amendment, given that it is so consistent with their own policy.

I also support Amendment 60, in the name of the noble Lord, Lord Patel. I am very glad that he introduced an amendment on children to remind us of the potential effects on children of some of these changes. I draw noble Lords’ attention to what the Joint Committee on Human Rights, of which I am a member, had to say on this matter. It referred to the concerns that,

“arise about the possible impact on children of the provisions in the Bill which extend charging for NHS services … Extending charging to migrants not previously charged for accessing health services, and extending the range of services for which charges apply, are likely to have a deterrent effect on accessing health care, which in turn is likely to have a particularly detrimental effect on the children of such migrants”.

I will not go into the full detail but our recommendation was that to meet these concerns,

“about the impact of extended charging for health services on children’s health, we recommend that new guidance be issued specifically on the s.11 Children Act duty”,

which applies to the NHS,

“explaining to front-line decision-makers in the health sector exactly how that duty applies in the context of extended charging for NHS services”.

I should therefore be grateful if the Minister would say what the Government’s response is to that.

I want to go on to talk about a number of amendments that relate to pregnant women. I will not make the health case because it has already been made so well

by people who are much better placed than I am to make it. I want to reflect on some of the comments made by Ministers in response to concerns raised at Second Reading. In his letter, the noble Earl, Lord Howe—the noble Baroness, Lady Barker, referred to this issue—singled out,

“those seeking maternity treatment as the most prominent among so-called health tourists”.

I am glad that he used the words “so-called” in front of “health tourists”, because it is a horrible term. He talked of “widespread evidence”. Like the noble Baroness, I should be grateful if the noble Lord could clarify what that evidence is. My understanding is that no primary research has been undertaken. If he was referring to the Department of Health’s research, noble Lords should bear with me while I quote from the report of the Joint Committee on Human Rights, which noted:

“Given the very wide range of the estimates it has produced”—

the noble Baronesses, Lady Barker and Lady Cumberlege, referred to these “very wide” estimates—

“we caution against ascribing too much weight to the Department of Health’s research when assessing whether the Government has demonstrated an objective and reasonable justification for the differential treatment to which the health charging provisions in the Bill give rise”.

The letter therefore seems to ascribe too much weight to not very firmly based evidence—it is not research, as such.

The Minister, the noble Lord, Lord Taylor, in his helpful response to issues raised at Second Reading, reassured us in his usual soothing way that, following representations from Maternity Action and the Royal College of Midwives about the harmful effects on pregnant women among illegal migrants, short-term visitors, failed asylum seekers and visa overstayers, the proposals in the Bill did not apply to them. However, Clause 34 extends the reach of NHS charging provisions to migrants not currently covered. Will the proposals not therefore increase the likelihood of a pregnant woman falling into this category, and is it possible to consider the Bill separately from the parallel healthcare changes being proposed?

If we really are all barking up the wrong tree with our concerns about pregnant women, I hope that the Minister can give us a firm assurance that not one pregnant woman who would not be charged under the current rules will not be charged as a result of the Bill and the related health changes. If he cannot give that assurance, I hope that noble Lords will support this range of amendments that exempt pregnant women.

Finally, the claim at the end of the noble Earl’s letter that, taken together, the changes will,

“maintain safeguards to ensure necessary treatment is not denied”,

ignores the extent to which necessary treatment is already being denied. That point was ably and well made by the noble Baroness, Lady Cumberlege. The letter denies the extent to which pregnant women are deterred from accessing services, even though they would not be charged until afterwards, for fear of the implications of being charged, reported or whatever, or for fear of misapplication of the rules. A report of

the Joint Committee on Human Rights, going back to long before I even joined your Lordships’ House, referred to the evidence on this. It said:

“The arrangements for levying charges on pregnant and nursing mothers lead in many cases to the denial of antenatal care to vulnerable women. This is inconsistent with the principles of common humanity and with the UK’s obligations under ECHR Articles 2, 3 and 8 ECHR. We recommend that the Government suspend all charges for antenatal, maternity and peri-natal care. We recommend that all maternity care should be free to those who have claimed asylum, including those whose claim has failed, until voluntary departure or removal from the UK”.

That recommendation was never accepted. That was a few years ago but my understanding from Maternity Action and the Royal College of Midwives is that pregnant women are still deterred and the rules are still misapplied. The Bill is taking us in the diametrically opposite direction to that recommended by the Joint Committee on Human Rights back in 2006-07.

I also look forward to what the Minister has to say in response. I hope that he can genuinely reassure us this time, because I was not reassured by his response when these issues were raised in at Second Reading.

Baroness Tonge (Independent Liberal Democrat)

My Lords, I support all these amendments—in particular, Amendment 63, to which I have added my name. Unfortunately, due to circumstances, I was not able to be present at Second Reading, but I support these amendments because I worked in the health service for more than 30 years, particularly in women’s health services, implementing, supplying and managing those services. My late husband worked in the health service for more than 40 years.

The first point that I would like to make from that experience and that of many colleagues with whom I am still in touch concerns health tourism. It really is most extraordinary that this term is bandied around to scare people that the health service is being misused by countless numbers of people who really should not be here. It is the same old thing that appeals to Daily Mail readers: these people should not be here and they must not access our facilities. Yet, in all that time neither I nor my husband ever came across health tourism and nor have I ever heard colleagues talk about it. I reinforce what the noble Baronesses, Lady Barker and Lady Lister, said: the letter from the noble Earl, Lord Howe, was extremely woolly in that department. I think that the so-called evidence for this is really just anecdotal.

Perhaps I may say a few words about the noble Earl, Lord Howe. He writes a wonderful letter and he is the most emollient man. I think that if I were on my deathbed and the noble Earl appeared, I would rise and feel well again. He has that ability. He is in the wrong profession—he really should be out there tending the sick because he makes us feel happy and cured. However, being a cynic, I do not believe all that he says, and I hope that sometimes he does not believe it either.

So let us sit back and think really hard about whether health tourism exists. In any case, if, through some medical sleuth, we identified that there were health tourists, would the problem be large enough to make a difference? Would it really bring in that much more money to the health service?

In passing, my late husband was at St Thomas’s Hospital, which is alleged to have experienced the “Lagos shuttle” in relation to maternity care. St Thomas’s and the Royal College of Midwives have denied this, so I question whether this should be used in any way as evidence for charging pregnant women if they want to come to this country as migrants.

My second general point is that one of the reasons why I support Amendment 63 is because it points out awfully well how terribly difficult it will be to make any of the charges. How will that be done? I have been out of the health service for quite a while and I wonder who will implement this? If a pregnant woman says, “I’m pregnant and need antenatal care”, presumably a layer of bureaucrats will have checked her bit of paper. However, what if she does not have a bit of paper, forgot to get it, has lost it or does not speak English? She may have high blood pressure or be carrying twins—we will not go into all the medical obstetric possibilities that the noble Lord, Lord Patel, mentioned. If so, will we really deny the woman care? Doctors and nurses go into their profession because, I hope, they possess a certain amount of compassion, and want to help people. We have to ask patients myriad questions before we even start asking medical questions about their health. Are we to add another layer of questioning? How will we have time to do it? We do not have enough doctors and nurses. They are all overworked, so how will we implement this? Again, will it be financially worth it to create all that distress and bureaucracy?

I know that I have made general points but I say finally that I want to support all noble Lords who have pointed out that if we fail to give proper antenatal care to a pregnant woman we are failing her and her future health, and we are failing the baby or babies she is carrying and their future health. That is not only a double human tragedy but it is denying them their human rights. It is also setting up far more work and expense for the health service in the future if it is not dealt with properly. I beg the Minister to reflect on this between now and Report and to withdraw this awful provision.

Baroness Masham of Ilton (Crossbench)

My Lords, this list of important amendments deals with the health of some very vulnerable people. I have put my name to Amendment 65, but several deal with exemption of payment for pregnant women if they are unable to pay. I do not know which of the amendments is most appropriate but I hope that the Minister will accept the spirit behind the amendments and bring forward an acceptable amendment on Report.

Charges at the point of care create risks that women will not attend care, will attend late in their pregnancy or will be denied access to care because of inability to pay. This can prevent midwives identifying and treating health conditions early in pregnancy which, in turn, can lead to significantly worse health outcomes for vulnerable, migrant women. NICE has acknowledged this and recommended that care providers take additional measures to promote early engagement with maternity services. FGM reversal is best undertaken prior to 20 weeks of pregnancy. Charges at this point of care can result in higher costs later to the NHS. Pregnant

women who are HIV positive need treatment so that their babies are born free of HIV. They should not be put off seeking care. Delayed or no antenatal care can lead to complex interventions at a later date. For example, identifying and treating urinary tract infections during standard antenatal care prevents a woman developing a kidney infection that can result in premature birth which can be very expensive to the NHS. I hope that the Minister will do his very best to agree to some of our points.

Lord Harries of Pentregarth (Crossbench)

My Lords, I have listened carefully to the debate and support the general thrust of all the amendments. However, like the noble Baroness, Lady Masham, I am not clear which of the amendments particularly meets the Bill. I hope the Government will indicate not only whether they are receptive to the general thrust but which amendments are particularly inadequate. I hope the Minister will address the question posed by the noble Baroness, Lady Tonge, of what exactly is meant by the phrase “health tourism”. What is the evidence that it exists?

Baroness Finlay of Llandaff (Crossbench)

My Lords, this has been an important debate and I declare all my health interests. In speaking briefly, I will not reiterate the points made by the noble Baroness, Lady Cumberlege, and my noble friend Lord Patel but they are incredibly important.

When the Minister comes to reply, perhaps he will give the figures in respect of the actual cost of antenatal care versus the actual cost of complications. Let us not forget that a massive haemorrhage in labour or a massive problem with obstructive labour will cost a great deal of money in emergency treatment when, if they had been picked up much earlier with a simple ultrasound examination, the problems could have been avoided. Will the Minister give the costs and the research evidence behind the reason for the Government not exempting pregnancy and children? Will he say what discussions the Government have had with the royal medical colleges and the Royal College of Midwives, in particular, over the background to this measure and its implementation? For doctors, nurses and midwives trying to implement it on the ground it will be a nightmare.

What do the Government intend to do to monitor the effects of the measure—in other words, how will they audit it—when and if they proceed to implement the Bill as it is currently drafted? Will that audit include a cost of the complications that would have been avoided in the event that pregnant women had had appropriate antenatal care?

There is a great deal of evidence behind this. From all the amendments that have been tabled today it seems evident that a consolidated and focused amendment will be brought back on Report. Like others who have spoken, I believe it would be most sensible for the Government to listen today and take the evidence on board, rather than push the House to determine its view.

Lord Avebury (Liberal Democrat)

My Lords, I should like to add a few words to what my noble friend Lady Barker has already said about Amendment 64A which, unlike some of the other amendments in the group, covers postnatal as well as prenatal treatment.

We had a meeting with representatives of the Royal College of Midwives, as mentioned by the noble Baroness, and Maternity Action on 27 January and we have taken note of the strong arguments for exempting these patients from charging, as I hope the Minister will have done by the end of this debate. As has been said repeatedly, there is no official estimate of the net cost to the NHS of non-EEA short-term migrants needing maternity treatment once those exempt from charging are removed from the equation. Neither in the Government’s briefing nor in any other source have I been able to find a reliable estimate of the volume of alleged maternity tourism. However, as has been said, anecdotal evidence exists, of which the Minister’s letter is an example.

This all seems to have arisen from an assertion by Sky News that 300 women had been stopped at Gatwick but then had to be admitted because they were assessed as being more than 36 weeks pregnant and therefore unable to travel back to their countries of origin. This information was said to have come from a government report, but no title or reference was given. The noble Baroness, Lady Cumberlege, quoted the letter from the noble Earl, Lord Howe, giving a wide range of estimates of the volume of health tourism generally but not maternity tourism in particular. All it had to say on that subject was that maternity tourism formed a large proportion of the total value of health tourism. Surely the answer to that problem is for the Government to stipulate that airlines flying pregnant women to UK destinations should be required to obtain certificates of the length of pregnancy from doctors they can trust, and for carriers that bring women who are more than 36 weeks pregnant to the UK to be subject to fines. That should not be too difficult because the alleged maternity tourists are said to come from a limited number of destinations. When my noble friend the Minister comes to reply, I would like him to make some comments about that idea.

At the other end of the spectrum from the Sky News report was an article about a woman whose case was reported in the Guardian. She had been living in the UK as the wife of a British citizen for seven years, but for some reason not explained in the article had evidently not obtained indefinite leave to remain. Having paid Lewisham Hospital £5,000 for maternity services in regard to care during and after her first child’s birth, she was terrified of going near the NHS and was expecting to give birth without medical supervision because she and her husband were still paying off the bill for the first child.

My noble friend Lady Tonge asked about the denial of treatment for women who present themselves as maternity patients but cannot satisfy the health authorities that they are legitimately entitled to those services. Surely the answer to that must be that the delivery of the services should come first and the ascertainment of the woman’s right to treatment dealt with afterwards. I cannot imagine that any clinician would say that they

would not provide maternity services for a woman in the early stages of pregnancy, and that may be the answer to those who say that complications arising from a variety of serious causes might result from the failure to treat those who are in the early stages of pregnancy. I hope that I am right in saying that this will not happen because of the first duty of clinicians, mentioned by the noble Baroness, Lady Lister, to treat patients who come before them.

Baroness Tonge (Independent Liberal Democrat)

Will the noble Lord give way? I appreciate his point, but if someone gives a patient the benefit of the doubt for antenatal care and it then turns out that they do not have an entitlement to treatment, do they then say that the patient is not going to get any more antenatal care?

Lord Avebury (Liberal Democrat)

My Lords, it has been the case in the past that people who receive services to which they were not entitled incur a debt. I believe that something like two-thirds of the charges levied on these people lie on the table because they cannot be recovered.

Baroness Tonge (Independent Liberal Democrat)

As I am sure my noble friend is aware, pregnancy goes on for nine months. It is not a short intervention which is treated and the patient then goes away; it is an ongoing thing that includes postnatal care and goes on for a long time, as the noble Baroness, Lady Barker, pointed out. This is a long-term treatment and it is important that it should be so. Perish the thought that treatment is cut off mid way.

Lord Avebury (Liberal Democrat)

No, what I was saying is that I hope that the treatment would be given irrespective of the woman’s entitlement while checks are being made to see whether she is a valid patient of the NHS or is someone who should incur the charges. However, if the charges do fall on the woman, I hope that they will simply lie on the table, as obviously a substantial proportion of the costs of treatment of migrants has done in the past. From the official figures given by the Department of Health, I think it was two-thirds of the charges incurred—not just by pregnant women but by persons who were not entitled to treatment presenting themselves to the NHS. In no case that I have heard of were patients denied treatment, but the charges piled up and the debt was left there on the table. I do not know what the mechanisms for recovery will be under this system, and perhaps the Minister will deal with that point in his reply.

I assume, and want confirmation, that no woman would ever be denied treatment, but if it was ascertained subsequently that she was not entitled to it, the debt would be recorded somewhere. Whatever steps the NHS might take to recover it would be fair enough, but if it could not be recovered, like so many other debts which have been incurred by migrants generally in the past, would it be written off to the NHS? I would like reassurance from the Minister on that point.

Undocumented migrants such as overstayers and failed asylum seekers, of whom there are estimated to be half a million, are unlikely to be able to pay for maternity or indeed any other medical services. If such

people work, they are on or below the minimum wage and are now likely to become unemployed with the tightening up of checks by employers on their right to work. Health authorities may invoice patients from this group, but can the Minister say what proportion of the debt is recovered and whether there is anything in this clause, or indeed in the Bill as a whole, that will make it easier to collect the money? Will they be able to transfer the debts at a discount to a debt collector, and will they be any better off than they would have been in the past before this clause was enacted?

Earl of Listowel (Crossbench)

My Lords, in listening to my noble friend Lord Patel’s concerns, which I share very strongly, about children and the charging of children, it occurred to me that there might also be an issue about the immunisation of children. If significant numbers of children do not get immunised, that might pose a threat. I would appreciate the Minister addressing that question in his reply.

Lord Taylor of Holbeach (Conservative)

My Lords, this has been a very full discussion about all aspects of healthcare and healthcare charging, some of which lie within the provisions of the Bill and some of which lie way beyond it and are actually part of the Department of Health’s consultation. I guess there are two ways of dealing with this debate: I can give either the short answer or the long answer. I have chosen to give the long answer—I hope that noble Lords will indulge me—in the hope that I will be able to disabuse them of some of their anxieties and reassure them. I am very mindful of the kind words from the noble Baroness, Lady Lister, but I am also slightly anxious as a result of the description of my noble friend Lord Howe. I am equally concerned to try to be as upfront as I can be about what the Bill provides for and to reinforce my noble friend’s letter, which noble Lords will have received, which seeks to place measures in this Bill in the context of wider health service charging.

Perhaps it would be helpful to provide a brief reminder of the intentions behind Clauses 33 and 34. I will refer to my noble friend Lord Howe’s letter because it sets out the context for these provisions, which is the Department of Health’s wider programme of work on migrant access and financial contributions to the NHS. Likewise, I want to reassure noble Lords that, first and foremost, the NHS is, and will remain, free at the point of delivery for permanent residents. But it is a national service, not an international health service. We believe that migrants should have a form of access to the NHS that is commensurate with their immigration status. That is our policy position.

As my noble friend Lord Avebury said, we have perhaps one of the most generous health services in the world. Temporary migrants with leave of more than six months currently qualify for free care almost immediately after their arrival in the UK. In effect, this means that only tourists and illegal immigrantsare generally chargeable for healthcare in the UK. I ask noble Lords to bear that in mind when we come to discuss the detail of the amendments.

Temporary, non-EEA migrants will be required to pay an immigration health surcharge. Our policy is that this will provide them with generally the same free NHS access as permanent residents. This will cover treatments including maternity services. I remind noble Lords that this is not a charge to be paid when they go to the doctor or to hospital; this charge is paid on application for a visa to come to this country. It is a charge that is part of the package and is designed to give those people—who, I agree, could be vulnerable—the same status as citizens and permanent residents of this country.

As my noble friend Lord Howe set out in his letter, in itself the Bill will not make any changes to NHS structures or remove the ability of the Department of Health or devolved health ministries—we must remember that while immigration is UK-wide, the administration of healthcare is devolved—to exempt certain groups or treatments from overseas visitor charging on health grounds. Short-term visitors—those here for less than six months; that is, people who are not provided for in this Bill—and illegal immigrants will continue to be liable to NHS charging, as they are now. There is no change proposed by the Bill.

Decisions on what services should and should not be exempt from this charging regime are set out in the NHS charging regulations, which are laid before Parliament, where matters such as those raised by many noble Lords today could be discussed. The regulations are a matter for the Department of Health and the devolved Administrations for health purposes and not part and parcel of immigration legislation.

Baroness Masham of Ilton (Crossbench)

Does the Minister agree that they should be working together in maternity cases? It is health but it is immigration as well.

Lord Taylor of Holbeach (Conservative)

I hope that I will be able to go on and talk about these matters when I address the specific amendments. I hope that when I have concluded my remarks, the noble Baroness will feel that I have indeed satisfied her in that respect. I understand the vulnerability of pregnant women and the care that is needed to ensure that both mother and child have healthy prospects.

The health surcharge is designed to ensure that legal migrants make a fair contribution to the NHS, commensurate with their immigration status. We intend for it to be applied fairly and without unintended consequences. As I have just said to the noble Baroness, Lady Masham, pregnant women should not be adversely affected—I listened with great care to the noble Earl, Lord Listowel, and to subsequent speeches on this subject. However, it is important to consider the safeguards already provided in the Bill.

In respect of the provisions relating to landlords, there are exclusions from the restrictions in accessing accommodation at Schedule 3 to the Bill to protect the vulnerable. Local or housing authorities providing accommodation in discharging a statutory duty—for example, under national assistance or children’s legislation—are not subject to these restrictions.

Asylum seekers and failed asylum seekers who face recognised barriers to return will be authorised to rent

property by the Home Office, and the department will continue to support destitute applicants. Accommodation for vulnerable individuals, such as hostels for the homeless and refuges for victims of violence, will also be exempt from the checking requirements—I mention these because the noble Baroness, Lady Smith, rightly expressed concern about the vulnerable and I shall address her amendments later.

We need to consider the checks that would be required by some of the amendments. These would be intrusive; indeed, it would be objectionable to ask all temporary female migrants of childbearing age if they were pregnant and to verify that information. How could the Home Office or a service provider establish that an individual was indeed pregnant rather than merely seeking to circumvent the rules? Rather than a simple check of documentation, which is what the Bill provides for, inquiries would need to be directed to the individual’s health provider. We must also consider the unintended distress that such a practice could cause. What if a woman was reluctant to reveal a pregnancy? What if she suffered a miscarriage while her visa or other applications were being considered? She would no longer be exempt; she would need to tell us of her loss at a time of great distress. The more one looks into the detail of this and the practical application of the policy, the more the intrusive nature of these amendments becomes clear.

Some of the amendments would allow pregnant women who were illegal migrants to rent accommodation, open bank accounts and hold driving licences. As such, they would help them establish a life in the UK. However, they would also create a dangerous loophole through which illegal migrant women might be encouraged or pressurised into becoming pregnant so that they could rent accommodation or open a bank account for themselves or their family members. We surely cannot introduce legislation that places women at risk of such exploitation.

Before turning to the particular amendments, I shall address some of the questions that have been asked. The noble Baroness, Lady Smith, asked me about the health consultation. The Bill provides that certain expensive treatments could be charged for, even though persons have paid the surcharge—it is important to have flexibility in the legislation—but when the Act is initially implemented it is our clear policy intention that there will be no further charges for treatments where people have paid the surcharge. They will be treated as if they are permanent residents. The Bill’s provisions are therefore wider than the application of the legislation

The noble Baroness also asked me about the transitional arrangements. There are no transitional arrangements to the extent that anybody who is already here under existing immigration laws permitting them a period of stay greater than six months will not to have to pay the surcharge. The payment will be required only of people who are making a new application or new applicants. It should be noted that if somebody is extending their leave by making a fresh application the surcharge will become due. There is no question of trying to recover the surcharge from people who already have a right to be in this country for more than six months.

Baroness Smith of Basildon (Labour)

I apologise for interrupting the Minister, and I am grateful for his response to my queries. I am still slightly confused on the issue of pregnant women. I think that he said that the Bill allows for such charges but there is no intention to make them. If I have that wrong, perhaps he could clarify it for me. The only reason it has been flagged up is that the public health consultation mentioned additional charges. I want to be absolutely clear that if a woman has paid the surcharge, there is no additional charge to be made. I may have misunderstood, but what he said seems slightly contradictory.

The other point is on transitional arrangements. If someone is already here legally, my question is about the practicality and workability of the measures. How will we be able to distinguish between someone who has paid the surcharge but is here illegally and someone who is here legally but has not paid the surcharge?

Lord Patel (Crossbench)

If the Minister will allow me, before he answers the noble Baroness, can I make something clear? We keep confusing surcharge with levy. Let us talk about the levy that will be imposed on people coming here who are not visitors. Once that levy has been paid, it will allow them to access all health services. Is that quite clear?

Lord Taylor of Holbeach (Conservative)

Yes, that is exactly right. They will have the same access to health services as is available to a permanent resident. That is the whole purpose. It is administratively a tidy arrangement; it is straightforward and easy to police; and people will be paying it at the same time as they apply for their visa. Their visa application will show that they have those rights, so if anyone seeks to charge such a person, they will not be chargeable because they will have a clear right to free healthcare, just as the noble Lord and I would.

It is really important to emphasise that point, because the whole point of having the levy, the charge or whatever we call it, is to provide a contribution from people who stay here and may impose some cost on the health service but to avoid asking them for payments for services provided or to take out an insurance policy before they come here to cover any chance that there will be health costs. It will be an asset to the health service in the sense that it will provide money to support the health service. It also regularises the position of the individuals involved. I hope that that satisfies the noble Lord.

Lord Patel (Crossbench)

It does, but I wonder whether this is new policy thinking, because much in the Bill, particularly in this part, implies that the Government want to be able to impose charges for other things.

Lord Taylor of Holbeach (Conservative)

I do not think so. I think that the Bill’s provisions are purely about health service charging for those who come here for a fixed term of six months or more and who are not here as visitors. It clearly differentiates between those who are here legally and with proper documentation and those who are illegal, so it will make it more difficult for those people who are here illegally to avoid the implication of their illegal presence here in the United Kingdom. We should

remember that most people who are here illegally are overstayers; they are not people who have come in but people who should have gone home. That is one thrust behind the legislation.

Baroness Williams of Crosby (Liberal Democrat)

May I press the Minister just one step further, since this is quite a complex area? I think I am right that, at present, students count as being ordinarily resident as distinct from permanently resident. In future, because the ordinarily resident concept will broadly disappear, they will be regarded as permanent residents only if they put in the time to become, eventually, citizens in that sense. Many students, particularly those who are post-doctorate, continue to work in some area associated with what they are doing. For example, many post-docs work on research and are paid for it. If those students then pay taxes and national insurance on those earnings which they receive, but which are often well below what the market rate would be for their level of qualifications, am I right in thinking that they would not have access to free health treatment unless they had paid the surcharge at the moment when they got the visa?

Lord Taylor of Holbeach (Conservative)

They will have access currently, as the noble Baroness will understand. When they make an application to come here from now on, they will have to pay the health surcharge on top of the visa that they are currently applying for. I hope that I have made that clear. At the same time, it has been suggested from the Box that I ought to make it absolutely clear that the surcharge will be paid when a person applies for a visa and for leave to remain when they are in the UK and extending their leave. I think that was what I said, but the Box obviously thought that it is such an important point that everyone should understand that.

Lord Patel (Crossbench)

My Lords, what the Minister said in response to my question is clearly recorded, so we can all read it. As I understood it, I thought he said that once the health surcharge—let us say it is £200—is paid, for the duration of their legitimate stay in this country all health services will be available to them.

Lord Taylor of Holbeach (Conservative)

It is a per annum charge, so if they are here for three years and are not a student it will be three times £200. But yes, that is exactly right.

Baroness Williams of Crosby (Liberal Democrat)

On this point, I am sorry that we are pursuing the Minister, but can I take this one step further? I was talking specifically about a post-doctoral graduate who might be earning some relatively small sum while he was a post-doctoral graduate. I take it that he would therefore not be exempt from the surcharge as well even though he would be paying both national insurance and taxation, if he was about the taxation threshold, and had paid the surcharge already. That is where the sense of some unfairness in the system arises rather strongly.

Lord Taylor of Holbeach (Conservative)

I suppose that at any boundary point, there are bound to be these sorts of situations occurring. The post-doctoral leave to remain would be in addition, perhaps, to a university degree.

There would be an additional application, so indeed it would be allowable because they would not be permanently resident here in the UK. That is a correct analysis of the situation and the noble Baroness, Lady Williams, is absolutely right in pointing that out.

Lord Avebury (Liberal Democrat)

My Lords, I hesitate to add to the interruptions that the Minister has already suffered, but I think I can understand what the noble Lord, Lord Patel, was getting at. Clause 33(4) states:

“In specifying the amount of a charge under subsection (3)(b) the Secretary of State must … have regard to the range of health services that are likely to be available free of charge to persons who have been given immigration permission”.

That implies that not all health services will be available to that person, but the noble Lord has insisted that such persons will be treated on the same basis as a native of this country in accessing the health service. Why do we need subsection (4), which implies that there are other services which the health service provides that are not covered by the surcharge?

Lord Taylor of Holbeach (Conservative)

I thought that I had made that clear in answer to an earlier question, and I am just trying to find my notes on that matter. When the Bill is initially implemented, it is our clear policy intention that there will be no further charges for treatment. The provision in the Bill is there for this particular period, but we will clarify the position on implementation. The policy position is that there will be no further charge. That is not on the face of the Bill, as the noble Lord, Lord Patel, rightly points out, but I am giving him the policy position from the Dispatch Box. I hope that that reassures him and my noble friend on that point.

Baroness Tonge (Independent Liberal Democrat)

Would the Minister be patient one more time? I thank him very much for giving way. Unless the granting of a visa is made dependent on paying the health surcharge, will poor migrants—let us assume that a lot of people wanting to come to this country are coming for a better life and are very strapped for cash—not waive the health charge, or whatever we like to call it, and assume that because they are healthy when they apply for their visa they will never need medical treatment? Is there not a danger that we are forcing people into a situation where they will not be able to receive any medical treatment at all because they will be too poor?

Lord Taylor of Holbeach (Conservative)

I have to say that we are not looking to put people in that situation. Indeed, one would hope—this is the reason for the provision—that if people are here for a period of time, they have got cover for their healthcare. That is the whole point of the charge in the first place. If people come as temporary visitors then that is a slightly different position, but they make that choice. They make the choice to come here, and they carry the responsibility to do so.

Perhaps I may turn to some of the amendments. It is good that we have had this chance to talk about the principles behind the charging and I hope that it has clarified the position to some degree. However, there are points here that I think I need to clear up. The first

is that the restrictions to services set out in Part 3 are designed to protect our services from illegal immigrants—people who are remaining here outside the law. Many of these provisions will have no impact at all on pregnant women who are in the UK lawfully. The Government are committed to ensuring that the new restrictions and charges in Part 3 are appropriately targeted and do not impose a disproportionate burden on either service providers or migrants.

I should like to address some other points regarding Amendments 59, 60, 63, 64A and 65, which seek to exempt pregnant women from the health surcharge or the NHS treatment charges. I fear that there has been a misunderstanding about the purpose of the surcharge and the manner in which it will operate. As I say, the surcharge will be paid by legal, temporary migrants who come to the UK for more than six months. Our policy intention is that those who pay the surcharge, including pregnant women, will not be subject to most other NHS treatment charges. That will include both antenatal and postnatal care. They will be charged only for services that a UK resident might also be expected to pay for.

Amendment 60 also seeks to exempt children under the age of 18 from the surcharge. This would undermine the general principle that temporary migrants should contribute to the NHS, commensurate with their immigration status. Children are as likely to need NHS care as anyone else. It is therefore reasonable to expect parents—and it would be parents—to make this contribution on behalf of their child.

We have seen the headlines about health tourism. I am afraid that Amendments 63 and 65 would exacerbate the problem of maternity tourism. They would allow any pregnant woman to use the NHS free of charge. The NHS is not equipped to supply free maternity services for the rest of the world, and I do not think that that is an unreasonable thing for a government Minister to say.

Baroness Cumberlege (Conservative)

Amendment 63, which I tabled, proposes four new subsections. Proposed new subsection (1A) states:

“Notwithstanding subsection (1), any pregnant woman shall be treated as ordinarily resident”,

and proposed new subsection (1B) states:

“However, subsection (1A) shall not apply where there is evidence the woman has entered the UK for the purpose of obtaining healthcare”.

I think that is quite clear. I am saying that people who apply here simply for the purpose of obtaining healthcare should normally have to pay. Perhaps the Minister will clarify that. I am still very concerned about the three examples I gave. Will he address them? The first is a woman who came in with her husband and the relationship has broken down. Is she now exempt from these charges? The second example is a woman who is destitute and living on the streets. If she becomes pregnant as a result of a sexual assault, is she exempt? The third is a woman who is married to a British man and has submitted an immigration application to the Home Office who becomes pregnant and gives birth while the application is being assessed. Is she to be charged? It is not just maternity services; it is the other services being introduced in this Bill, such as prescriptions, dental care and A&E.

Lord Taylor of Holbeach (Conservative)

My noble friend is very prescient because I was just about to turn to Amendment 63. It is exceptionally difficult to prove that a migrant had a prior intention to use the NHS. Pregnant migrants would simply say that they fully intended to return home for the birth of their child. It would be difficult, if not impossible, for us to prove otherwise if they were a temporary migrant. This amendment would require GPs and hospital staff to act as immigration officers, and that is exactly what we are trying to avoid in setting this charge.

I have an answer here for my noble friend on victims of sexual assault. I have been speaking for 30 minutes, which is way beyond the conventions of the House, in answering these amendments. I am quite prepared to go on if noble Lords are prepared to do so. Other noble Lords are waiting to hear the Statement, and I have to crave their indulgence. If I skip any points, I will try to sweep them up by writing to all noble Lords who have spoken on this group of amendments, but there are an awful lot of points. I am literally but halfway through my speaking notes.

My noble friend asked about the operation of NHS charging regulations. Urgent treatment will always be provided no matter what the circumstances, and the Department of Health will still have the power to exempt treatments from charges. It is considering what exemptions for vulnerable groups are appropriate as part of its reform programme; there is no provision in the Bill.

My noble friend also asked whether women who have outstanding NHS debts will receive care. Women who pay the surcharge will not incur NHS debts. Where illegal immigrants or visitors incur debts, they will still receive treatment where it is immediately necessary or urgent. Their NHS debt for this treatment exceeding £1,000 will be taken into account by the Home Office when determining future immigration applications.

I reassure my noble friend Lady Tonge and the noble Baroness, Lady Finlay, that pregnant women in need of NHS care will receive it. Our intention is that surcharge payers will receive this care free of charge, at a fraction of the real cost of maternity services. Those who do not pay the surcharge, such as tourists and illegal migrants, who might otherwise be charged for maternity care, are also protected. Guidance to the NHS is explicit that, in order to protect the lives of both mother and unborn child, all maternity care, including routine antenatal care, must be provided to all women without delay caused by charging issues. I hope that I have made that clear in all the answers that I have given: the health of mother and child is paramount, regardless of the charging regime or the status of the mother.

I want to address the point that the noble Baroness, Lady Smith, made about victims of domestic violence. The Government are quite clear that domestic violence is a terrible thing and are committed to combating it in all its forms. If an individual is the victim of domestic violence, they have full protection of the criminal and civil law and of the law enforcement

agencies, regardless of their immigration status. That is not in question. But that is not to say that all victims of domestic violence should expect that they can stay here in the UK. There is provision in the Immigration Rules to grant indefinite leave to remain to victims of domestic violence who are here as the partners of someone who is a British citizen or settled in the UK, or a Foreign or Commonwealth member of Her Majesty’s forces who would be able to become settled were it not for service in those forces.

The noble Earl, Lord Listowel, also asked about access to vulnerable people. On child immunisations, the Government are committed to protecting public health as a priority. The Department of Health has confirmed that existing exemptions from NHS overseas visitor charges will remain for treatment of specific infectious diseases; that includes HIV, for example. The Department of Health is considering which groups and treatments should be exempt from NHS overseas visitor charging as part of its wider reform programmes, and we will look at child immunisation in that way.

Baroness Smith of Basildon (Labour)

I am sorry to intervene on the noble Lord; I know that noble Lords are anxious to get on to the next debate. The answer the Minister gave me was not the answer to the question that I asked. I asked about those who have leave to remain in this country and are here legally—they could be UK citizens—but, having fled the domestic home where they have been subjected to violence, do not have the documents to show to a landlord and so cannot prove their status. How does the noble Lord intend for that matter to be dealt with, given the problems that it will cause to women fleeing domestic violence?

Lord Taylor of Holbeach (Conservative)

My Lords, I remember that the noble Baroness painted this scenario and I understood it well enough; I am sorry if I missed that point in picking up another. There are exceptions for refuge accommodation and local authority-provided housing. After all, a broad range of individuals are in this situation. Social services will be able to help them with long-term housing needs and asylum seekers will also be authorised to rent. If I have not satisfied the noble Baroness, I do not want to mislead her or the House by giving her an off-the-cuff response which is beyond my brief at the minute. I will write to her, and copy in everyone, on this matter.

I am looking through these notes, and see that I have satisfied a number of questions—such as those raised by the noble Lord, Lord Patel, on children—in the way in which I have answered the broader matters. However, I recognise, too, that I may not have covered all the points made by noble Lords, but I am very mindful of the time. If noble Lords will forgive me, I will ask the noble Earl, Lord Listowel, to withdraw his amendment. I thank all noble Lords who have contributed to the debate, which is by way of a warm-up, I suspect, for further adventures in these fields with the amendments that are yet to come.

Earl of Listowel (Crossbench)

My Lords, I thank the Minister for choosing to give the lengthy reply rather than the short one. This is clearly a matter of great concern to

many of us, so I am most grateful to him for taking the time to answer our points as carefully as he could. I beg leave to withdraw the amendment.

Amendment 48 withdrawn.

House resumed.

Committee (3rd Day) (Continued)

Lord Hannay of Chiswick (Crossbench)

My Lords, last week we had a useful debate about the negative impact of some aspects of the present Bill on overseas students, both undergraduates and postgraduates, wishing to come to this country. That debate took place on Amendment 26; today we are discussing Amendment 49.

Ministers can be in no doubt already of the depth of concern felt in all corners of the House about the damage being done by the cumulative effect of the Government’s immigration policy to what is, by common agreement, one of Britain’s most buoyant and valuable invisible exports, and of the strong desire that Ministers should think again before imposing any further charges or burdens on overseas students.

Last week we discussed the new appeals procedure; today we are considering what I would describe as the two most worrying aspects of the Bill so far as overseas students are concerned—the NHS charge and the provisions on accommodation. It is the aim of Amendment 49 to remove the threat to this very important part of our economy by, as it were, carving out full-time students from the application of those provisions.

I shall try not to weary the Committee with too much repetition of the general points and facts about the contribution of the higher education sector to our economy and the reasons for believing that it is already being harmed by the cumulative effect of the Government’s immigration policy, about which I have spoken—and that, I add, before any impact from the measures in the present Bill has taken effect.

I hope that the Minister can respond to this: what other British economic sector, bringing in more than £10 billion net a year and rising, is being put at risk by the Government’s own policies? Is there any other industry that we do that to? The latest statistics from the Higher Education Statistics Agency show that we are losing market share to our main competitors—to the US, Australia, Canada and, perhaps not too far in the future, to France and Germany, where more and more courses are being offered in English.

Let me cite one or two of the findings from a National Union of Students survey carried out in January this year on a sample of 3,000 overseas students

already in this country; that is to say, people who will not be directly affected by the measures we are discussing today. Some 74% of them said that the proposed NHS charge would have made it more difficult or impossible for them to study in the UK, while 82% of those with dependants, who are mainly postgraduates paying much higher fees, of course, said that free access to the National Health Service was important to their choice to study here. Some 40% said that the introduction of landlord checks would have negatively impacted on their decision to study in the UK, and that figure rises to 51% in the case of PhD students. Those are pretty sobering findings.

When it is suggested that overseas students should surely in equity make some contribution to any welfare costs, it seems to be completely overlooked that such research as there is shows that the costs incurred are substantively outstripped by the benefits that these students bring to our economy. Unlike what I will call genuine economic migrants—people who come here looking for work—these people bring with them over £20,000 a year in cash which goes into our economy. They are creating employment both at our universities and in the towns and cities that host those universities, as research by the University of Sheffield shows. They often enable our universities to maintain a wider range of important subjects, such as engineering, science and mathematics, than would otherwise be the case. I do not imagine that anyone supposes that taxpayers’ money is going to be available to fill any gaps that might be caused by a shortfall in the number of overseas students who would otherwise be attracted by the excellence of our academic establishments.

I hope that I and others who are to speak to this amendment will have demonstrated why removing full-time undergraduate and postgraduate students from the scope of these measures, as Amendment 49 proposes, is not just a piece of special pleading but justified as a rational analysis of our national interest. I beg to move.

Baroness Williams of Crosby (Liberal Democrat)

My Lords, my name is attached, along with others, to the amendment moved by the noble Lord, Lord Hannay. I will speak briefly to make one or two points that perhaps are not so widely part of this debate, because, as I have rung up acquaintances of mine in universities—I know quite a few, having been an Education Minister—I have become more aware of the depth of the challenge to our university and higher education system and, at one remove, of the depth of the challenge to the front wave of our economy in terms of its dependence on innovation and invention. I will not detain the Committee for long, but I believe that what I am saying, although supplementary to what has already been said by the noble Lord, Lord Hannay, deserves a great deal of thought.

Let me begin by saying that what has attracted students from overseas to this country has been not only the English language and the excellence of our universities, but also a deep sense of our being an old and stable democracy. People have a sense of freedom of expression in this country, along with freedom of intellectual discussion and debate. There is no doubt

that, rather surprisingly, in the fields of science and technological research, this country has continued to be a magnet for students from all over the world in a way that one would not really expect for a country of our size and one that is not in the very first rank of economies, like the United States at the present time. It is very important that the context of what attracts overseas students to this country is something that we maintain. In particular it means our marked ability to tolerate different points of view, and to tolerate people of different races, nationalities and languages. That has been a hallmark of studying in this country.

Anyone who reads the history of the United Kingdom will be more than aware that on three occasions we have benefited vastly from immigration. The first occasion was the immigration of German Jews in the 1930s, who brought with them an extraordinary level of understanding and knowledge of medicine and science, including a number of very distinguished Nobel laureates. The second great wave was immigration from the Caribbean in the 1960s without which, quite frankly, we would not have a working National Health Service today because of the huge contribution they have made to staffing that public service. The third wave, more recently, was of immigrants from Asia and east African refugees who came here in the 1970s and gave a tremendous boost to our commerce, business and research.

However, it is not the case that the concerns being expressed here are those only of overseas students, although I echo completely what the noble Lord, Lord Hannay, said about the very disturbing information from the National Union of Students. He mentioned the fact that more than 50% of undergraduate students said that they would think hard before coming to us again. Perhaps even more significant and important is that no fewer than 66% of postgraduate students—half of our overseas students are postgraduates—said exactly the same thing. In light of the changes being made—the increase in visa fees, the health surcharge and all the rest of it, these students would think hard before coming here again. Let me say in passing that we do not seem to recognise our extraordinary dependence on these postgraduate students. I can give an example. Time after time we have recruited doctors from the Indian subcontinent to sustain our health service. A great bulk of them have been postgraduate students who came from India to study in the United Kingdom and then went on to work as postgraduates, and in some cases decided to become citizens of this country and continue to sustain the NHS.

I would add to that that there are people of great significance and wisdom who would associate themselves powerfully with the view that the discouragement of overseas students has a devastating effect on our economy, in particular the science and engineering sectors. I shall quote two of them. The first example is a quotation from the CBI which has said in a public statement:

“Despite the government’s assurances to the contrary, many businesses fear that complex recent work permit and visa reforms have created a perception that Britain isn’t open for business”.

That is often treated as something that is said by those who come from outside this country, but no, it is something that has been said officially by the CBI, the leading organisation representing industry in the UK.

The second example comes from the president of the Royal Society, Sir Paul Nurse, who is a very great scientist indeed. Time and again he has pleaded with Governments to give a more generous reception to overseas students. I shall quote his words:

“The rhetoric from the Home Office, combined with the complexity involved with immigration rules and visas, has led to a perception internationally that the UK is not particularly welcoming”.

I have given these examples because no one can pretend that these are partisan statements made for political ends. They are statements by distinguished people who believe that what they are saying should be a warning for the rest of us.

I will give another example. Something comes out every year called theAgent Barometer, which is published by a body called ICEF, together with the Enterprise Institute. This year, it said in its report on 2013 that there is now a steady decline in Britain’s attractiveness. In particular, it pointed out that in one year Canada has leapt to become the second most attractive destination for overseas students, the position that we held for a very long time, with only the United States higher. That is because Canada has changed its visa regulations and has decided on a campaign to welcome overseas students. It has certainly not added a series of obstacles to their coming to the country. The noble Lord, Lord Hannay, made the crucially important point about what we might call the localism element when it comes to overseas students and the universities that serve them. Anyone who knows the many cities where new universities have been born in the past generation will know how, in almost every case, the new university brings with it a degree of demand, excitement and stimulation which the old city simply did not have without it. That has been a huge contribution, against the great pull of London, to making this country intellectually and industrially lively and innovative well outside the London bubble.

There is another thing which is of great importance. The attempt that the Government made to try to meet some of the problems and objections about our becoming less attractive to overseas students—in particular the so-called exceptional talent scheme, introduced only two years ago, which allowed 700 visas to be taken up by the most brilliant scientists who could be attracted to this country and another 300 by the most brilliant artists—has failed dismally. So far only 80 of those 1,000 visas have been taken up because people who are inclined to accept them discover the obstacles on the way, including the cost of a whole range of things that they did not perhaps take into account in the first case.

There is another subtle and in some ways even more disturbing factor, which hardly anybody notices, although it was just touched upon by the noble Lord, Lord Hannay. As a former Education Secretary, it is something that certainly burns with me. I was very shaken to hear one of the most senior people out of the many that I spoke to over the weekend from the university sector—I will not name him but he is certainly in one of the very top positions in the university world—tell me that his university is considering dropping the so-called STEM courses. STEM stands for science, technology, engineering and mathematics. He said that without overseas students

coming in substantial numbers, the university was unable to finance these courses. He said, rather sadly, that there would not be sufficient British recruits to make up the difference; the university would simply have to drop the courses because it could not afford to sustain them in the situation where they were largely not taken up.

We are slipping in terms of engineering and science, as many noble Lords will know. The number of our own young people who opt for engineering and science courses is steadily declining, and the examination results in engineering and science are not very impressive. We are largely sustained in these fields, which are crucial to revive British manufacturing and to sustain British science, by overseas students, most of them postgraduates, who join our teams and work on cancer research, pharmacology and cybernetics—the whole range of what one might call the first new wave of scientific and engineering areas. We are no longer giving them the encouragement that would bring them to our country. That is really serious. How else do we imagine we will sustain an economy in the coming years if we cannot maintain the quality and brilliance of our research?

Another very great man who I will not name, also a leading researcher, said to me that time and again he finds that his teams need people with some innovatory experience from another country, but increasingly they cannot come, do not want to come or, because most of them are at an age when they have wives and children, cannot afford to come. The surcharge is deceptively low, and if you have a wife and two children it becomes really quite substantial.

I plead with the House to take this very seriously. I think we are in the process of killing the golden goose, which is a very foolish thing to do. We are, essentially, becoming more inward-looking. I am not blaming just my own Government, of whom I am a supporter; the practice of British Governments for many years now has increasingly failed to recognise the need to welcome people from overseas, help them and make them feel at home.

I conclude by saying that I am not a bit surprised that the United States takes first place. Having been a professor at Harvard for 10 years, I know the immense lengths that Harvard goes to to attract, hold, sustain and make happy people from all over the world. I sometimes think that it is like a huge vacuum cleaner simply sucking up talent. I do not believe that is the best thing that can happen to the world. However, I recognise that if we do not leave the doors open in our own old but brilliant country—which really does mean substantial changes to the legislation in front of us—we will have only ourselves to thank as we start slipping our way through the 21st century.

Baroness Warwick of Undercliffe (Labour)

My Lords, I have added my name to this amendment because I agree with the noble Lord, Lord Hannay, that it is a fundamental mistake to subject international university students to further hurdles, barriers and restrictions. Instead, I believe this House should send a clear message to the Government: international students should be encouraged, welcomed and supported. This carve-out amendment would send that message, and I hope it will find wide support. I note that in adding my

name to this amendment, I am joined by noble Lords from all sides of the House. Indeed, it is characteristic of our debates about international students that there is consensus among the parties. We know that at the highest level of the coalition, Cabinet Ministers recognise the absurdity of policy which drives the Government to stifle the UK’s prospects for growth in higher education exports—despite the fact that this is now one of our most important export markets and one with the strongest potential for growth.

While we invent new restrictions, our competitors are going to considerable lengths to reduce them. Australia, as is so often the case, has done us the favour of experimenting with draconian visa restrictions and has learnt from that experiment. The consequence was that students went elsewhere. After a wholesale review—the Knight review—Australia has rapidly set about undoing the damage that it inflicted on itself, streamlining visa processes and offering more generous post-study work opportunities as part of a dramatic about-face on immigration policy in relation to students. Nevertheless, Australia reckons it will take a decade to recover its former position.

We are not doomed to repeat that mistake, but we must stop being complacent about what is happening, which is why this amendment is so necessary. Ministers repeatedly quote partial UCAS and visa application figures as though they disprove the concrete enrolment data. The Minister must know that visa applications do not always translate into enrolments and that a relatively small proportion of international students apply through UCAS anyway—not least because UCAS does not deal with postgraduate admissions.

Recently, the right honourable Oliver Letwin used a Telegraph interview to point out that the Government’s net migration target was “statistical nonsense”. I agree. As senior Liberal Democrats have pointed out, it is not in fact coalition policy, but a Conservative pledge. It appears to me staggeringly unlikely that the target will be met. Can the Minister assure the House that he will use his influence to persuade his colleagues in the Government that this is the right time to withdraw gracefully from the position they have got themselves into?

I put it to the Minister that measures such as the ones we are dealing with in the Bill are part of a wider attempt to make the UK as unattractive as possible to those who might come here. Since students are the largest category of visa applicant, it particularly targets them. Since the majority of student visa applicants are now bound for our universities—because the Government have made it next to impossible for everyone else—they, in turn, are particularly hard hit. I agree that many other groups will be hit by the residential tenancy and NHS surcharge provisions in the Bill, and I shall certainly join other noble Lords in supporting amendments that would reduce the impact of the Bill on all migrants, not just students. Meanwhile, I urge noble Lords not to be distracted by arguments that the amendment we are now debating will not help other groups.

I understand the charge that support for this amendment looks like special pleading from the university lobby, but it misses the point: the overwhelming majority of those affected by these measures will be students,

many of them living away from home for the first time. There seems a real risk that those students will choose to go elsewhere if they are faced with high initial charges for access to NHS services and are prevented from securing accommodation in advance of their arrival. I agree with the noble Lord, Lord Hannay, and others that the wholesale exemption of students would be preferable to piecemeal improvement.

Lord Cormack (Conservative)

My Lords, 20 years ago, along with my friend, the noble Lord, Lord Radice, I was invited by the late, great—I use the word advisedly—Lord Dahrendorf, one of the most remarkable international figures ever to grace your Lordships’ House, to be a visiting parliamentary fellow at St Antony’s College, Oxford. We were the first two. I am sure I speak for the noble Lord, Lord Radice, who is not in his place. We were immensely impressed by this postgraduate Oxford college, which attracted students from all over the world. Many of them went on to hold positions of high importance and real influence in their native countries but always had a sense of real gratitude, affection and, indeed, obligation to the institution at which they had studied here.

I am still a member of the Senior Common Room at St Antony’s and just a couple of weeks ago I was talking to our present warden, Professor Margaret MacMillan, herself an eminent Canadian historian who has just written a most remarkable book on the origins of the First World War. She said that at the moment there are students from 73 different countries at St Antony’s, and that many current Governments of the world include those who received at least part of their education there. I believe there are four or five in the Mexican Government alone.

That is truly remarkable but it is not unique to St Antony’s, eminent as that institution is. When students come to this country and study, they contribute far more than they obtain, and go back with a knowledge and affection for the United Kingdom. Of course, that does not apply just at postgraduate level. In the fair city of Lincoln, where I now live, we have two universities: the University of Lincoln, which has in a remarkably short space of time become a very significant university; and the smaller Bishop Grosseteste University, which began more than 100 years ago as an Anglican teacher training college and is now a proper university. Both those universities have students from a variety of countries.

As the head of another college said to me not long ago, we are in danger of making those who consider applying feel that they are not entirely welcome here. I cannot for the life of me believe that that is our intention. Of course it is not. I know it is not the Prime Minister’s; I know it is emphatically not the view of my noble friend the Minister. Nevertheless, as we all know, perceptions in politics are very important. There are, in India in particular, young men and women who believe that they are not as welcome as we should make them feel.

I said in a previous exchange in this House that far better that a bogus student come to a bogus college than we shut out somebody who might in the future be

Foreign Minister of his country or win a Nobel Prize. That puts it very simplistically but I would not depart from that. We really should be treating students separately from other immigrants. They come, they pay, and the vast majority of them go back, and very often those who do not enrich our society by staying.

A few moments ago my noble friend Lady Williams talked of those who came as Jewish refugees before the war and gave a new depth and dimension to the intellectual life of this country. We have in your Lordships’ House those who were in the wave of Ugandan Asians expelled by that ghastly dictator, Idi Amin, in the early 1970s. I shall always be very proud that it was a Conservative Prime Minister, Edward Heath, who opened the doors for them, and they have enriched our society.

We have been admirably led by the noble Lord, Lord Hannay, in his brief, concise but extremely persuasive speech. We are dealing with students, with young men and women from around the world who still look to Britain as being a place where they can enjoy intellectual freedom, benefit academically, acquire and develop knowledge, and engage in research that will enrich all. I beg my noble friend, when he comes to reply, to acknowledge that there is a difference between the student immigrant and others.

I will concentrate my activities on this Bill on students because I believe that this is the part of the Bill that is most defective. I urge noble Lords in all parts of the House, whatever their political affiliation, to support the plea made by the noble Lord, Lord Hannay, and so admirably followed up by my noble friend Lady Williams and the noble Baroness, Lady Warwick. I sincerely hope it will not be necessary for the House ever to divide on this issue because I hope the Government will recognise the powerful good sense of the arguments that have been advanced and which I am trying, in a gentle and modest way, to reinforce and support.

Lord Patel (Crossbench)

My Lords, I strongly support the amendment moved by the noble Lord, Lord Hannay, which seeks to remove tier 2 and tier 4 students from the Bill in all its aspects. I will speak also to my own Amendment 57, which relates specifically to the health charges for tier 2 and tier 4 students. Before I do that, I will just comment on the unintended consequences of some of the Bill’s provisions.

Let us take the evidence that students will have to produce of their bona fide tier 2 or tier 4 visas. I came to this country as an east African Asian schoolboy in the late 1950s, to do A-levels before entering university. I did them at a school in Harrow—not the public school. That is not the point. The point is I went to look for accommodation, which I eventually found, and I still remember the address: 38 Priory Road NW6, near Kilburn. The adverts for rooms in the newspapers that I looked at would either say “No blacks” or they would say nothing. So you went to addresses whose adverts did not say, “No blacks”—what was the point of going to a place that did? Sometimes the door would open and shut in your face, with a response, “Sorry, the room has gone”, before they even asked whether you had gone there for a room. There will be unintended consequences of having to provide proof for non-EU students. Later I found out

why there were five east African Asians and one non-east African Asian—there were six of us—staying at that address. It was because we were paying a higher rent. The landlord—whom I would not name, but I do remember his name—knew that we were no trouble. We were no trouble because we had no money anyway. We were law-abiding, decent young people—I hope. But that is exactly what will happen: those landlords who are willing to take non-EU students will charge higher rents. That will be the unintended consequence of the clause in this Bill relating to renting.

That is one good reason why I would favour a carte blanche removing students from this legislation. I declare an interest: I am the chancellor of the University of Dundee. With our strength in life sciences and being the second university in Dundee with strength in computer sciences, we have a large number of non-EU students. A tier 2 student’s perception of a health levy would be that this was just another example of unfriendliness in the United Kingdom. They would already have paid a lot of money for visas, for English language tests and sometimes for interviews, and they will now have to pay more. Is there an evidence base to suggest that students access the NHS disproportionately? There is no evidence, from general practice, from A&E departments or from specialist hospitals, that students disproportionately access healthcare—quite the reverse. In my case, the students that we used to see were the girls who came to contraceptive clinics, but, most of the time, even my wife, who did general practice, did not see students particularly. So there is no evidence that students disproportionately access the NHS.

It has already been said that there are huge net economic gains to be had from having students in this country—of several billion pounds. A study carried out by Oxford Economics showed that students in Sheffield contributed £120 million to the local economy. Let us remember that they pay for housing; they pay for their travel; they pay for everyday living costs; and they also pay indirect taxes because they buy stuff on which they have to pay VAT. There is no economic loss associated with our having international students. However, the likely impact of a perception—it might be a perception but perception becomes a reality—is a decline in the number of overseas students, particularly in STEM subjects and in those related to medicine where at one time there were large numbers. Figures that I have been quoted show that the total number of visa applications fell from 313,000 in 2009-10 to 207,000 in 2012-13. Forty per cent of our students come to university through pathway providers, which are mainly independent schools. They have seen a decline of 21% and we are likely to see a further decline in total numbers as a result of these pathway students not coming to university. All in all, including international students in the provisions of this Bill will have a greater detrimental effect on universities.

It was interesting to read in evidence given to the Science and Technology Committee inquiry on STEM subjects by Philip Lockett of London South Bank University, Ian Bradley of Manchester University and Daniel Stevens of the NUS—noble Lords can read the transcript—that they felt that an NHS levy and charges would deter students coming to the UK, even though such a levy might be only £150. Tier 2 students—the

postgraduate and research students—are among the most valuable students that you can have. From them, you pick out the brightest and the best, and you keep them here because they will contribute to our university strength. They felt that the levy and other difficulties that the Bill would pose for them in finding accommodation et cetera would deter them from coming here. In a survey of 3,100 students, 83% of PhD students felt that the levy would have a detrimental effect; 82% of those who had dependants said that it would have a detrimental effect—let us remember that the levy is on top of the visa cost for dependants that is going up by 50%. All these costs quite rightly add to their perception that we do not welcome non-EU international students. I know that we have had that debate and that it is not the intention of the Government, but the perception needs to be addressed.

Lord Phillips of Sudbury (Liberal Democrat)

My Lords, I had a communication this very morning from the University of Essex, from which I stood down as chancellor at Christmas after more than 10 years, which drew my attention to the fact that the Times of Indianewspaper recently had a headline stating, “Indian students feel unwelcome in Britain”. Other noble Lords have mentioned that. Indeed, the speeches we have had do not leave a great deal in need of saying, but I want to emphasise a couple of things.

The University of Essex, apart from the London School of Economics, has the greatest proportion of overseas students of any university in the United Kingdom. Happily, I may say that undergraduate applications for this year, coming in the autumn, have declined by only 1%, although it is notable that the decline in applications from China and India is 16%, which has all sorts of significances of which I am sure the Committee is aware and on which I shall not enlarge.

What I want to emphasise—and the noble Lord in moving the amendment touched on it very effectively—are the non-economic aspects of a university education in this country. I think that many here now would agree that our universities and the opportunity that they provide to students from every corner of the globe are a jewel in our national crown. It is quite extraordinary that we are, almost inadvertently, undertaking a series of changes that lead to the consequences which other noble Lords have emphasised in terms of the dropping-off of applications to come here and so on. The non-economic consequences of having overseas students at our universities can be underestimated. Some talk of it as “soft power”. I understand the force of the phrase, but I am more keen, if one is allowed to be in this age, on the personal ties and relationships that are formed by having a large body of overseas students among our students here, whether undergraduate or postgraduate. Those personal ties, loyalties and affections work miracles after they go away from their university, miracles in all aspects of human life: cultural and economic, of course, as well as personal, societal—you name it. I think that all of us would agree that the most valuable thing that we ever take from a university is our relationships and the extraordinary broadening of our understanding of the lives of other people in other continents that comes from a close, lifelong relationship with someone

you have met at university or some number you have met. I am lucky enough to have a number of lifelong friends who came from other countries. What you get from that and they from you cannot be put in terms of pounds, shillings and pence and is of infinite value in a world wracked with problems and tensions. This country cannot with any semblance of common sense do anything to damage in any way that jewel in our crown at a time when the whole wide world is competing for students. Everybody wants foreign students. Every country in the world is expanding its student base at huge rates—China and India are two examplars.

I hope that my noble friend, who has an unenviable job in summing up on the amendment—

Lord Taylor of Holbeach (Conservative)

Not at all.

Lord Phillips of Sudbury (Liberal Democrat)

There we are: he is an optimist from the Fens. I hope that he will take heed of all that has been said. I have just a small last point. The bureaucratic consequences of the Bill are horrendous, and the amendment has a wonderful simplicity about it. It simply removes overseas students from the tentacles of I do not know how many aspects of our modern, burgeoning bureaucracy.

Lord Cameron of Dillington (Crossbench)

My Lords, I believe this to be a very important amendment, and I am very glad to follow the noble Lord, Lord Phillips.

As some noble Lords will know, I spend some of my time visiting African developing countries with a view to promoting agriculture, and smallholder agriculture in particular, as a tool for development. While I am there, often on parliamentary visits, I meet parliamentarians in those countries, Cabinet Ministers, Prime Ministers, Vice-Presidents and even occasionally Presidents, and heads of institutions, top civil servants, heads of research stations and so on. It amazes me how many of those people have paid for themselves to be educated at British universities and institutions.

Being a bit more mercenary than the noble Lord, Lord Phillips, I want to make the point that the resultant Anglophilia that that education gives them, the resultant ingestion of our culture, way of life and thinking must be of huge value to UK Inc, as it were. It must be worth all the budget of the British Council, the BBC World Service, millions of pounds-worth of diplomacy in embassies, millions of pounds-worth of DfID’s great worldwide reputation and even, if it came to a fight, probably a couple of regiments as well.

We must do everything possible to encourage—not just not to discourage but to encourage—those overseas students because, in the short and long term, their value to us is huge. This is a very good case of government silos, because the Home Office clearly sees its job as to control immigration but ignores in this case the wider implications for UK business, UK education and UK reputation in its foreign policy. I beg the Minister to send out the message to the world that we are open for business and that those students—most likely the future leaders of their country—should

be given every incentive possible, not just not discouraged but seriously encouraged, to come to pay for themselves to attend our institutions and absorb our culture and values.

Lord Tugendhat (Conservative)

My Lords, the noble Baroness, Lady Warwick, said that the amendment enjoyed support from all quarters of the House. I speak as the Conservative sponsor of the amendment, and I am very happy to do so.

We have heard a number of powerful speeches and I think that I agree with every word that has been spoken. I particularly draw attention to a point made by the noble Lord, Lord Hannay, in his introduction when he said that he was not making a special plea for any given set of individuals. Rather, he was pleading on behalf of one of the most successful sectors of British life and of the British economy in order to enable it to continue to be one of the most successful, not only within this country but in international terms.

If I may say so, it is very important when the Minister answers that he should not treat this as being something directed towards a particular group of people who come to this country, as if we are conferring some favour on them. Rather, he should deal with the issue in the context of the impact that the Government’s proposals will have on one of the most successful sectors of British life and of the British economy. The ability to attract international students is both a means by which British universities excel and a measure by which others can see that they are excelling. To diminish in any way the free flow of talent to this country would be very damaging.

I should like to make one final point, because so much has been said that there is no point in repeating it. The Government should look at the beam in their own eye, if I may say so, on this issue. The Government understand very well that, when they make senior appointments to different institutions, they want to attract talent from all over the world. Indeed, they boast of their ability to do that and of their willingness to make appointments of non-Brits to high places in this country in a way that most other countries would not in the case of foreigners. They paid vast sums of money to attract a redoubtable Canadian to run the Bank of England—about four times what the president of the Federal Reserve gets, they were so anxious to attract his talents to this country. Another very talented Canadian—paid rather less, actually—is at the head of the Royal Mail. There are many other examples, I am happy to say, of talented people being attracted by the Government to contribute to the British economy.

The Government understand perfectly well the importance of attracting the best people to run British institutions, and they should be commended for their lack of chauvinism in that regard, but that is also true of universities. If universities cannot continue to attract the best talent from all over the world, that will seriously damage their ability to continue to contribute as much as they do to the British economy. As my noble friend Lord Cormack, said, those who stay after graduation are often the people who contribute the most to academic research, industrial start-ups or the

businesses they build up. Those are all factors which I feel that the Government have overlooked in this rather ill-conceived measure.

Lord Hope of Craighead (Judge)

My Lords, I should like to say just a few words in support of the amendment of the noble Lord, Lord Hannay, based on my experience as chancellor of Strathclyde University for 17 years. Having spoken to many students of the kind we are talking about and having hosted alumni events overseas, I think that my experience has been very similar to that described by the noble Lord, Lord Cameron, in that we have trained those students in our country and find them in positions of great influence in the countries to which they went after leaving.

I shall not repeat the points made so well by so many other noble Lords; I endorse all of them as background to what I should like to say. Perhaps the Minister will be kind enough to focus precisely on what the amendment is intended to do. If he reads its wording, he will see that it encompasses all the various things in Part 3: access to tenancies, bank accounts, driving licences and other services. Of course, among the services is what Clause 33 deals with: access to the health service. There is a difference between the Clause 33 matter, which I shall come back to in a moment, and the other services mentioned in the opening words of the amendment.

The difference is this. As I understood the Minister’s words in the earlier debate, the purpose of the other clauses is to flush out people who are not entitled to be here. It is to deal with people who are not legal migrants. We find that in Clause 16(2), 35(2) and 42(1) all of which direct attention to people who require leave to enter or remain in the United Kingdom but do not have it. I raise this point because the amendment is dealing with tier 2 and tier 4 visa holders—people who, because of the terms of their visas, are entitled to be here. Bearing in mind all the points that noble Lords have made, why is it necessary to subject tier 2 visa holders and tier 4 general visa holders to these restrictions? Why is it necessary for them to go through these hurdles to have access to, for example, a bank account? Why is it necessary to do that for driving licences?

As for Clause 33, that is a different point and I do not want to go over the debate that we had earlier this afternoon. However, while I did not intervene in that debate because the Minister was under great pressure from many people who were doing that very thing, there is one point that struck me in looking at Clause 33. It is that its wording, which is designed to confer a power on the Secretary of State to make provisions for charges to impose, begs so many questions. Who, for example, are the persons on whom the charge is to be imposed? Clause 33(1)(b) refers to,

“any description of such persons”,

but who are they and what is the intention of that provision? We then have all the various steps in subsection (3), including the points that other noble Lords drew attention to. With the greatest respect, my suggestion is that the noble Lord and those advising him should have a very careful look at the wording of Clause 33. I suspect that the debate which we had

earlier, and which I am not going to rehearse, has flushed out some points of real concern about the breadth of the wording, what it is really intended to do and whether it is necessary to do what it is seeking.

Quite apart from that, there is the point that others have made: that to subject overseas students to this sort of extra charge is bound to have consequences. Two words struck me as I have been listening to the debate. One was “cumulative”, in the point made by the noble Lord, Lord Hannay. It is about the cumulative effect of all those measures that are made. The other was “perception”, because perception is fuelled by rumour. Figures have been put forward in this debate as to what students in this country, and perhaps overseas students, are thinking. What about all those who are wondering to which country they should come? They are the people whose perception should really worry us. There are also the rumour makers. Their rumours may not be based on accurate figures, which may have been the point that the noble and learned Lord, Lord Wallace of Tankerness, was making the last time that we spoke. However, the fact is that the rumours and the perception are there. The Government really have to face up to the fact that to pile on more cumulative items on to this package of things which are fuelling that perception is very ill advised. I hope that the Minister will explain to us why he believes it necessary to do that.

Baroness Benjamin (Liberal Democrat)

My Lords, I support Amendment 49, moved by the noble Lord, Lord Hannay, and I agree with everything that has been said so far in support of that amendment.

I would like to highlight the views of the students’ guild at Exeter University, where I am chancellor and so I express an interest. The students’ guild has raised concerns on behalf of the international students at the university, with whom it has had several meetings. The most worrying thing to come out of this meeting is about the proposal that international students must prove to potential landlords that they have the right to be in the UK before they are allowed to secure accommodation. As many international students are required to secure accommodation before they come to the UK, this poses an unnecessary and potentially impossible burden for them as they will not be able to present the documentation needed. The students’ guild also feels that this check will force many to endure extra expense, as letting agents charge for the process, yet the Government gain no further value in this monitoring. In addition, it feels that landlords may turn anyone who they perceive to be from international backgrounds away from their accommodation because they do not understand how to check for immigration status and do not want to risk the £3,000 fine.

A recent NUS survey of more than 3,000 international students found that 28% felt that their international background already had a negative impact on their ability to find accommodation, and they fear that the Bill will make it even more difficult. This is not a workable policy and international students will have to pay the price for the UK Government’s attempt to implement it.

Exeter University prides itself on doing a thorough check on international students when it comes to securing accommodation for them and strongly feels that it is best placed to do so in a controlled and responsible manner. The students’ guild believes that landlord checks, together with the proposed healthcare levy and the loss of appeal rights, will further undermine the attractiveness of the UK as a study destination, particularly after the removal of post-study work visas. International students bring not only economic benefits to the UK but diversity and a global perspective to Exeter. They are an integral and celebrated part of Exeter’s experience and the guild is very concerned at the damage, measurable and immeasurable, that the Bill will cause to students’ experience on its campus.

On graduation days at Exeter, I embrace graduates from all corners of the world. It is like being at the United Nations. I tell them to go out and change the world, to make a difference, and they all promise to do so but they also express their love and allegiance for Exeter and to the UK. I would hate to see this pledge disappear and to see that devotion and loyalty to our country damaged in any way, so I sincerely hope that the Government will reconsider these proposals. I so look forward to hearing the Minister’s response on these matters.

Lord Marlesford (Conservative)

My Lords, I would like to speak, as briefly as I do passionately, in support of the noble Lord, Lord Hannay. My noble friend the Minister is well aware that I have always been enthusiastic about the proper, effective and efficient control of our borders in the national interest. Indeed, there are a number of areas in respect of national security where there is much more that can be done. I hope to introduce some amendments on Report to fill some of those gaps.

However, it is very sad that, when a government department is seeking to produce policies to deal with sensitive issues and there is a choice between being subtle and acting in a crass manner, all too often the crass seems to win. I am convinced that the overwhelming empirical evidence is that students who come to this country, whether they be at schools, universities, business colleges or military establishments such as Sandhurst, Cranwell or the Royal College of Defence Studies, contribute hugely to their own future as well as ours. One of the features of this relatively small country is the way that we act as a catalyst in world chemistry. We are a catalyst for tolerance, for the rule of law, for decency and for the cultural and political aspects of what we call civilisation. I would never be able to vote for something that reduces our country in respect of being that catalyst.

Earl of Sandwich (Crossbench)

My Lords, the Minister will not be surprised that I wanted to have a last word about colleges. We have many illustrious representatives of the universities but every time that we have this debate I think, “Why has no one mentioned the colleges?”. The proportion of foreign students in our colleges and other institutions is quite a bit higher. The noble Lord, Lord Hannay, refers in the amendment to “all institutions”, so they are covered, but the noble Baroness,

Lady Williams, made an important point about the sustaining of courses: if you do not have enough students, you do not have enough courses. This is happening right now. I know personally of a college in London—I am not a representative of it—that is losing staff and courses as fast as it is losing its students. I think that last year they had an 80% loss, which they are now trying to make back up again. I remind the Minister of my interest there.

Lord Bourne of Aberystwyth (Conservative)

My Lords, in opposing the amendment, I certainly do not do so in any spirit of being against the importance that higher education students have to this country; clearly, they are important. We have had some very passionate speeches, with which I find myself much in agreement, about the danger of speculation, rumour and perception. However, it is important that we keep the changes that are put forward in perspective, and that we look at some of the facts as well. I put down some Written Questions and had back some answers based on figures from the Office for National Statistics about student numbers from some of our important markets. The latest figures available show significant rises from China, Hong Kong and Malaysia. Admittedly there are falls from India, but that is against a background of a fall in the value of the rupee, and other countries, such as Australia, have also noticed a fall in Indian student numbers. One or two noble Lords suggested that already a drop in student numbers was feeding through. That is certainly not true of many of our important markets.

Yes, perception is important, as are overseas students, but I would like to say something specific about the health charge, because I do not think that the amount has been addressed directly. The noble Lord, Lord Patel, suggested that we were suggesting that students were making calls on the health service disproportionately. I do not think that that is being suggested. I accept that that is not remotely the case.

Lord Patel (Crossbench)

Just to clarify, my Lords, I was suggesting that students do not make disproportionate claims on the NHS.

Lord Bourne of Aberystwyth (Conservative)

That is certainly true but of course the charge is lower than the charge for other people, so that is going to be recognised in the proposal. The amount of the charge, at £150 per year, is significantly less than the average student would cost the health service, and I accept that that is as it should be. I think that the charge is actually lower than for other people. We need to get in perspective just how much the charge is: it is £150. I am not minimising that but, if you look at it spread over a year, and many of the students at a higher level will be here for a full year, you see that it is the cost of a Sunday newspaper each week throughout the year. It is important to keep that in perspective.

I look at the charge in terms of whether it is fair. I know what the noble Baroness, Lady Warwick, suggested, but we have to look at it in the round against the other changes. Compared with the other proposals, is it not fair that students should pay a charge, a levy, as well? I

think that it is, against the background of the Bill and indeed of the other people in this country who have contributed.

Lord Hannay of Chiswick (Crossbench)

I am most grateful to the noble Lord for giving way. I was a bit puzzled by his saying that the charge is spread over a year. The whole point about this charge is that it is not spread over a year but is paid up front. Moreover, if you ask for a visa for the whole of your study period, the charge is tripled and up front.

Lord Bourne of Aberystwyth (Conservative)

I was specifically addressing the health charge. When I say that it is spread over the year, I mean that the benefits are spread over a whole year, and many students are here for a whole year. I appreciate that it is paid as a lump sum. On the issue of fairness, I think that it is fair, looked at across the broad sweep of the changes that are being proposed.

The other issue is whether the charge is competitive. Some noble Lords have cited the position in the United States. As I understand it, they require insurance, and the cost of that is at a much higher level. The USA is the chief market for students; more students go there, as has rightly been said, than elsewhere. I am not suggesting that we slavishly follow the USA, but, if we are going to make the point about competition, we have to look at other states and how they handle this issue. Many of them have a charge or require insurance. We have to look at it globally in that way.

Lord Clement-Jones (Liberal Democrat)

My Lords, I suspect that we are rapidly moving into territory where everything has been said but not everyone has said it. Given that, I wanted to respond not only to the noble Lord, Lord Bourne, but also to my noble and learned friend Lord Wallace of Tankerness, who responded a week ago to Amendment 26 from the noble Lord, Lord Hannay, and my noble friend Lady Hamwee’s Amendment 80 to reassure us about the impact of the Bill. The fact is, though, that the Bill exacerbates the impact of previous policies towards overseas students. The noble Lord, Lord Hannay, and many other noble Lords have talked about the contribution to the UK economy and to soft power, while my noble friend Lord Phillips has talked about personal ties.

However, the hard figures already show a drop in overseas student numbers. My noble and learned friend Lord Wallace of Tankerness, and indeed the noble Lord, Lord Bourne, today, have taken comfort from the increase in Chinese students in particular in recent years, compared to Australia and France. If the riposte of the noble Baroness, Lady Warwick, and my noble friend Lady Williams was not enough, the recent British Council document Education in East Asia—by the Numbers (Making Sense of the Slowdown in Outbound Student Mobility from China) shows a global slowdown in outbound Chinese student numbers. This demonstrates that we cannot stand still and that we need to increase our share of Chinese students if the numbers are not to fall. That is the very latest document from the British Council.

We cannot take the risk of alienating aspiring students from China and other emerging markets. My noble and learned friend Lord Wallace said:

“We are still an attractive proposition for people wishing to come and study”—[Official Report, 3/3/14; col. 1192]—

but he himself admitted to us that a good story is not being told and it cannot be told with the Bill as it is. No one quarrels with measures designed to prevent abuse of the immigration system, but if we do not redress the impression—indeed, as the noble and learned Lord, Lord Hope, said, the perception—that students are not welcome, we will see more severe reductions in student numbers. What better way to counter that impression than to totally exempt overseas students from the Bill?

Lord Woolf (Crossbench)

My Lords, the noble Lord, Lord Clement-Jones, indicated that nearly everything that people wanted to say has already been said. I am only too conscious that that is the truth, because the second of the two short points that I wanted to make has just been made by the noble Lord himself.

The reason why I think the amendment should be welcomed by the Government is that it is a signal that we do want students. I know a bit about the university world because for a time I was chairman of the council and pro-chancellor of London University and then chairman of the council of University College London. What is needed is something to point to so as to destroy the perception, which is undoubtedly increasing, that this country does not want students. If we made this exemption, when those who are attached to universities travelled the world to recruit students, as they do, they could respond to that perception by saying, “This is nonsense. Look at what we did in the Immigration Bill”—which by then would be an Act of Parliament—“and you can see that it takes a step which positively is favourable for students”. That would be a very important message.

I want to make a point that I do not think has yet been mentioned. Although I agree with everything that the noble and learned Lord, Lord Hope, has said, I fear that he was probably more economical with his time than I am being with mine and did not want to mention it, but if you travel to many parts of the world, as the noble and learned Lord and I have done, you find that in most countries you visit there are substantial numbers of former law students who are struggling to establish the rule of law there. The interest in the rule of law around the globe is growing all the time, and its importance in international affairs is being constantly demonstrated. The Statement we had today emphasised the importance of the rule of law. Students who have received a grounding in law in this country go back to their countries and are the champions of furthering the rule of law. So, again, it is right to say that we want to be able to make ourselves as competitive as possible in that regard.

Lord Stevenson of Balmacara (Labour)

What an excellent debate this has been, my Lords. I have counted 16 speakers on one side, and one on the other. I congratulate the noble Lord, Lord Bourne, on putting his head above the parapet. Although I think he picked up

some of the arguments, I did not think his heart was entirely in it, but he put up a brave show. There was lots of vigorous nodding on the Front Bench, but all to no avail.

This amendment seeks to exempt bona fide overseas student from the provisions relating primarily to housing and health charges because I do not think, despite the fact that the amendment says so, that bona fide students are caught by the measures on bank accounts and driving licences, but I would be grateful if the Minister would confirm that when he responds.

This amendment has received considerable support from around the House. We should not really be surprised at that. I took part in a debate about nine months ago that was led by the noble Lord, Lord MacGregor, whose committee had reported on just this point. That debate was again virtually unanimous in recommending that the Government’s then policies should be reviewed carefully to ensure that they supported the arrival and proper education of students from overseas, but here we are.

There seem to be two main thrusts to the arguments which have been made by noble Lords today: first, that this series of measures is one of a number of hurdles and burdens that, taken together, represent an attack on our universities, making it more difficult for students from overseas to study here and thereby endangering one of our most successful exports; and secondly, that the measures are unworkable, possibly discriminatory and overly bureaucratic, will not achieve what they set out to do and should be withdrawn. We have a great deal of sympathy with both those arguments, and we will be listening carefully to what the Minister has to say on the questions that have been raised this afternoon, and I am certain that we will be returning to this matter on Report.

At Second Reading, I referred to the recent BIS publication International Education: Global Growth and Prosperity. Its introduction states:

“There are few sectors of the UK economy with the capacity to grow and generate export earnings as impressive as education”.

It goes on:

“Overseas students who come to Britain to study make a huge contribution to our economy”.

As we have heard, the most recent estimates are that overseas students paid about £10.2 billion net in tuition fees and living expenses in the UK. They boost the local economy where they study as well as enhancing our cultural life and broadening the educational experience of the UK students they study alongside.

This BIS report makes it clear that attracting international students is not an easy matter and that we have many competitors. If the numbers of international students in higher education is to stay as it is or even to grow, there are a number of things we must do right. The report picks out that,

“we must show that the UK values international students, will provide a warm welcome and support while they are here and will keep in touch after they go home".

The questions for the Minister when he comes to reply are, first, whether the measures proposed in the Bill support the assertion made by the Government that the UK is open for international students and that they are welcome to come here; and secondly whether the measures in this Bill help, not hinder, both

that general supposition and the reality faced by overseas students in gaining a visa and making a success of their studies here.

There are a number of other questions that I hope the Minister will respond to. He has a good record, not of answering across the Dispatch Box, but at least in writing to us, and I hope he will pick up the various points that have been made. As I was listening, the questions that struck me included: has the department an assessment of the continuing viability of certain STEM courses in particular, of courses offered in higher education in general, and of certain institutions as a result of the decline in student numbers that we think will happen if these measures are introduced? This was spoken to very positively by the noble Baroness, Lady Williams, and others. The noble Lord, Lord Cormack, wanted to know more about the impact on soft power. Have the Government made an assessment of the reduction of soft power as a result of these measures? Has the Minister talked to the CBI about its call for changes in the way in which the visa arrangements operate for various important aspects of supporting the economy? Has the department made an assessment of competitor countries, such as Canada and Australia, and their measures for supporting overseas students? If it has done that, will the Minister put a copy of the evidence in the Library so that we can look at it, because it would make interesting reading? What assessment has the department made of the point made by the noble Lord, Lord Phillips, about personal contact? That is something that we all have experience of and recognise. He said that we cannot measure it in economic terms, and he may be right, but I think you probably could value it. It is certainly important in terms of the world that we live in.

In the commentary circulated after Second Reading, the Minister did not really engage with the issues that have been raised this afternoon. He wafted away rather airily some of the points made by several speakers and did not feel that the discouragement of international students would affect the way they choose the UK, although we have heard differently today. I think the view around the Committee is that these additional procedures and costs will create the impression that it is harder to secure a visa to study in the UK than it is in other countries. Even if that is not the case, it will add significantly to the up-front visa cost compared to our competitors. What evidence is there that the Home Office recognises the risks it is taking in relation to our competitiveness in this market?

On the detailed points, residential accommodation has attracted the most attention. There is no suggestion from what we have read from the Government that they have any interest in how this system must look to prospective students. As we have heard, international students already face difficulties in securing accommodation and are often made to pay large fees and advance rent payments. As the noble Lord, Lord Patel, reminded us, this Bill may result in landlords refusing even to consider international students as tenants or charging higher rents or additional fees to cover the extra hassle and administration costs. Does the Minister not agree that this clause could cause considerable anxiety and could add to the perception that the UK is unwelcoming?

In the Minister’s commentary, he said:

“I do not think the measures would discourage private landlords from letting to international students”,

because,

“landlords in our university towns and cities are familiar with their clientele and know that they represent a sound and stable choice of tenant for their properties, in the main for at least an academic year if not longer”.

So that is okay then. To his credit, the Minister conceded in his commentary that certain categories of student accommodation would be exempted from the landlord’s provisions and said,

“we will look closely at the rationale for doing so when we consider this in Committee”.

I look forward to his further thoughts on this important point this evening.

Some noble Lords raised the position of international students who need to arrange accommodation in advance of their arrival. In the commentary, the Minister said:

“The Government intends to make regulations under the Bill which will provide for overseas students to be able to arrange accommodation in advance of taking up their studies in the UK, and for such tenancies to be entered into conditional on the production of the relevant visa or residence permit when the student arrives and takes up residence”.

It would be useful if we can have further information on that because it is clearly a very important point.

Given that overseas students with the requisite visa are often offered accommodation owned or administered by the university which is offering them a place, why does the Bill not recognise this and simply exempt all such university-provided accommodation, including the currently exempted halls of residence?

A number of noble Lords expressed concerns about the proposed introduction of the NHS charges. The main argument seems to be that international students and staff already make a significant contribution to the UK economy. International students bring in over £10 billion a year, while international academic staff pay taxes and national insurance while they are here.

The Government’s plans are for a health surcharge for access to NHS services of about £200 in general and £150 a year for students. As the noble Earl, Lord Howe, said in his letter to all noble Lords, over a working life, the payment of taxes and NI contributions usually provides a contribution to the NHS but new arrivals have not yet done so, and are not likely to be able to build up the long-term commitment and contribution that those permanently settled here have made. We do not object to the principle, since it is legitimate for those who are coming to partake in the system to make a contribution, particularly when the NHS is under pressure, but it is legitimate to press the Minister on whether a one-off cost, payable in full at the time that the visa is obtained, is actually in the best interests of our commitment to overseas students. That is the question.

A couple of other questions were raised during the debate, and I shall mention them for completeness. Has the department done any research to test whether this new system will discourage undergraduate and postgraduate applications and, if it has, will the Minister place a copy in the Library so that we can look at it? As the noble and learned Lord, Lord Hope, said,

given that the Bill deals mainly with illegal immigrants, not those with leave to be present, why is Clause 33 really necessary? The point here is that the students are already covered by the visa application. Surely that can be considered sufficient on this point. Can the Minister when he responds, or separately in writing, give us the argument for the £50 discount on students? It is £200 for most people but £150 for students. If there are reasons for that, I would be interested to know what the economic argument would be, given the disproportionate use that is made of the NHS by students. Fifty pounds seems an odd figure to have chosen.

Fees, charges and living costs already make the UK a relatively expensive destination for study. As others have said, the Government cannot on the one hand impose new procedures and costs for prospective overseas students and on the other blandly claim that we are “open for business”. As the noble Lord, Lord Tugendhat, said, it would be wrong to think of this amendment as special pleading for the students. This is actually about our standing in the world, our history and our culture, and about our economy going forward.

Taken as a whole, the requirements for students who wish to study in the UK are in many cases much more stringent than in our competitor countries, particularly when you take into account language requirements, academic progression, limits on study time, the ability to bring in dependants and police registration. These new challenges will have an effect. Do the additional cost and hassle, and the impression that we are tightening up, justify the risk? Perceptions, as the noble Lord, Lord Cormack, reminded us, are important in this matter. Are we, as the noble Baroness, Lady Williams, said, killing the golden goose?

I look forward to hearing the Minister’s response. However, like the noble Lord, Lord Hannay, I believe that we will need to return to this issue on Report.

Lord Taylor of Holbeach (Conservative)

Well, my Lords, this subject certainly engenders good and powerful debates. If arguments are repeated, perhaps noble Lords feel that they are worth repeating. I have to repeat my arguments. I am afraid that the Government cannot accept the amendment, but perhaps I can help noble Lords by telling them why that is, and why we feel that, despite our policy of welcoming the brightest and the best with no limit on numbers, students are an important part of any strategy which deals with immigration.

I start with that strategy. The noble Baroness, Lady Warwick of Undercliffe, challenged me on the whole business of net migration. Reaching the tens of thousands remains the Government’s objective. We chose a net migration target because we want to control immigration due to its effects on social cohesion, infrastructure and public services. These arguments are frequently discussed in other areas, but they form the background to why this legislation has come forward. Jobs and wages are affected by migration but, when it comes to students, there is no cap on numbers—I repeat, no cap on numbers—of genuine students who want to come here. They are welcome. Those who have the right qualifications, sufficient funds to cover their fees and maintenance costs and a good level of English can study here, and there is no limit on numbers. Our

reforms, to tackle the widespread abuse that was occurring in the system we inherited, have favoured our world-class universities.

Those reforms are working. The number of issued student visas has dropped by around 27% from the high in 2009, while visa applications from university students were up 7% in the year ending December 2013 and applications from students going to Russell group universities were up by 11%. Higher education statistics show that numbers of international students in our universities held steady in 2012-13, with a small decline of 1%—but numbers of UK and EU students have fallen by more than that. It is true that there has been a decline in the number of Indian students at our universities, but this followed a period of soaring numbers and, by contrast, there has been strong growth in numbers of students from China, Malaysia and Hong Kong in 2012-13.

A British Council survey published in 2012-13, of more than 10,000 young people across India, showed that the UK was their most favoured destination, chosen by 21% of respondents. Young Indians put British universities first for postgraduate courses. As my noble friend Lord Bourne of Aberystwyth said, we are not losing out to our competitors. The UK is the second destination of choice for university study, with only the USA attracting more international students. Numbers of Indian students going to universities in our competitor countries have also fallen.

The noble Lord, Lord Stevenson, spoke of visa costs; we will be discussing those when we discuss the fees orders. We do not think that the cost of a student visa deters students from coming here. It is around average when compared to our competitors and represents a small proportion of the overall cost of studying here. The addition of the NHS surcharge will not, in our view, alter that balance. I will address specifically, giving graphic examples, some of the costs that can be incurred by students when they are here when we debate amendments that are specifically about those surcharges.

In considering the amendment, I invite noble Lords to reflect upon its practical effect. The noble and learned Lord, Lord Hope of Craighead, sought to know why students seeking accommodation, bank accounts, driving licences and access to the NHS were included in the Bill. They are already required, either under the current law or current practice, to prove their identity. There is no extension, and the noble Lord, Lord Stevenson, acknowledged this in his speech. Additionally, when applying for a driving licence or seeking hospital treatment, they already must demonstrate their immigration status in the UK. Genuine students do this now by presenting their biometric residence permit or their passport and visa documentation. That is all that is needed for an immigration check, but it is important and that is why they are included. Of course, they are not the target, but the people who do not possess that identification are. I hope that the noble and learned Lord can therefore understand why it is important that we use this weapon in addressing illegal immigration.

I know that a number of noble Lords will want to talk about landlord checks. Schedule 3 already provides

an exemption for specific types of student accommodation. As I have previously indicated, we have listened carefully to concerns raised by the higher education sector about the adequacy of this exemption, and we will return to this later in the debate. I do not wish to spoil the denouement, but the next group of amendments deals specifically with landlord checks and it would be more appropriate to deal with those there.

I cannot repeat sufficiently that the Government take every opportunity to communicate the message that students will find a warm welcome in the UK, even if it takes a debate of this type. I can say it again: there is a warm welcome for students in this country. I hope that noble Lords will take that message on board and that Universities UK will be reinforced in its argument in promoting higher education in this country.

I mentioned the Indian situation: young Indians put British universities first for taught postgraduate courses. The UK was also top with the United States as a quality destination for research doctorates and undergraduate degrees. We are a premier centre for higher education in the world. As I said at Second Reading, we have an excellent offer for university students. There is no limit on the number of students who can come. University students can work here, and postgraduates can bring dependants. We have ensured that there are good opportunities for graduates to stay in skilled work or to set up or develop a business.

The indications are that that approach has been successful, and we continue to attract students to study at our world-class universities. Visa applications were up by 7%, and more than three-quarters of all student visa applications are for studies at a higher education institution. The most recent higher education statistics show that the number of international students studying at Russell group universities rose by 5% in 2012-13 and that the number of those enrolling rose by 4% in the same year. A comparison of the most recent UK higher education statistics with those of other countries shows that the UK continues to attract a good share of the international student market. For the year to September 2013, the UK issued 1,873 more visas to Indian students and 33,011 more to Chinese students than Australia.

The UK is the second most popular destination, as I said before, and student numbers in Australia and France have dropped at a similar rate to the UK. Although Canada has experienced strong growth, it attracts only a quarter of the number of international students who come to the UK. There was strong growth in students coming to our universities from China, up by 6%, Malaysia, up by 3%, and Hong Kong, up by 15%, which shows that the UK still succeeds in attracting high-quality students.

Calls to exclude students from the net migration figures miss a basic point: there is no cap on the numbers. Changing the way we measure migration would not make any difference to our student migration policy. The United Nations definition of net migration includes all migrants who change their place of residence for 12 months or more. That acknowledges that all migrants, students included, have an impact on communities, services and infrastructure for the time they are here.

All our competitors—Australia, Canada and the USA—include students in their net migration figures. I should also say that this is not a perfect world. The noble and learned Lord, Lord Hope of Craighead, talked about the justification for students and asked why we need to have any controls on them at all. It is not the case that all students leave. In the year to September 2013, while 124,000 non-EU students came to Britain planning to study for over a year, only 49,000 left the country. I hope that noble Lords will just think on those figures and then perhaps put themselves into the position of the Home Office, which seeks to make sure that we have legal migration into this country.

Lord Hope of Craighead (Judge)

Is the noble Lord suggesting that the unaccounted-for balance is made up of overstayers without leave to remain or people who, having studied here, are given permission to remain for longer than was originally envisaged?

Lord Taylor of Holbeach (Conservative)

I think that the noble and learned Lord will understand that I suggest both. The graduate course has been a success—we are increasing the numbers of students who are staying on for postgraduate work—and the business entrepreneur course is equally successful. There will be some, but there is unfortunately still some evidence that the tier 4 student migration group—it is a special route; it is not the same as everything else; students are treated as a special case—is being misused in some cases. That is why it is important that we have checks in place to make sure that that does not occur.

My noble friend Lady Williams suggested that the exceptional talent route has dismally failed. We do not accept that. We recognise that the number of visas that are taken up under that is low, but it was always thought that that would be the case. However, we are working with all the competent bodies—the Royal Society, the Royal Academy of Engineering, the British Academy and the Arts Council—to improve the process so that the visa process payment will not be paid until the competent body has endorsed the application. We are working with these bodies to ensure that the scheme is a success.

In answer to my noble friend Lady Benjamin, it is not the case that international students are unable to stay on and work. The post-study work route, which was much abused, which allowed all students to stay on and look for work, has been replaced by the graduate level job scheme, and we have made a success of that.

The noble Lord, Lord Stevenson, asked whether the cost of the surcharge in relation to the cost of studying was competitive with other countries. Yes, it was addressed in our published impact assessment, where the noble Lord will find the answers to a number of the questions he asked. However, I will make a point of writing to him with a full answer to all the various questions, some of which lie outside the Home Office’s own immediate area of engagement.

I understand that people want to make sure that the Government do not do anything that damages the reputation of this country as a centre of intellectual and academic excellence. I accept that. Speaking as a

member of the Government, I remind noble Lords that we have a responsibility to seek to control immigration. All the measures in the Bill are about methods of making sure that people who are in this country are here legally.

There is no difference between us on the benefits that overseas students bring to this country. That is why there is no limit on numbers, and why I will continue to seek to reassure noble Lords on the Bill. I hope that we will have a chance to discuss it before we come back to this issue on Report. Meanwhile, I hope that the noble Lord, Lord Hannay, will withdraw his amendment.

Lord Hannay of Chiswick (Crossbench)

My Lords, I thank all noble Lords who participated in a very impressive debate. I thank in particular my three co-sponsors of this amendment, the noble Baronesses, Lady Williams and Lady Warwick, and the noble Lord, Lord Tugendhat, who so eloquently set out the case which I tried to introduce. There were many other remarkable contributions to this debate, so I will not try to pick out any others.

In a previous debate on this subject—we are getting quite used to having debates on this particular subject—I likened the Minister to St Sebastian, filled with arrows but still smiling. The best pictures of St Sebastian always show him smiling despite the number of arrows that have gone through him. The Minister always handles this with great good temper. I was very pleased on this occasion that he had one supporter, as that removed the sense that we were indulging in an unfair debate.

I hope that we can stop having a war of statistics. The Minister came back again to the point about the UN figures. No one is contesting that the Government will continue to submit to the UN figures in the way that the UN has asked for—that is to say, all people who stay for a year or more. But there is not the slightest difficulty about disaggregating those figures and putting them together again before sending them into the UN. If the Government wanted to, they could leave students out of this Bill completely but, at the same time, continue to make the same returns. I hope that we do not have to come back to that. I think that the war on statistics has gone about as far as it can go. Frankly, citing several times the enormous enthusiasm for Indian students to come to this country sits a little oddly alongside a 49% drop in the past two years. If that is enthusiasm, I do not think we can afford many more victories like that.

The one thing that I would like to pick out was the very perceptive statement from the noble and learned Lord, Lord Woolf, that if we really wanted to show that we want the brightest and best to come without any limit on numbers, we should pass this amendment, because that would send a message of complete clarity to all the people who may be hesitating and thinking that we are rather unwelcoming.

The Minister spoke about the Government’s overall aim to get net migration down to the tens of thousands—a policy that does not always seem to be shared by all

members of the Government, but I know that it is the Government’s policy. He quoted that and seemed not to understand the contradiction between saying that and saying that there was no limit on students coming here. Students are 60% of that net figure. How on earth are you going to get down from 230,000 or 240,000 to below 100,000 without cutting back on students? The answer is that you are not. You either believe in one part of the policy or you believe in the other, but if you believe in both you are going to do the splits.

Before we get to Report, I hope that the Government will take into consideration all the views that have been expressed around the House. There is an easier way out of this, which is in the national interest, and I just hope that the Government will take it. Meanwhile, I beg leave to withdraw the amendment.

Amendment 49 withdrawn.

Earl Attlee (Conservative)

My Lords, I beg to move that the House do now adjourn—I mean, that the House be resumed.

House resumed.