It is not that unreasonable for the government to find ways to reduce the cost to the NHS of treating people who are new to this country, and haven’t contributed to the health budget. But the way Health Minister John Reid has gone about it is to rush in an ill-considered panic measure, which may stop the odd foreign businessman booking himself in for a kidney transplant, but will also ensure we will see in the UK something we have so far avoided: a ‘third world in the first’ of diseased, destitute and desperate people with Aids who aren’t entitled to anything but emergency care.
Previously, if ‘illegals’ managed to hang on in this country for more than 12 months, they could get full NHS care. The new measure, which requires no parliamentary debate, removes their right to any NHS care, ever, apart from that provided by A&E departments.
The government wants to ensure that the only people staying here will be successful asylum seekers, foreign students, people on work permits, and people seeking permanent citizenship. The assumption seems to be that if you make life difficult enough for the rest, they will go back where they came from. Will they heck.
The UK is now the wealthiest large European country. Our money exerts an irresistible gravitational pull. The history of the USA, among other places, teaches us that people are prepared to put up with unimaginable hardship in order to make better lives for themselves.
The government has already removed any entitlement to benefits and housing for the same people. They didn’t go home. Instead we had a new class of homeless sleeping in shop doorways.
What will happen now will be that the ones who have HIV will be further discouraged from seeking HIV tests and treatment. Like people excluded from health insurance in the USA, they will only go to hospitals when they are virtually dying, and disappear again once patched up. Doctors attempting to give more than minimal care will be forced to lie to their managers, and possibly be sacked, in order to save lives.
There is another way. What that beacon of compassionate liberalism George W Bush has proposed, recognising that US agriculture would collapse without the input of illegal immigrants, is that anyone who can prove they are working gets temporary guest-worker status, renewable once a year. They therefore become taxpayers and contribute to the official, as well as the unofficial, economy. The cost of treating people with HIV would still exceed what they pay in tax, but a similar measure here would at least give ‘illegals’ who are working a measure of dignity, independence and status, and allow our doctors to carry on saving their lives.
Talking of the cost of HIV drugs, Abbott Laboratories has recently caused outrage in the USA by a sudden sixfold increase in the price of its protease inhibitor (PI) drug Norvir - ritonavir. At present this is just in the USA, but treatment experts are convinced the EU price will follow suit eventually.
Abbott is saying that it originally priced Norvir to be dosed as the sole PI in a regime, which means taking six capsules twice a day. It is now almost exclusively used to boost the level of other PIs, meaning two to four caps a day instead of 12. So poor old Abbott is only making 20 per cent of the intended profit. But as it is, it’s still one of the most widely used HIV drugs.
Abbott will have to work a lot harder to convince activists and doctors that it isn’t doing this in order to price other companies’ ritonavir-boosted PIs off the market in favour of their own Kaletra.
This is an own goal for Abbott and is incredibly short-sighted. There is now
relentless pressure in most countries, not just developing ones, to reduce
the cost of HIV treatment. Drug companies must get the message that HIV is
now a common, treatable, global disease; charging Rolls-Royce prices for antiretrovirals
when they should be pricing them like bicycles simply isn’t sustainable.
Gus Cairns, Editor in Chief
