Bearly Newsworthy: No, Lee. 'Health Tourism' is Not the Problem
There is a more than a whiff of xenophobia, wild misdirection and political pantomime at the heart of Reform UK's proposals on the NHS, writes the Bear
If there was ever a man who doesn’t want to miss the opportunity to blame a systemic, foundational issue on foreigners, it’s our “30p” Lee.
This week in Parliament, Lee Anderson – Reform UK MP for Ashfield – offered a novel solution to the NHS backlog. Not funding, not workforce, not capacity, not infrastructure. No, Anderson suggested we could solve it by tackling “health tourism.”
Now, let’s set aside, for a moment, the deeply uncomfortable whiff of xenophobic scapegoating that seems to follow Anderson around like a flatulent Labrador and explore reality.
The most glaring and imminent issue with his “idea” is that health tourism, as a concept, is wildly misunderstood – especially by the people most obsessed with it. It’s a favourite talking point of certain corners of the right-wing press, conjuring images of cunning foreigners swanning into A&E, demanding free nose jobs and disappearing into the mist before the invoice arrives. The reality is both far less dramatic and far less significant.
The Real Figures
Let’s start with some numbers. The Department of Health and Social Care’s own figures estimate that health tourism – that is, people travelling to the UK specifically to obtain NHS treatment they’re not entitled to – costs the NHS around £100 million a year. That’s just about 0.3% of the NHS budget. To put that in context: it’s about the cost of a handful of senior management restructures or, say, two or three of Matt Hancock’s many pandemic brainwaves.
And even that figure is contentious, because it often gets muddled up with perfectly legitimate NHS charges for overseas visitors. Emergency treatment is free for everyone, yes – because we are a civilised country – but anything beyond that? That’s chargeable.
In fact, if you’re not ordinarily resident in the UK (and haven’t paid the requisite £1,035 a year immigration health surcharge) and don’t have an exemption, the NHS charges you 150% of the national tariff. That’s right – the very same health tourists we’re meant to be panicking about are actually a source of income. And before anyone gets misty-eyed about the “burden on taxpayers”, those treatments are typically pre-paid or backed by travel insurance.
The real health tourism, if you want to talk about it seriously, is happening in the private sector – and it goes both ways. British people fly to Turkey for dental work and cosmetic procedures. Wealthy overseas patients pay top rates to be treated privately in London. None of this is clogging up the NHS, because it doesn’t go anywhere near it.
So when Anderson stands in the Commons and suggests that health tourism is to blame for our waiting lists, what he’s really doing is reaching for the oldest trick in the populist playbook: misdirection.
The problem isn’t underinvestment, it’s the foreigners.
It’s not a broken social care system, it’s the foreigners.
It’s not years of policy failure and workforce shortages, it’s the bloke with a funny accent and a gammy leg.
This isn’t just lazy politics – it’s deeply unserious. Because if you want to talk seriously about the NHS backlog, you have to look at what’s actually driving it. And as you may have gathered so far, no, it’s not a handful of health tourists.
The Real Factors at Play
There are, broadly speaking, five major factors at play.
First, there’s workforce – or rather the lack thereof. Years of pay erosion, burnout, Brexit-driven departures, and poor planning have left us tens of thousands of clinicians short. You can’t run a health service without enough people to staff it.
Second, there’s social care. Or rather, the lack of integration with it. Patients who are medically fit can’t be discharged because there’s nowhere for them to go – and that clogs up beds, delays admissions, and slows down everything.
Third, there’s capacity. The NHS simply doesn’t have enough beds, operating theatres, diagnostics or infrastructure to handle the level of demand it’s under. That’s a direct result of political choices over the past two decades to squeeze budgets and cut corners.
Fourth, we have the pandemic backlog. Covid-19 didn’t just overwhelm the NHS – it forced the suspension of routine services, created a tidal wave of delayed diagnoses, and sent elective care spiralling. Recovery takes time, planning, and – yes – money.
Fifth, and perhaps most critically, there’s public health. The UK has some of the worst health outcomes in Western Europe. Chronic conditions are on the rise. Obesity, diabetes, heart disease – all on an upward curve. And that’s not just bad luck; it’s the result of neglecting prevention, hollowing out public health budgets, and failing to tackle the wider determinants of health.
So no, Lee. It’s not the Chinese person who had a heart attack while on holiday that’s driving this crisis. It’s a system built on sand, eroded by successive Governments and now being used as a stage prop by grifters and demagogues who couldn’t tell the difference between an integrated care system and a Greggs sausage roll.
Insurance Nonsense
And yet, true to form, Reform UK isn’t done. In addition to blaming health tourists, they’re also proposing a shift to an insurance-based healthcare model. The thinking seems to be that if we just make everyone pay directly for healthcare, everything will somehow magically improve.
This is, to put it mildly, nonsense.
The UK already has a form of universal health insurance. It’s called the NHS. Funded mainly through taxation and partly by National Insurance, it pools risk across the entire population – exactly what insurance is meant to do. Reform UK’s plan, vague as it is, would likely jack up costs, restrict access, and import the worst features of the American healthcare system.
I say that with the benefit (and frustration) of having worked in both.
The US spends twice what we do per capita and still has worse outcomes on multiple measures. Insurance doesn’t equal efficiency – it equals complexity, gatekeeping, and inequity. If you want a two-tier system where wealth determines survival, then sure, take Reform’s hand and follow them into the fog. But don’t pretend it’s a solution. It’s a fantasy.
And that, in the end, is what Reform UK traffic in: fantasy. Like their obsession with flags, it’s politics as pantomime. Big gestures, loud rhetoric, simple stories – but absolutely no workable policy behind it. Just blame, grievance, and a lot of shouting about things that feel important but aren’t.
And the most important message out of this is that none of it will fix the NHS. None of Reform’s ideas will reduce waiting lists. None of it will solve the workforce crisis or improve access or shorten that anxious wait for a cancer diagnosis.
Because Reform UK isn’t about reform. It’s about resentment. It’s about telling angry people that their lives would be better if only someone else had less. It’s not medicine – it’s snake oil. And people like Anderson aren’t offering cures, they’re just selling the illusion of one.
Absolutely right. What the NHS needs is less meddling, fewer political “bright ideas” and more funding. The NHS has one of the higher multiplier effects where every £ spent by government into the NHS produces more ££’s spent into local communities by all those extra doctors, nurses, porters, cleaners etc. (assuming they can still be trained and recruited). A better health service also means people get back to living their lives again more quickly, in employment, retirement or whatever and spending money again.
Incidentally, taxes and NI don’t pay for the NHS, or anything else. The government creates the money through the BoE. See Richard Murphy, Stephanie Kelton, Scotonomics and others on MMT.