UK relationship 'at risk' if new arrivals require health insurance

More than two years ago the States backed a proposal which it hoped could save taxpayers money by excluding newcomers from States-funded secondary health care and instead directing them into a commercial compulsory health insurance.

But the Policy & Resources Committee has warned that such a scheme would have numerous risks and wants to be freed of the States’ direction to take the work forward.

‘The committee has identified risks to recruitment and to the islands’ reciprocity agreements with the UK, which it considers outweigh any financial benefits associated with restricting secondary care for new arrivals... including arrivals over pension age,’ said P&R.

P&R had been directed to look into a scheme originated as an amendment from by Deputies Al Brouard and Peter Ferbrache during a 2022 debate about population and immigration policy. It has been included on a list of 37 outstanding States resolutions which the senior committee will ask the States to rescind at its meeting next week.

It was estimated that at least 40% of people who had been resident in the island for less than 10 years arrived from the UK or other Crown Dependencies.

The figure rose above 75% for recent arrivals aged over 65. P&R said it was concerned that denying them access to the States’ secondary health care system could result in problems for Guernsey people visiting or relocating to the UK.

‘Access to NHS services is available as soon as a person moves from the Channel Islands to the UK with the intention of becoming ordinarily resident,' it said.

‘Not offering UK residents relocating to the Bailiwick the same access to health care as established for the rest of the population would at the least require discussion with the UK and has the potential to impact the reciprocal health agreement.

‘The committee does not want to take action which may risk or change the access to UK care for persons visiting or relocating to the UK.’

Most new arrivals to Guernsey and Alderney are of working age.

Figures compiled in 2023 identified that nearly 10,000 people had relocated to the islands in the past 10 years. Approximately 80% of them were aged between 18 and 65, with a peak between 30 and 39.

This pattern is encouraged by Guernsey’s population management regime. New arrivals of working age are considered vital to replace older residents leaving the workforce.

‘Introducing an insurance requirement for all new arrivals would add a new barrier to immigration,’ said P&R.

‘It risks making off-island recruitment more difficult and increasing the cost of recruitment, particularly for high turnover and low wage sectors where employees would find it harder to service insurance payments, and for sectors without an existing insurance offering for employees.’

The top two sectors for the employment of migrants are hospitality and public administration.

P&R also pointed out that people of working age have relatively low annual health costs, at an average of approximately £2,200 per person, but if they were on median earnings they could be expected to pay about £8,000 a year in taxes.

The estimated cost of providing health care to pensioners with less than 10 years’ residency in the island was approximately £4.4m. a year.

But P&R said that introducing compulsory private health insurance for pensioners only would not realise savings of that amount, and would be discriminatory.