Introduction
1. There is a clear risk that older visitors from overseas could add to pressures on an already struggling NHS. In recent years there have been about 14 million visitor admissions per year from outside the EU, some from countries where the virus is a significant factor. Nearly ten million of these visitors were citizens of 48 countries who can currently visit the UK for up to six months without applying in advance for a visa. The total population of these countries, which include the USA and Japan, is about 1.1 billion. This paper proposes that all non-EU visitors should be required to apply for a visa in advance of travel.
2. We recommend that visas should normally be issued only to those under the age of 50 as they are much less likely than older visitors to need hospital treatment even if they should suffer the disease while in the UK. Special arrangements would have to be made for senior business visitors. Arrivals from the EU have been running at about 40 million a year; a similar approach would be highly desirable on public health grounds but this would raise a very wide range of issues. Meanwhile we should implement controls in respect of non-EU visitors.
3. Migration Watch UK is committed to highlighting evidence gaps in the interests of transparency (regarding our own work) and accountability (on the part of the government and other statistical bodies). For a note on data limitations and evidence lacunae regarding the data used to compile this report, please see paragraphs 26 to 29 below.
Summary
4. For so long as there is no vaccination against the Coronavirus its presence transforms the context in which we must consider border controls. We know that it is highly contagious and that we have no scientifically proven treatment for it, let alone a cure.
5. We also know that we have more than eight million citizens aged 70 or over for whom this disease is especially dangerous (Office for National Statistics), together with a further one million or so who are especially vulnerable for medical reasons. It may also be that males and members of the BAME communities are more vulnerable.
6. The infection is now worldwide and is likely to spread rapidly in Asia, Latin America and Africa where, due to health or social factors, public health and medical facilities will struggle to cope.
7. For the time being passenger flows to the UK are severely limited, compared to the previous numbers, by the collapse of air travel and by much reduced rail and ferry services from the continent. Many of those arriving are likely to be returning Britons. However, it will not be very long before we have to consider who, in the current unprecedented situation, should be allowed access to the UK.
8. The NHS is already under severe strain and it is a key government objective to sustain it. Non-EEA visitor admissions to the UK have been running at about 14 million per year in recent years. Any who fall ill with the Coronavirus will be entitled to medical treatment, including hospital admission if necessary. It surely makes sense not to admit older visitors who would have a significant risk of needing hospital treatment.
The numbers
9. The numbers crossing our borders are very large. There were an estimated 146.3 million passenger arrivals in 2019 – including returning UK residents (there were 143 million in 2018) – Home Office admissions statistics. It seems likely that international travel will decline in the years after this crisis, partly because airline capacity is likely to be reduced and also because there will be reluctance to visit countries where the virus is still perceived to be a problem. Meanwhile, arrivals by air are running at about 15,000 a day or 5.5 million a year – a small fraction of the normal level of 118 million per year (average over the past decade – Home Office figures) but still a significant risk of new infections. London’s Heathrow airport normally has about 600 flights landing on an average day, but – in the midst of the lockdown – about 60 arrive daily (see BBC News).
UK nationals
10. 80 million of the 143 million arrivals in 2018 were returning British nationals most of whom would have been abroad for business or leisure. Obviously, they have a right of entry that cannot be denied.
EU citizens
11. Of the same total, some 40 million were from the EEA. For as long as we are in a post-Brexit transition period they also have a right of entry to the UK. A number of EU member states such as Germany, Austria and Hungary have reintroduced border controls with regard to some fellow EU citizens (but not, so far, British citizens) – see summary of measures taken by EU member states. There would be very strong political arguments against imposing travel restrictions on EU citizens but this cannot be automatically excluded if circumstances were to require it.
Non-EEA citizens
12. There have been approximately 20 million passenger arrivals by non-EEA citizens each year. The vast majority of arrivals relate to visitors (tourists), with the next largest category being people returning to the UK already being or having previously been resident. The most common nationalities given leave to enter in 2018 were (rounded) – Home Office statistics:
United States 6 million (4.6 million of whom were visitors)
China 2 million (890,000 of whom were visitors)
Australia 1.5 million (1.1 million of whom were visitors)
India 1.5 million (800,000 of whom were visitors)
Canada 1.3 million (a million of whom were visitors)
13. Figure 1 below shows that in 2018 there were 13.9 million visitors, of which 9.6 million were non-visa nationals. 4.3 million were non-EEA nationals returning to the UK after a visit elsewhere and 845,000 others were in transit. (“Non visa nationals” are those who are not required to apply for a visa in advance of travelling to the UK) – see Home Office admissions statistics.
Figure 1: Non-EEA passengers given leave to enter the UK as visitors – Home Office
14. The full statistics for non-EEA passengers being given leave to enter for more substantive reasons are not available for 2018 (the statistics with regard to those coming for the purpose of study have not been provided). Therefore, we take the 2017 number. This amounted to just under 600,000 (all these numbers are rounded) – Home Office. They divided as follows:
Study (including short term study): 417,000
Work: 158,000
Family: 21,000
Previous policy
15. The issue of access to the UK for arrivals from Coronavirus-infected countries was raised earlier in the crisis. The British government declined to take any action other than the distribution of a leaflet to those arriving. Accommodation near airports was also made available for those who wished to self-quarantine. A study by Southampton University revealed that 190,000 people flew into the UK from Wuhan and other high-risk Chinese cities between January and March. “The researchers estimated that up to 1,900 of these passengers would have been infected with the coronavirus.” (see Sunday Times, April 2020). The government has said its response is based on scientific advice that such a step would not be effective as the test available at the time was not accurate so that much valuable time and effort would be wasted trying to trace the contacts of arrivals who were not, in fact, carrying the virus. Other research, however, has found that travel restrictions can, and did, slow the spread of the Coronavirus (Science magazine, March 2020). It should also be noted that Ireland temporarily ceased accepting any new visa applications[iii].
16. We have been in lockdown for several weeks and expect to remain in that situation for some weeks, perhaps months, in the hope that this will keep the case load within the NHS’s (increasing) capacity. The economic and social cost of this effort will be very great. Yet there is a clear risk that this vital progress could be put at risk if unrestricted entry were to be permitted to millions of passengers from countries where the virus was still extensive.
17. Responding to reports that 15,000 people a day are flying into the UK, the Health Secretary told ITV on 16 April “We don’t test at airports because the number of people coming through has dropped dramatically.” He added “The epidemiological impact of keeping travel open is very small because there is already large transmission here.” Apart from being debateable, this position takes no account of the potential additional strain on the NHS.
18. However, there is a way forward that would focus on the key issue of the strain on the NHS – namely to focus on placing a ban on older visitors who are much more likely to need hospital treatment than younger ones. Modelling by the Scientific Advisory Group for Emergencies (SAGE) published in the Daily Telegraph on 16 April predicted that, in the UK, the likely requirement for hospital treatment for each age group would be approximately as follows:
Age Group % requiring hospital treatment
For the Coronavirus
20-29 1.2
30-39 3.2
40-49 4.9
50-59 10.2
60-69 16.6
70-79 24.3
80+ 27.3
19. It follows that, if the picture in the visitor’s country of origin is broadly similar to that of the UK, any additional strain on the NHS could be minimised by restricting visitor visas to younger applicants. We recommend an age limit set at 50. However, this might impede travel by senior business people so special arrangements would be needed to cover them.
20. To implement such a policy it would first be necessary to require all travellers, including visitors, to apply for a visa before travelling to the UK. This change would particularly affect citizens of countries (listed at Annex A) who currently are not required to apply for a visa in advance of travelling to the UK. There are currently 48 non-visa countries with a total population of 1.1 billion (although the status of additional countries such as Taiwan, the UAE, Kuwait and Dubai is ambiguous). A requirement for a visa before travel would also, if necessary, permit the exclusion of visitors from countries where the virus was especially widespread.
21. The mechanics would not be especially difficult. Travellers would need to apply to the British mission. Their ages would be checked and a visa stamped in their passport. Airlines could be expected to check that passengers for the UK had the necessary visa before departure.
22. This prior visa requirement would also provide a framework, once a reliable vaccination becomes available, to check that foreign nationals had been vaccinated before issuing a visa. This would be similar to regulations currently in effect in some countries, for example with regard to Yellow Fever.
23. Priority could be accorded, at least initially, to those with a substantive reason to travel to the UK such as study, work or family (para 12 above).
24. Measures of this kind should help the tourist industry to recover while minimising the impact on the NHS.
Conclusion
25. We are now in entirely new territory. The government’s priority is, rightly, to ensure that the NHS is not overwhelmed. Ensuring that millions of foreign visitors are prevented from adding to those pressures would be a valuable step towards achieving that aim while returning to normality.
Shortcomings in the evidence and informational lacunae
26. There are gaps in the evidence regarding Home Office visa admissions. While the Home Office have provided the total number of passenger arrivals in the year to 2019 (146.3 million), there is not yet a breakdown of the figures into EEA citizens, non-EEA citizens and British citizens.
27. There is also data missing regarding the breakdown of passengers given leave to enter the United Kingdom by purpose of journey by main category and country of nationality (see table ad_03 in the Home Office admissions dataset). While the figures for ‘work’, ‘family’ and ‘other’ are provided, those for ‘study’ are absent.
28. The Home Office have also pointed to a significant data gap with regard to the government’s scrapping of landing cards in May 2019. As the Home Office puts it: ‘In light of the introduction of new digital systems at the border, the use of landing cards was reviewed (see ‘Landing cards’ below). The review resulted in the decision to remove the need for non-EEA nationals to complete a landing card on arrival into the UK. Further data relating to visitor arrivals will not be available until an alternative method of collection is developed. On 5 August 2017, the Home Office launched a consultation on a proposal to end the requirement for non-EEA passengers to present a paper landing card on arrival into the UK from 1 October 2017. The consultation set out the statistical implications of the change and how to respond to the consultation, which closed on 2 September 2017. The government confirmed in the Spring Statement 2019 that to coincide with the ePassport gates expansion, the government would begin to abolish landing cards for non-EEA travellers. On 20 May 2019, it removed the need for all non-EEA travellers to fill in landing cards upon arrival in the UK and expanded the use of ePassport gates to seven more countries. The government’s response to the consultation was published in May 2019. As anticipated in the original consultation, ahead of new electronic data sources being developed, the withdrawal of landing cards has resulted in a temporary loss to the passenger arrivals data broken down by nationality and reason for travel. Data on the total number of passenger arrivals will continue to be available as this comes from a different source.‘
29. Finally, the government does not appear to publish a simple list of those countries whose nationals are not required to obtain a visitor visa in order visit the UK. This is odd and should be addressed, as such information is clearly of public interest.
Annex A – Countries whose nationals are not currently required to obtain a visit visa to come to the UK for a stay of up to six months (ie countries not listed in Immigration Rules – Appendix V: visitor rules).
Andorra
Argentina
Aruba
Australia
Bahamas
Barbados
Belize
Brazil
Brunei
Botswana
Canada
Chile
Costa Rica
Dominica
El Salvador
Grenada
Guatemala
Honduras
Hong Kong
Israel
Japan
Korea (South)
Malaysia
Maldives
Mauritius
Mexico
Micronesia
Monaco
Namibia
Nicaragua
New Zealand
Panama
Paraguay
Papua New Guinea
Samoa
St. Kitts and Nevis
St. Lucia
St. Vincent and the Grenadines
San Marino
Seychelles
Singapore
Solomon Islands
Tonga
Trinidad and Tobago
United States
Uruguay
Vanuatu
Vatican
City