Immigration is an increasingly significant factor in the identity card debate, but does it come at the expense of more important considerations, asks Lyn Whitfield

The Home Office consultation on identity cards closed at the end of January, with the first signs of a proper public debate just visible. Unfortunately, the signs are that when a full debate is held, it will be muddled by the increasingly nasty backlash against immigration, in which the NHS is becoming embroiled.

A public meeting on what the government calls 'entitlement cards'was held at the London School of Economics, just before the consultation closed.Home Office minister Lord Falconer issued a press release the day before, claiming that 1,500 responses to the consultation had split 'two to one' in favour of cards. People, he said, were worried about identity fraud, illegal working and immigration. An entitlement card would tackle all three.

'In particular, it would reduce pull factors to the UK for illegal immigration and [illegal] working... we are one of only two countries in the EU who do not have any sort of identity card system in place and this makes us vulnerable.'

Lord Falconer's finger-in-the-breeze calculation of support for ID cards riled the meeting. Privacy International, a privacy campaign group that helped to organise it, says an e-mail campaign with www. stand. org. uk generated 2,500 responses - mostly against the cards - in a week.

It has since called for the parliamentary ombudsman to investigate the consultation, arguing that it breaches the Cabinet Office code of practice on such exercises.

Privacy International says the consultation document, Entitlement Cards and Identity Fraud, lacked 'necessary detail' and the government failed to prepare an 'impact assessment' on how its proposals could affect particular groups, such as people from ethnic minority backgrounds, the elderly or the socially excluded.

The last point is the most important. Anti-card campaigners worry about 'function creep', where if a card scheme was introduced, more and more uses would be found for it.

Charter88, which campaigns for political reform, says other countries that have ID cards also have written constitutions. The UK government is proposing to introduce a card with no such safeguard against a gradual erosion of civil liberties.

The Foundation for Information Policy Research, an internet policy think tank, says a card scheme would be used to link government databases, enabling close monitoring of individuals. It would also be used extensively by the private sector.

Lord Falconer has dismissed these arguments.

His press release says: 'Only the most basic details... should be stored centrally', and individuals would have a choice about whether to hand over their details 'if they think it would make their lives easier'.

The argument about choice is simply disingenuous.With a card scheme in place, people are likely to face a 'choice' between using it to get healthcare or a mortgage, or doing without.

Privacy International says cards would become 'internal passports'.

This could have a profound effect on the NHS.

The British Medical Association says the 'marginalised and vulnerable'might benefit from cards that prove they have a right to public services.

However, 'the itinerant, the housebound, the mentally ill and those with special needs'would be the least likely to obtain or carry them.

BMA also points out that 'doctors are not agents of the Home Office'. If cards were introduced, however, medical staff might be 'drawn into assessing eligibility for services', which could undermine trust in the healthcare system.

Marion Chester, legal officer of the Association of Community Health Councils for England and Wales, told the LSE meeting there was no doubt cards would be used to exclude. Public services are generally moving from being universally available to being available only to people who meet certain criteria, she said, citing the rationing of some NHS treatments by age as an example.

Identity cards will just accelerate this trend by making it easier to check people's details against pre-determined eligibility criteria.However, the fact that identity cards could be used to exclude people from the NHS is precisely why one of their most vociferous supporters wants them.

Migration Watch UK is the controversial pressure group that has grabbed newspaper headlines by claiming two million immigrants will arrive in the UK over the next 10 years, bringing in HIV, tuberculosis and hepatitis B and overloading its infrastructure.

In its submission to the Home Office consultation, Migration Watch UK says illegal immigrants make 'no direct taxation contribution to the country' but use its services. In particular, it says, they use the NHS, which may be committed to a 'lifetime's care' for people with serious conditions such as HIV. Entitlement cards would 'reduce the attractiveness of the UK to potential asylum seekers and illegal immigrants by making it more difficult to gain entry to the UK'.

The alleged abuse of the NHS by aliens and visitors is a hot topic. London teaching hospitals have been awash for years with tales of 'health tourists'who come to Britain to claim free treatment that is unavailable - or expensive - in their own countries.

The government has hinted that visas will no longer be issued to obviously sick or pregnant would-be visitors and that prospective immigrants could be screened for HIV.

In this climate, it is perhaps not surprising that entitlement cards should have emerged as another 'solution'. Former Conservative minister Peter Lilley told the LSE meeting: 'Let's be frank, any pressure for this [a card scheme] from the general public comes from the widespread belief that we are being swamped by illegal immigrants, and that if the police were able to stop anybody who looked or sounded a bit foreign and check for their ID card, things would get better because if they didn't have a card we could throw them out of the country.'

But this, he said, was not true - if only because most immigrants arrive legally or claim asylum and would therefore qualify for cards (the government has already introduced an entitlement card scheme for asylum seekers).

Meanwhile, Mr Lilley predicted, there would be 'uproar'when 'the average Daily Mail reader' realised that he would have to prove his entitlement to services he had 'paid for all his life'.

This may be true. But any sensible debate about ID cards is now likely to be coloured by the immigration issue - if only because ministers themselves have decided to use it as the main reason to think about introducing them. l A feature on identity cards was published in e-novation, 26 September 2002. Further information is available at: www. homeoffice. gov. uk, www. fipr. org and www. privacyinternational. org