Health is a human right. So why is the NHS turning migrants away?


22 October 2019

The founding principles of the NHS are slowly being diluted, eroded and privatised. Since 2017, NHS trusts have been obliged by the government to charge refused asylum seekers and irregular migrants upfront for secondary care services. This means that hospital care is refused for these groups until payment has been made, and has resulted in deaths and suffering on an unknowable scale.

Not only are people being turned away from our health services, they are also being charged 150% of the costs of treatment. Non payment of any bill over £500 within 2 months means the NHS will report the patient to the Home Office and be complicit in any resulting deportation. This is a direct contradiction of the idea of a health service that serves everyone, is free at the point of delivery and is not based on ability to pay.

The hostile environment in action

The hostile environment is a daily reality for many in the UK.  It means the damaging possibility of living in detention for years, as the UK is the only country in Europe with indefinite detention. It means being banned from working and forced to survive on £5.39 per day while the ineffective Home Office process your claim. It means that you might be unable to register with a GP as you have been incorrectly told that documentation is required to do so. Or it means being diagnosed with cancer, and sent home without treatment. It even means that in Lewisham and Greenwich NHS Trust, all patients are put through an Experian credit check to ascertain their chargeability, which could breach GDPR (the law on use of data). This is after it came to light that the NHS is still sharing data with the Home Office, even though it said it would stop the practice.

What the hostile environment policy does not recognise is that there are a multitude of reasons that migrants might be living in this country without documentation. This became urgently clear when the Windrush scandal broke in 2018, when the concept of ‘British nationality’ was shown to be just that: an idea. Belonging to this ephemeral group can be violently expanded or collapsed at the whim of the interests of the British government. As a result of this, the hostile environment places migrants into vulnerable situations, at risk of exploitation and abuse with little recourse to protection by the state.

Freedom of movement and access to healthcare

At Global Justice Now, we campaign on freedom of movement for all people. This dream of a future where people are able to move as and when they need, incorporates rights for migrants in their new home. Just because you find yourself on the move or in a new home, it does not mean you will be a financial burden on the health system. In fact, reports show that if migrants were allowed to work, then they would contribute to the economy. Migrants are also generally healthier, but it is forcing them into destitution and making them fearful of accessing care that leads to costly public health interventions. With war, poverty and the climate crisis driving migration across the globe, the UK government needs to face up to its role in all of these battles and its duty to provide reparations to the millions directly affected by their actions. As said by A.Sivanandan, “We are here, because you [are] there.”

Universal Health Coverage

If you read the news in September, you would have seen the UK affirming its commitment to universal health coverage. Speaking at the UN General Assembly the UK’s Secretary of State for International Development said, “Universal health coverage is a smart investment. Not just for health, but for all the Global Goals. It reduces poverty and drives prosperity.” We whole-heartedly agree. Yet the UK can’t claim to champion universal health coverage and also lock people out of its health system on the basis of nationality - it’s complete hypocrisy. At the moment, anyone in this country can access primary and emergency care, but even this is set to become chargeable in the near future.

The crisis in the NHS is multifaceted, but it is not a crisis of migration. It is a crisis of chronic underfunding, of a drastic cut in staff training positions, and the legacy of PFI and other private interests that are draining public funds. The government’s own assessment has put deliberate health tourism at 0.3% of the NHS budget, while PFI initiatives relate to 2%. Recently the Royal College of Nursing has criticised the government for committing an extra £1 million to the bodies put in place to recoup these costs. At least 23 NHS Trusts are owed £1 million or more, in no doubt due to the fact they are charging people with no ability to pay £7,000 to give birth, to give just one example.

Patients not passports

The Patients not Passports toolkit was launched in 2019 by Docs Not Cops, Medact and Migrants Organise as a resource for those who are supporting migrants who face charging when accessing NHS care. It provides a guide for what to do if you come across a migrant facing NHS charging through your job in a hospital or in the local community. There is also information about how to join their campaign, and a quick guide on how to challenge stigma around the NHS and migration when having conversations.

This coming Wednesday, people around the country will be holding vigils outside their local hospital to mark the 2 year anniversary of upfront charging being introduced. In Birmingham, Bristol, Lewisham, Whitechapel and Manchester, join members of the public as they commemorate those that have suffered as a result of this inhumane policy. With candles, banners and testimonies, we will remind our government that we are patients not passports, docs not cops and that the hostile environment is being enacted at the expense of human suffering and will never be in our name.

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Photo: Protest outside the Home Office against the hostile environment. Credit: David Mirzoeff/Global Justice Now

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