Migrants Denied NHS Care

A recent report found that many migrants in England who need NHS care are being denied treatment, on average for 37 weeks, this is despite many suffering from serious conditions such as cancer, heart problems or kidney failure.

One in three often end up waiting between six to twelve months, some face an even longer delay and in one such case a woman who had a serious heart complaint could not access care for more than four years.  Most of the people affected are refugees, asylum seekers and others who have been denied care by NHS England, often in breach of the rules as it deems them ‘not ordinarily resident in the UK’, under Westminster government’s ‘hostile environment’ approach to immigration.

According to the charity Doctors of the World, delays are just one week shorter on average for migrants whose poor health means they need what the government calls ‘urgent or immediately necessary’ treatment.

Despite the seriousness of their conditions they still have to wait on average 36 weeks after a diagnosis before receiving healthcare, and in one particular case urgent treatment was still withheld for two and a half years.

Anna Miller, head of policy and advocacy at the charity which provides healthcare to people who cannot access NHS services, said: “These long delays involve an extended period of an all-consuming extreme uncertainty, anxiety and distress for patients who have cancer, kidney failure or heart problems and who end up in a state of terrible limbo.

These delays are however, in stark contrast to the maximum 18 week waiting time within which people in England should be treated by the NHS.  Until the covid pandemic 80% were being seen within this time frame.

This report has prompted renewed calls for the government to scrap the requirement it introduced in 2017 for migrants to pay 150% of the cost of normal NHS care, upfront before being able to receive it, despite usually being penniless.

Labour, the Liberal Democrats and key health organisations, including the British Medical Association, the Faculty of Public Health, and the Royal College of Emergency Medicine have voiced unease regarding the charging regime, denying people potentially life-saving care.

Chair of the council at the British Medical Association, which represents doctors, Dr Chaand Nagpaul said: “It is alarming and disturbing that this report highlights the scale of delays and obstruction to urgent care facing migrants who are seeking asylum in our nation, including those who are entitled to free NHS care.  Safeguards mist be in place to protect people in vulnerable situations from an inhumane delay to treatment, as well as ensuring that those who need immediate treatment aren’t deterred from seeking it”.

The report highlighted how the Royal Derby Hospital had told Saloum, an ant FGM campaigner from Gambia, who was destitute and homeless that it would not give him palliative chemotherapy for two brain tumours and lung cancer, unless he paid upfront – it also charged him £8,397. for initial treatment he had received after collapsing and falling unconscious.

All but one of the 27 people included in the new audit, were destitute with no income.  It concluded that the data from the charity’s hospitals access project showed that the NHS charging policy is being applied to destitute individuals with no realistic prospect of being able to pay for the NHS services they receive.  It raises questions regarding the cost effectiveness of this current policy as NHS staff time used for charging and pursuing destitute individuals for NHS service is more likely a waste of resources.

Miller said: “Migrants needing healthcare struggle to understand why one day a doctor may tell them that their treatment is urgent and needs to start tomorrow and the next day they receive notification from the hospital’s overseas visitors office seeking many thousands of pounds up front, which obviously being destitute they can’t do”.

The audit found that care was delayed in six cases because hospitals wrongly conclude that someone who was eligible for free care was ineligible.  Sixteen other people were said to have been mistakenly denied ‘urgent and immediately necessary care’, because NHS trusts wrongly applied the rules on when someone could be reasonably expected to leave the country and gave care elsewhere.

A Department of Health and Social Care spokesperson said: “Urgent treatment should never be withheld.  Services such as NHS 111, Primary care, and A & E continue to be free of charge to all patients – including those from overseas”.

“Many migrants to the UK are entitled to free NHS care because they are ordinarily resident here or exempt from charge.  This includes vulnerable people like refugees, asylum seekers and victims of modern slavery”.