Fight racism and defend migrants
The hostile environment
“The hostile environment is a sprawling web of immigration controls embedded in the heart of our public services and communities. The Government requires employers, landlords, private sector workers, NHS staff and other public servants to check a person’s immigration status before they can offer them a job, housing, healthcare or other support. Landlords and employers can face fines and even criminal sanctions if they fail to do so.
Immigration controls are now embedded in everyday interactions between trusted public sector workers and the people they are supposed to serve: nurses and patients, police and victims of crime and teachers and their pupils. New offences mean undocumented migrants find themselves criminalised for doing what they must to survive – in some cases simply for working or even driving”
Liberty: A Guide to the Hostile Environment 2018
Championing patients and staff
All hospital trusts now have the mechanisms in place to know exactly how much every individual patient’s care cost, whether you are required to pay, the ability to send you a bill and have in place debt collection agencies to chase you if you can’t pay.
We believe strongly that hospitals should not be a hostile environment. Keep Our NHS Public has campaigned against the introduction of NHS charges for migrants since their introduction in 2014. We believe that the NHS should be free at the point of use for all, and that these charges are an attack on our communities and the basic principles of the NHS.
Charging for NHS treatment
Government policy has rendered 600k people, including 120,000 children, ineligible for free NHS care.
Since the law changed in 2015 many people are no longer deemed ‘ordinarily resident’ in the UK and are charged for all NHS care at 150% of cost price except for emergency care. This has put many lives at risk and caused great hardship for many of our local residents. Since 2017 this policy has been further ramped up by the Government with more and more pressure being put on Trusts to collect money from those deemed as ‘non-resident’. Unpaid debts can lead to visas, or right to residency being removed.
Pregnant women are thought to be particularly targeted and a Freedom of Information request from Save Lewisham Hospital Campaign showed over 500 women in Lewisham and Greenwich NHS Trust in 2018 alone, were asked to pay up to £9,000 for having a baby. A new report from Maternity Action backed by the Royal College of Midwives in September 2019 showed these charges risked making women unable to access appropriate perinatal care.
See Maternity Action guide: I have Questions about Charging for NHS Maternity Care
Campaigning in the North East
In 2019 Keep our NHS Public North East asked all of our local NHS Trusts (via a Freedom of Information request) about the total cost of the charges sent to non EEC nationals, their total income, the percentage of the charges they recovered from non EEC nations, the name of their debt collection company and how much they paid for their debt collection.
Newcastle Hospitals, Northumbria, NTW Mental Health Trust, QEGateshead, South Tyneside Hospitals and City Hospitals Sunderland (now South Tyneside and Sunderland NHS Foundation Trust) and County Durham and Darlington Trust all replied. All employ debt collection agencies, for charges that vary from 0.01% to 0.03% of their income. However, NTW Mental Health Trust told us that 0% of their charges had been recovered by them because ‘it is not cost effective to pursue as its destitute migrants with no access to funds’.
Over the last year KONPNE, have been working with “Connected Voice”, “Haref” and “Asylum Matters” on the issue of migrant charges and the sharing of data between our hospital Trusts and the Home Office. During the COVID period we have been talking to local authority councillors from Newcastle and Gateshead regarding the possibility of them writing to their local NHS Trusts to ask that they consider suspending charges and data sharing.
During the COVID 19 pandemic Black and Minority Ethnic patients have died disproportionately, even while working as doctors, nurses, cleaners, in care homes and public transport. Migrants face NHS charges and may be reported to the Home Office if they can’t pay. Fear keeps people from seeking treatment, and women may have died in childbirth as a result.
“You don’t know if you have Covid if you’re too scared to see a doctor,” says Consultant
Microbiologist Dr Jonathan Folb from Liverpool. “We cannot defeat this pandemic if people are too scared to be tested, treated, or participate in ‘track and trace’.
The advent of COVID 19 has brought the matter of migrant charges and sharing of data into the limelight. The current NHS charging policy was amended on 29th January, meaning that no charge should be made for diagnosis or treatment of COVID-19 as a Public Health measure. This does not undo the years of hostile environment policies which have prevented many from accessing health services. The very real fears of sanctions or deportation as a result of accessing public services has long been documented by those working in the migrant rights sector. These fears have been shown to cause much morbidity and mortality among our most vulnerable residents.
COVID-19 has exacerbated an already urgent situation, with many undocumented migrants losing their livelihoods and now ineligible for government support. This prompted a group of 60 cross-party MPs, 7 healthcare unions (including multiple Royal Colleges, the BMA and Doctors of the World) and over 100 civil society organisations to write to the Health Secretary, calling for an immediate suspension of charging for migrants and all associated data sharing with the Home Office. This approach has also been championed by the WHO, who rightly point out that inclusion will not only help to protect the rights of migrants, but will also serve to protect public health and stem the spread of COVID-19.
They called on Priti Patel (Home Secretary) to:
– ensure access to healthcare – this means immediately suspending all NHS charging and data sharing with immigration enforcement, and launching a public information campaign that makes
clear that healthcare services are available and safe for all migrants to use
– ensure all migrants have access to vital public services by suspending ‘No Recourse To Public Funds’ conditions
– make assurances that no one will be penalised for missing appointments, reporting or court dates due to illness
– make sure no one is made an ‘overstayer’ because of being self-isolated or unable to return to a country that is not safe to travel to, by extending or modifying visas
– release everyone detained under immigration powers to reduce the risk of COVID-19 entering the detention estate and causing avoidable harm
– provide specialist support for those housed in shared Asylum Accommodation to enable safe access to medical services, testing, and where necessary, re-housing for particularly vulnerable people.
See Medact / Migrants Organise / New Economics Foundation: Patients Not Passports: Migrants Access to Healthcare During the Coronavirus Crisis
“Keep Our NHS Public North East”, with “Connected Voice”, “HARAF” and “Asylum Welcome” have been talking to councillors from Newcastle and Gateshead council about the situation locally.
On 24th June Cllr. Martin Gannon (Leader of Gateshead Council) and Lynn Caffrey (Chair of Gateshead Health and Wellbeing Board) wrote to Yvonne Ormston (Chief Executive of QEGateshead) on the issue of migrant charging.
⊕ Challenging the hostile environment – what you can do to fight racist policies
Hospitals, dentists and GP surgeries have been asked by government to display posters explaining that NHS care is not free for everybody.
If you see one of these posters you can; –
– Ask why it’s being displayed
– Ask if it can be removed
– Remove it
Sign the open letter to Priti Patel https://www.jcwi.org.uk/protecting-migrants-from-covid-19
Write to the Department of Health and Social Security by using the Patients Not Passports template letter https://act.patientsnotpassports.co.uk/
Use this template pack (compiled by Medact) to write to your local council to ask them to contact their local hospital trust
If you belong to a political party or union please ask your branch to adopt the Model motion – Migrant Charges This relates specifically to Covid-19 and charging migrants for NHS care
Check out some of the toolkits linked below – written by experts – there is MUCH that you can be doing….
And don’t forget to share your experiences with “Keep Our NHS Public North East” via email@example.com
Asylum Matters https://asylummatters.org/
Docs Not Cops http://www.docsnotcops.co.uk/
Patients Not Passports https://patientsnotpassports.co.uk/
Migrants Organise https://www.migrantsorganise.org/
The Joint Council for the Welfare of Immigrants https://www.jcwi.org.uk/protecting-migrants-from-covid-19
Docs Not Cops / Medact / Migrants Organise: Patients Not Passports Toolkit
Doctors of the World: Safe Surgeries Initiative
Maternity Action: I have Questions about Charging for NHS Maternity Care
Medact / Migrants Organise / New Economics Foundation: Patients Not Passports: Migrants Access to Healthcare During the Coronavirus Crisis
Joint Council for the Welfare of Immigrants / Doctors of the World: Toolkit_for_NHS_Charging_Regulations
Joint Council for the welfare of Immigrants / Doctors of the World: A_Short_Guide_to_Access_to_NHS_Health_Care_for_Migrants
DOHSC document (February 2020): Guidance_on_implementing_the_overseas_visitor_charging_regulations_-_Feb_2020