We Need An End to NHS Charges for Migrants
Healthcare charges for migrants are excluding people from getting the help they need during the coronavirus pandemic. They must end.
The coronavirus pandemic brought into sharp focus the value of immigrants and key workers in our country and our city.
On Thursday evenings during lockdown, the forced quietness of Sheffield was punctured with claps, clanging pans and fireworks, accompanied by rainbows in windows. The NHS is deservedly embedded in the fabric of our national pride - a universal health service, freely available based on need, not wealth.
But despite the existence of the NHS, the UK has seen disparities in health outcomes for Black and minority ethnic (BAME) people. Black people are at the greatest risk of contracting coronavirus compared with their white counterparts. Bangladeshis are twice as likely to die of the disease. Key workers and people born outside the UK are also disproportionately impacted. These patterns are not new - to cite another example, a Black woman in the UK is five times more likely to die during childbirth than a white woman, an Asian woman twice as likely - but the pandemic has brought these pre-existing inequalities to wider public attention.
Over the years, so many of us, including frontline healthcare workers and minority groups, have felt like we have been screaming into the abyss when demanding professional bodies and politicians look seriously at these health inequalities. One key demand to address these inequities is to bring the NHS back to its founding values - a universal service, free at the point of need.
Since the Immigration Act 2014 was implemented, migrants can be charged to use the NHS at up to 150% the cost of their treatment. Not only this, but their immigration status can also be shared by NHS providers to the Home Office. This law is unstitching the fabric of our national pride by making migrants too afraid to access the basic human right to healthcare.
This legislation has led to Black and brown people being asked to prove their ‘Britishness’ before being able to access care. A recent report by Medact, Migrants Organise and the New Economics Foundation highlighted the shocking case of a Black British man asked to prove his eligibility for NHS care whilst in a coronavirus-induced coma. A Public Health England report showed that for many BAME groups, historic racism and a lack of trust in NHS services resulted in a reluctance to seek timely care, with late presentation leading to poorer coronavirus outcomes.
Recent report by Medact, Migrants Organise and the New Economics Foundation.
neweconomics.orgMigrants and BAME people are disproportionately represented in key worker jobs, keeping our NHS going, keeping our supermarket shelves stacked, driving our loved ones to essential services, cleaning our streets, hospitals and care homes, and keeping us all safer in this pandemic. This means that migrant charges and information sharing between the NHS and the Home Office put all of us at greater risk. We need people to trust the health service to access testing and then self-isolate if we are to avoid outbreaks. We need healthcare professionals to focus on delivering care, not worrying about the ethics of denying care and sharing sensitive information.
The government was forced to acknowledge this stark reality and an exemption to coronavirus charging was finally put in place, but there has been no culturally-appropriate communication strategy to allay migrant fears, nor training for healthcare providers to understand exclusions and eligibility. The complex charging system has led to erroneous information and bills being sent to migrants living in Yorkshire. Migrant fears and BAME mistrust in the NHS persist.
Frontline healthcare workers in our city are calling out this systemic racism and demanding an end to migrant charges. Kate Bernard, a final year medical student and GP receptionist in Sheffield, said:
These policies are racist. Their effect is to systematically exclude people from receiving much-needed healthcare because of their background. As an NHS worker, it feels horrible to be complicit in enforcing inhumane Home Office regulations [...] I hope this pandemic can act as a wake-up call to the injustice of what is happening.
People from all walks of life who call Sheffield their home have marched in solidarity with the Black Lives Matter movement. These Sheffielders demonstrate that racial inequities are unacceptable to us.
This is why, as the UK’s first City of Sanctuary sees the return of chatter and car horns to its streets, Sheffield needs to break the silence on migrant charges.
