By Lorna Gledhill
Imminent changes are being made to health services in England that will negatively affect refugees, people seeking asylum and other vulnerable groups.
I am asking you to take urgent action to challenge these damaging and unworkable proposals which will cause unnecessary human suffering, and add additional pressure to our over-stretched NHS; these changes will almost certainly worsen health inequalities and prevent vulnerable people getting the care they need. Please see the briefing below about the changes, prepared by Asylum Matters - you can find a full briefing on the regulations here.
What can you do?
We have very limited time to halt these regulations and need your help. The aim is to get the government to withdraw the regulations and to this end, Asylum Matters, together with Doctors of the World, NAT, ILPA, and others have started an open letter to the Secretary of State for Health.
1. Please sign the open letter to Jeremy Hunt Secretary of State for Health, and invite any health organisation or health professionals you know to do the same by Mon 2nd Oct: https://goo.gl/forms/0rBkQHy4H9fRmEMt2
MPs of all parties can influence what happens next.
2. Please write to your MP asking them to raise the issue with the leader of their party, using the template email. To find your MP and contact details click here.
- Not got enough time? Tweet your MP with a link to the briefing (here).
On 30th September Docs Not Cops along with a coalition of organisations are marching on a London location to protest the introduction of immigration checks and upfront charging for all NHS patients and to share stories highlighting the human impact of these changes. More details will be released here
3. Join the action in person, or on Social Media using #PatientsnotPassports .This social media packagecontains suggested tweets and images.
Press Coverage
This issue is getting media coverage. Recent publications to date include:
· The Independant: Sick schoolchildren and women seeking abortions could be denied healthcare under new immigration charging rules
· Doctors of the World: the UKs charity workers should not be forced to be proxy border guards
· Politics.co.uk: School nurses could be forced to deny migrant children treatment under new rules
· Royal College of Physicians Commentary magazine: Show me the Money: Patient Charges
What are the changes?
In August, the Government proposed to amend the ‘NHS Charging Regulations’, which govern how people access healthcare in England and when they have to pay for it. While there are already processes in place for hospitals to identify and bill ‘chargeable’ patients for their care, these regulations introduce two significant changes.
1. Firstly, under the regulations, charges have been introduced for services provided by all community health organisations in England, except GP surgeries. A wide range of health services will be affected, such as school nursing, community midwifery, community mental health services, termination of pregnancy services, advocacy services, and specialist services for homeless people and asylum seekers.Community-interest companies and charities will also now be expected to check whether the people using their services are eligible for free care, and charge accordingly. Public health services commissioned through Local Authorities, which include mental health and drug and alcohol services, are also likely to be affected.
2. Secondly, the regulations introduce up-front charging which means that every hospital department in England will be legally required to check every patient’s paperwork before treating them. If a patient cannot prove that they are entitled to free care (and if they do not qualify for free care under a treatment based exemption), they will receive an estimated bill for their treatment and will have to pay it in full before they receive any treatment other than that which is ‘urgent’ or ‘immediately necessary’, as defined by doctors on a case-by-case basis. The regulations require trusts to record that a patient is not entitled to free NHS secondary care against that patient’s NHS number. This measure, and up-front charging, were not included in Department of Health’s 2016 consultation on NHS cost recovery and as such have not received public scrutiny.
Why be worried?
These regulations have been laid without evaluation of their impact on health outcomes and health inequalities and without sufficient Parliamentary scrutiny. Refugees and asylum seekers, although eligible for free care, will likely be deterred from accessing healthcare, due to widespread confusion over who is chargeable, and because they will be asked to provide identity documents that they cannot easily access. This already happens under the current system and will be made worse by the regulations. Refused asylum seekers not in receipt of Home Office or Local Authority support will have to pay up-front before accessing parts of secondary healthcare.
Others will be deterred from even approaching health services because they fear they will be charged. We also believe that the regulations will prove unworkable and costly to the NHS.
Please let us know if you take action on any of the above issues. I look forward to hearing from you soon!
Imminent changes are being made to health services in England that will negatively affect refugees, people seeking asylum and other vulnerable groups.
I am asking you to take urgent action to challenge these damaging and unworkable proposals which will cause unnecessary human suffering, and add additional pressure to our over-stretched NHS; these changes will almost certainly worsen health inequalities and prevent vulnerable people getting the care they need. Please see the briefing below about the changes, prepared by Asylum Matters - you can find a full briefing on the regulations here.
What can you do?
We have very limited time to halt these regulations and need your help. The aim is to get the government to withdraw the regulations and to this end, Asylum Matters, together with Doctors of the World, NAT, ILPA, and others have started an open letter to the Secretary of State for Health.
1. Please sign the open letter to Jeremy Hunt Secretary of State for Health, and invite any health organisation or health professionals you know to do the same by Mon 2nd Oct: https://goo.gl/forms/0rBkQHy4H9fRmEMt2
MPs of all parties can influence what happens next.
2. Please write to your MP asking them to raise the issue with the leader of their party, using the template email. To find your MP and contact details click here.
- Not got enough time? Tweet your MP with a link to the briefing (here).
On 30th September Docs Not Cops along with a coalition of organisations are marching on a London location to protest the introduction of immigration checks and upfront charging for all NHS patients and to share stories highlighting the human impact of these changes. More details will be released here
3. Join the action in person, or on Social Media using #PatientsnotPassports .This social media packagecontains suggested tweets and images.
Press Coverage
This issue is getting media coverage. Recent publications to date include:
· The Independant: Sick schoolchildren and women seeking abortions could be denied healthcare under new immigration charging rules
· Doctors of the World: the UKs charity workers should not be forced to be proxy border guards
· Politics.co.uk: School nurses could be forced to deny migrant children treatment under new rules
· Royal College of Physicians Commentary magazine: Show me the Money: Patient Charges
What are the changes?
In August, the Government proposed to amend the ‘NHS Charging Regulations’, which govern how people access healthcare in England and when they have to pay for it. While there are already processes in place for hospitals to identify and bill ‘chargeable’ patients for their care, these regulations introduce two significant changes.
1. Firstly, under the regulations, charges have been introduced for services provided by all community health organisations in England, except GP surgeries. A wide range of health services will be affected, such as school nursing, community midwifery, community mental health services, termination of pregnancy services, advocacy services, and specialist services for homeless people and asylum seekers.Community-interest companies and charities will also now be expected to check whether the people using their services are eligible for free care, and charge accordingly. Public health services commissioned through Local Authorities, which include mental health and drug and alcohol services, are also likely to be affected.
2. Secondly, the regulations introduce up-front charging which means that every hospital department in England will be legally required to check every patient’s paperwork before treating them. If a patient cannot prove that they are entitled to free care (and if they do not qualify for free care under a treatment based exemption), they will receive an estimated bill for their treatment and will have to pay it in full before they receive any treatment other than that which is ‘urgent’ or ‘immediately necessary’, as defined by doctors on a case-by-case basis. The regulations require trusts to record that a patient is not entitled to free NHS secondary care against that patient’s NHS number. This measure, and up-front charging, were not included in Department of Health’s 2016 consultation on NHS cost recovery and as such have not received public scrutiny.
Why be worried?
These regulations have been laid without evaluation of their impact on health outcomes and health inequalities and without sufficient Parliamentary scrutiny. Refugees and asylum seekers, although eligible for free care, will likely be deterred from accessing healthcare, due to widespread confusion over who is chargeable, and because they will be asked to provide identity documents that they cannot easily access. This already happens under the current system and will be made worse by the regulations. Refused asylum seekers not in receipt of Home Office or Local Authority support will have to pay up-front before accessing parts of secondary healthcare.
Others will be deterred from even approaching health services because they fear they will be charged. We also believe that the regulations will prove unworkable and costly to the NHS.
Please let us know if you take action on any of the above issues. I look forward to hearing from you soon!
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