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Lancet Migration calls for suspension of the NHS visitor and migrant cost recovery programme


Group says universal and equitable access to health services is needed; Prime Minister to look into No Recourse to Public Funds

Date of Publication:
27 May 2020

Lancet Migration calls for suspension of the NHS visitor and migrant cost recovery programme

27 May 2020

Lancet Migration last week called for the suspension of the NHS visitor and migrant cost recovery programme.

Based at University College London (UCL), Lancet Migration is a collaboration between The Lancet and academics and researchers in the field of migration and health.

CoverIn a briefing on the UK's response to COVID-19, Lancet Migration said the measures put in place by the Government risk being inequitable and ineffective without the explicit consideration of migrants and refugees.

It recommended that the Government suspend the NHS charging regulations for overseas patients, saying:

"The UCL-Lancet Commission outlined the importance of universal and equitable access to health services for migrants; COVID-19 has brought this need into sharper focus. The UK charging regulations (introduced by the NHS visitors and migrant cost recovery programme) are complex and difficult to implement. Evidence shows that exemptions are both insufficient and ineffective. For example, whilst migrants diagnosed with COVID-19 are exempt from healthcare charges, not all migrants will be aware of these exemptions and, to be implemented, the exemption first requires a diagnosis. In addition, the emerging paediatric syndrome associated with COVID-19 has occurred in children with both negative and positive tests, meaning not all children with this syndrome would be eligible for free care.

"The regulations disproportionately affect the most marginalised migrant populations such as those seeking asylum, trafficked and undocumented. Over 60 Members of Parliament (MPs), 6 Royal Colleges and the British Medical Association have called for the immediate suspension of the NHS charging regulations, which threaten both the health of individuals and the population as a whole during the COVID-19 pandemic."

In an opinion piece published last week in The BMJ, Lancet Migration said the NHS charging regulations "leave healthcare professionals in an impossible position. Rather than following the NHS founding principles of treating all people equally, regardless of ability to pay, healthcare teams are forced to deny care to people in vulnerable positions in our society, with consequences for all."

Migrants put off accessing healthcare due to the fear of incurring unmanageable debts and the fear of arrest, as data sharing persists between immigration and health services in some circumstances. "This fear has been found to result in delay in accessing healthcare, the negative impacts of which are amplified during an infectious disease outbreak," Lancet Migration said.

Lancet Migration called for the end of all data sharing between the NHS and the Home Office, and it also called for the suspension of the No Recourse to Public Funds (NRPF) condition.

Meanwhile, a visibly surprised Prime Minister said today that he would look into NRPF in response to a question by Labour MP and Chair of the Work and Pensions Select Committee, Stephen Timms.

During a meeting of the Liaison Committee, Timms asked the Prime Minister whether it was right that a hard-working family in his constituency with leave to remain had been unable to obtain any financial support during the Covid-19 pandemic due to NRPF. The Prime Minister first responded to Timms by asking: "Hang on, Stephen… Why aren't they eligible for Universal Credit or Employment Support Allowance or any of the other benefits?"

When Timms explained the NRPF condition, Prime Minister Johnson said: "I'm going to have to come back to you on that … because clearly people who have worked hard for this country, who live and work here, should have support of one kind or another. But you've raised a very, very important point. If people's condition of their leave to remain is they should have no recourse to public funds, I will find out how many there are in that position and we will see what we can do to help them."

Minnie Rahman from the Joint Council for the Welfare of Immigrants (JCWI) said on Twitter: "The Prime Minister said something today to the @CommonsLiaison that was both incredibly important and utterly shocking. He admitted that he does not know migrants and their families are unable to access public funds. His emotional response was, rightly, disgust. Most people are unaware that many migrants are unable to access Government support right now during a pandemic due to harsh visa conditions. At a time when it's clear to us all that support from the Government is the difference between life and death."