Former NHS chief joins our call to scrap new ID checks and charges for patients

Published 11th October 2017

A former head of the NHS and hundreds of individual medics have joined our call for Jeremy Hunt, the UK’s health secretary, to scrap new rules that will force community health workers to ID and charge some migrants.

Four charities – Doctors of the World, Asylum Matters, the National Aids Trust, and Freedom From Torture – created an open letter to Mr Hunt setting out the serious risks posed by the rules, which have been brought in without parliamentary scrutiny or proper consultation with NHS staff.

The letter was delivered to Jeremy Hunt on 9 October and has been covered by the Guardian today.

Over 190 organisations and groups signed the letter, ranging from high-profile bodies such as the Royal College of Midwives, the Royal College of Paediatrics and Child Health, and Amnesty International UK, to local services for vulnerable patients such as homeless people and asylum seekers.

Former NHS CEO Sir David Nicholson and over 430 individual medical professionals, including over 350 doctors and nurses, have also signed. There are 1,078 signatories in total.

From 23 October, all community health organisations in England that receive NHS funding will be legally required to check every patient’s immigration status. If the patient cannot provide ID to prove they are exempt from charges, they will have to pay in full before receiving any treatment. The fee will be 150% of the cost of their treatment.

The regulations are set to affect all community health services including school nursing, community midwifery, community mental health services, abortion services, and specialist services for homeless people and asylum seekers.

Even charities that receive NHS funding and provide these services will come under the rules. Upfront charging – charging before treatment – for many types of hospital care will also commence.

Doctors of the World totally opposes these new rules, which will force health workers to turn away patients who don’t have the ID documents required or can’t afford to pay. The rules will further deter some of the most vulnerable members of our communities, such as homeless people and victims of trafficking, from getting healthcare.

“We want to send a clear message to Jeremy Hunt that forcing health workers to check passports and act as proxy border guards is wrong. We’re delighted that high-profile Royal Colleges and hundreds of individual medics have joined our call,” says Leigh Daynes, executive director of Doctors of the World UK.

“At our clinics, we see destitute cancer sufferers, pregnant women and children who are already too afraid to see an NHS doctor because of their immigration status. These new rules will make the current climate of fear amongst our patients even worse.”

The government has made multiple commitments to assess how extending NHS charges will impact vulnerable people, pregnant women and children, but this has not happened. It estimates that extending charges beyond hospitals and into services such as those provided by charities are likely to recoup just £200,000 a year – 0.00016% of the NHS’ total annual budget.

The rules have been introduced in two stages, with the first taking place in August.

The UK already charges some non-British patients or their home countries for most NHS secondary care (hospital care) after their treatment. Accident & Emergency hospital treatment and GP surgeries are currently exempt, but the UK government has been clear that charging could be extended to these services in the future.

UPDATE, 17 October 2017: Our open letter was sent to Jeremy Hunt on 9 October 2017. Since that date, a number of other bodies have also endorsed the letter, including Unison and the TUC. An updated letter with a full list of signatories can be found here.


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