Published 18th April 2018

Over the last few days, the case of Albert Thompson has received a lot of media coverage and now the attention of parliament and the Prime Minister. The case shows that Thompson has been denied life-saving cancer treatment because he was deemed ineligible for free NHS care and unable to pay the £54,000 charges upfront.

At our London clinic, Doctors of the World UK regularly see cases like Thompson’s, where lifesaving care – 2017-08-29_NHSChargesRegs_DoTWbriefing – is withheld because it is classified as ‘non-urgent’. Those affected include victims of trafficking, asylum seekers and undocumented migrants, many of whom have been living in the UK for many years.

Dr Peter Gough, a volunteer at the DOTW clinic, highlighted how problematic these classifications can be:

“The terms urgent and immediately necessary are misleading, especially when a patient has cancer. The timing of treatment should be, first and foremost, a clinical decision rather than a financial one. We see advanced cancers in our clinic as a result of the NHS refusing to treat them until payment is forthcoming. It is inhumane”.

Djibril was a patient at DOTW’s clinic last year. He said that when he was refused cancer treatment he was “very scared and desperate […] and worried that [his] days were numbered”. He had arrived in the UK 17 years earlier, fleeing political persecution in his home country. Even though his asylum claim was refused, his country of origin would not issue papers to enable him to return and he was stuck in limbo.

Diagnosed with cancer in 2016, Djibril was told he needed surgery, but the operation was cancelled because his asylum case had been refused. Djibril’s medical notes explained that there was a risk of the cancer spreading if he did not receive treatment. Despite this, the surgery was deemed ‘non-urgent’ and was withheld until he paid in advance. With the help of DoTW and a lawyer, the treatment was provided after a significant delay.

The impossible situation that Albert, Djibril and many of our patients find themselves in is a direct result of the NHS charging programme, including new more restrictive regulations brought in last year, which fail to protect the rights of vulnerable people living in the UK to access life saving care.

Upfront charging in hospitals

Since October 2017, NHS hospitals in England are legally required to check all patient’s eligibility to free NHS care and make ‘upfront’ charges to those unable to prove eligibility. Non-urgent care is to be withheld if a patient cannot pay.

For those unable to pay in advance, the classification of care as urgent or non-urgent determines whether they can receive it or not. Guidance from the Department of Health and Social Care states that this decision must always be made by a clinician.

However, in our casework supporting patients DOTW often finds that NHS doctors have not been provided with proper guidance on the potential impact of their decision (i.e. refusal of care), and sometimes decisions are made without any input from doctors at all; this has resulted in patients being refused care that is crucial to their survival.

For more information about these charges: DoTW_Guide_to_Healthcare_entitlement-2018_final.


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