Entitlement to Secondary care services

UK law restricts people who have been refused asylum and undocumented migrants in England from accessing most NHS secondary care (hospital and community) services. These people have to pay large fees to receive treatment; and yet, most cannot afford to do so due to their vulnerable circumstances – being denied the opportunity to work or access welfare support. In Scotland, Wales and Northern Ireland people who have been refused asylum can access all NHS services free of charge.

In 2017, new rules require NHS Trusts in England to charge up-front for secondary care, meaning those who cannot pay have non-urgent treatment withheld.

At our clinic, we see patients who are in desperate need of medical attention but who are too scared of running up huge debts to see a doctor. Debts to the NHS are reported to the Home Office and used against people in immigration applications.

Since the NHS charging regime was introduced, we have engaged with the Department of Health & Social Care to ensure everyone living in the UK is able to access the healthcare they need. Drawn from our ground breaking research, and data and patient testimony collected in our clinic, we present the UK government with evidence of the harm caused when people are excluded from healthcare.

To ensure that NHS charges do not prevent people in living in the UK from accessing the healthcare they need, we call on the governments of the UK, Scotland, Wales and Northern Ireland to:

–  Reform healthcare charges to make them affordable for all, including an exemption for people living in destitution or on a low income, and refused asylum seekers.

– Exempt children and pregnant women from all charges.

– Remove the obligation on NHS Trust to charge patients upfront.

– Implement a full-scale, independent review of all NHS Charging Regulations which includes the equality impact on all migrant groups and British citizens, patient outcomes, and public health implications.


With your support, Doctors of the World will make sure nobody suffers or dies due to lack of access to healthcare.