Research from the group Doctors of the World UK illustrates how anti-migrant policies implanted in the NHS over years were causing serious suffering, even before the pandemic hit.
Their report found migrants waiting much longer to access the health service than non-migrants, with an average wait of 37 weeks. For those requiring “urgent” or “immediately necessary” treatment, the average was 36 weeks. Delays of years were not uncommon, with one respondent with a serious heart complaint waiting four years.
The report highlights extensive wrangling over whether people can access treatment and whether and how much they have to pay, even when they should be eligible for free treatment under the government’s rules.
The report found that NHS charges were being applied to many destitute individuals with no prospect of paying, with significant resources nonetheless spent on pursuing them. In one case study, a worker who fled Gambia after being persecuted for campaigning against Female Genital Mutilation was denied decent care, charged for minimal services, and hounded for payment until his death.
In many cases patients were wrongly told they were ineligible for free care, only for the decision reversed after long delays and much harm. The report outlines a case in which cancer treatment was repeatedly denied, and only finally started once the cancer had spread and it was too late.
Often people will eventually be treated with great difficulty and expense when the problem could have been resolved more easily, more humanely, and less expensively earlier on.
What the Tories absurdly call “health tourism” accounts for a tiny proportion of the NHS budget – 0.3% according to the government, most of which is actually down to British migrants overseas who return here to use the NHS. The government is not restricting access to services to tackle NHS underfunding, but to justify underfunding while pursuing its wider bigoted agenda.
In 1989 the Thatcher government excluded a number of migrant groups from access to free NHS care on the basis of not being “ordinarily resident”. In 2015 the Cameron government introduced a surcharge of £200 for many migrants to access NHS services, subsequently increased to £400. It also set charges for those who have not paid the surcharge at 150% of the cost of services.
In 2017 the May government expanded the range of services subject to charges, mandated NHS bodies to charge migrants upfront wherever possible, and insisted they act as an immigration agency by recording people’s status.
The Doctors of the World report recommends changing the definition of “ordinarily resident” to include everyone living in the UK, regardless of immigration status; a payment exemption for those with on low or no incomes; and a transparent system for challenging decisions, with cases resolved in two weeks.
The left and labour movement should demand that all forms of charging are scrapped, as part of restoring the NHS as a genuinely free and comprehensive service, accessible to all.