News on the Entitlement of Failed Asylum Seekers and Undocumented Migrants to Health Care Services

From United Kingdom Wiki

November 19th 2009 (see also here):

       Medsin-UK is a network composed predominantly of medical students with an
       interest in local and global health inequalities. Over the past few years,
       we have been working closely with Medact and the Entitlement Working Group,
       campaigning for access to primary and secondary healthcare for vulnerable
       migrants in the UK.
      
       In 2004, new regulations placed tight restrictions on free access to NHS
       services for refused asylum seekers and undocumented migrants in the UK. In
       March 2009, following legal challenge to the regulations, the high court
       confirmed that most refused asylum seekers cannot be considered 'ordinarily
       resident' in the UK, and are therefore NOT entitled to most hospital
       treatment. With little alternative access to healthcare, this places a
       highly vulnerable population at risk of harm, therefore breaching the
       internationally recognised 'right to health'. However, further appeal based
       on this demonstrable harm was not granted by the House of Lords, due to
       insubstantial evidence.
      
       With access to a large number of medical students and junior doctors working
       in hospitals, Medsin has begun to collect cases of potential or real harm
       suffered by individuals who are denied or unable to access care, to build
       the evidence base for possible future challenge to the regulations. Those
       affected may include individuals with legal access to treatment, but who do
       not receive it, being unaware of or unable to communicate their rights. If
       you have witnessed such a case, please fill out the 'Witness Statement' form
       attached (also downloadable from
       www.medsin.org/campaigns/medsinentitlementcampaign) and return to *
       access@medsin.org. Please pass this form on as
       you see appropriate.
      
       Thank you very much,
      
       Lizzie Moore
      

July 20th 2009:

News release on ACCESS TO NHS SERVICES FOR FOREIGN NATIONALS, released by the Government News Network.

June 2009: Treating failed asylum seekers: Access to primary care. Letter in BMJ. Website

April 6th 2009:

The High Court ruling of April 2008 (see below) found that failed asylum seekers could, in certain circumstances, pass the ordinary residence test that confers an automatic right to free NHS hospital treatment or, alternatively, be exempt from charges for hospital treatment after having spent one year in the UK. The Department of Health appealed this judgment and the case was heard in November 2008. The Court of Appeal (CA) handed down its judgment in favour of the Department on 30 March. See here the latest guidance from the DoH on the situation.

March 30th 2009:

Appeal Court Decision and DH advice of 2 April 2009

February 9th 2009:

"The Government looks certain to abandon plans to deny free GP treatment to failed asylum seekers, after the health secretary attacked their ‘sheer inhumanity’". News item from Pulse

September 23rd 2008:

The United Nations Children’s Fund (UNICEF) applauded the decision by the British Government to grant children seeking asylum, migrant children and those trafficked into the country the same rights as British children. UN News Centre

September 9th 2008:

Access to health care for asylum seekers and refused asylum seekers - Guidance from the BMA’s Medical Ethics Department download

In 2001 the BMA published guidance in response to queries from doctors treating asylum seekers. The BMA has repeatedly expressed its concerns to government about the plight of asylum seekers. This revision is interim guidance on access to health care for asylum seekers and refused asylum seekers following the April 2008 judicial review regarding a refused asylum seeker's eligibility to receive free hospital treatment.

September 1st 2008:

Master's dissertation (London School of Economics) on Access to Healthcare for Refused Asylum Seekers in England: A Study of Policy Implementation, by Kim Maynard. Download here

August 3rd 2008:

GPs demand right to treat refugees. Doctors' secret submissions show resistance to plans to deny care to failed asylum-seekers. Guardian news item

High Court ruling, April 2008

The situation in the UK is confused following a ruling of the High Court in April 2008 that left the position of failed asylum seekers and their access to the NHS uncertain. Until then, free health care was cut off for all failed asylum seekers in England and Wales. The ruling made it possible for failed asylum seekers to be considered 'ordinarily resident' in the UK, and, consequently, entitled to free NHS hospital treatment. The Department of Health in England is appealing against the ruling.

An information sheet on the ruling is available at the MedAct website

See also DoH website and TABLE OF ENTITLEMENT TO NHS TREATMENT (Correct as of May 2008)

Entitlement of refugee and asylum seeking children to free health care

Advice from the Children's Legal Centre, 24th June 2008

Free health care for failed asylum seekers in Wales

Welsh Assembly Health Minister Edwina Hart announced on BBC radio that failed asylum seekers in Wales would be given access to the National Health Service (NHS). http://news.bbc.co.uk/1/hi/wales/7409265.stm

Background to the ruling: An extract by Jamie Doward from the Home Office Press Office (The Observer, Feb 2008)

Controversial plans to bar hundreds of thousands of undocumented immigrants and failed asylum seekers from all but emergency health services are being considered by the Home Office. There are claims the move will place increased strains on hospitals and inflame community tensions, The Observer can reveal a joint Department of Health and Home Office review examining proposals to restrict free access to GPs' surgeries for failed asylum seekers and 'irregular migrants' is due to report in the new year. The review was supposed to report last month but was delayed until December because of disagreements between the two departments. While the Home Office is pushing for further restrictions on health care provision, which it sees as a 'pull factor' for people coming to the country, the Department of Health is believed to have reservations about how they will work. As a result of the row, The Observer understands, the review, which follows three years of consultation, has been pushed back until January.

Experts and MPs have expressed concerns at reports that the government has decided to introduce further restrictions on free healthcare which will affect almost 600,000 people.

According to the Institute for Public Policy Research (IPPR) think-tank, it is estimated there are up to 390,000 failed asylum seekers in the UK who are either unwilling or unable to return to their home countries and who would lose access to free healthcare provision if the government approves the plan. A further 200,000 migrants working in the UK on the black market would also be affected.

Currently everyone in the UK qualifies for free primary health care services - such as access to GPs. But asylum seekers were barred in 2004 from accessing free secondary health services, such as treatment in hospitals for HIV, amid concerns about the spread of so-called 'health tourism'- people travelling to this country to receive treatment.

At the time the restrictions were criticised by some migration experts who said there was no evidence to support claims many migrants travelled to the UK to seek treatment.

'Different hospitals developed different protocols and the system became confusing,' said Jill Rutter, senior research fellow at the IPPR.

Now, in what the government says is an attempt give clarity to the system, it is considering restricting free access to GPs' surgeries and mental health services for failed asylum seekers.

Experts warned the move would place greater pressures on A&E departments.

'This will increase community tensions,' Rutter said. 'What signals are going to be sent out if queues of asylum seekers are waiting at A&E departments because they can't register with a GP?'

And she said it could increase risks to public health. 'If you are unable to immunise people, it increases the risk of an outbreak in communicable diseases.' She added: 'The government is in danger of normalising what many people will see as a breach of human rights - someone's right to basic health care provision. The government is saying people who aren't entitled to healthcare should pay for it but asylum seekers are the very people who can't afford to pay for these services.'

Moyra Rushby of Medact, the organisation that provides health services for migrants, said: 'We are concerned that any further measures to restrict access to primary care will have profound impact on the health of an already vulnerable group of people. Potentially serious conditions such as asthma, normally diagnosed and treated in general practice effectively and at low cost, will be left untreated, becoming potentially life threatening.'

MPs have also expressed concerns at the direction in which the government is moving. Labour MP Neil Gerrard has raised an early day motion arguing against any further restrictions on free healthcare for asylum seekers. There will also be a meeting of MPs in parliament next week to highlight the issue.

A Home Office spokeswoman confirmed the joint review would now not be published until next year and said it had not decided whether to further restrict healthcare provision to illegal migrants and failed asylum seekers.

'The review is still under way and no definite proposals have yet been put forward,' the spokeswoman said.