Letter to Home Secretary and Secretary of State for Health and Social Care calling for suspension of NHS Charging Regulations
Dear Home Secretary and Secretary of State for Health and Social Care

As organisations representing healthcare professionals and refugees and migrants living in the UK, we call on you to suspend the National Health Service (Charges to Overseas Visitors) Regulations 2015 and 2017 and all associated immigration checks and data sharing, which risk undermining our national efforts to stop the spread of COVID-19.

To tackle the huge challenge of the COVID-19 pandemic together, it is critical that everyone currently within the UK is supported to stay healthy and included in nationwide public health measures. No one must be excluded, regardless of their immigration status. Recognising this fundamental public health principle, the World Health Organization has stressed the importance of ensuring all migrants and refugees have equal access to health services, are effectively included in national COVID-19 responses and are not prevented from seeking care due to fear of immigration enforcement.

Any measure known to obstruct the delivery of healthcare or prevent patients coming forward to NHS services is inappropriate and dangerous during a pandemic. A wealth of evidence shows that the regulations prevent people with insecure immigration status, including those seeking asylum, from seeking the medical care they need, often because they cannot afford to pay and fear it will impact on an immigration application.  Medical organisations have long warned the regulations risk undertreating and underdiagnosing infectious diseases in these populations, undermining management of communicable disease, calling for them to be suspended. The current pandemic is an urgent reminder of why this is needed.

We recognise that the Government moved quickly to add COVID-19 to the list of conditions exempt from charges under the regulations in recognition of the need for the whole population to access NHS services during the pandemic. However, this exemption does not ensure that those with pre-existing conditions can seek the care they need without fear of charging or exposure to immigration enforcement. Under the current exemption, these patients would be charged for the treatment and management of their pre-existing conditions whilst in hospital, or may even have treatment withheld if they cannot pay.

Doctors of the World UK currently supports patients who are being denied NHS services due to their immigration status. These patients are all seriously unwell with poorly managed conditions, most fall into the COVID-19 high risk groups. They are at increased risk of requiring in-patient care if they contract COVID-19 and, if hospitalised, would not be entitled to free NHS treatment for their pre-existing condition.

The present exemption also fails to protect NHS staff time and resources, which must now be focused on providing patient care above all else. In accordance with the regulations, which increase workloads and take time away from patient care, for the purposes of billing doctors are required to not only make decisions about the urgency of any overseas patient’s care, but now must also determine whether treatment is being provided in relation to COVID-19 . This is a wholly inappropriate use of NHS time amid the current crisis.

During this public health emergency, it is critical that we do everything possible to keep the whole population safe and healthy to stop the spread of the disease. We have seen the Government introduce a number of measures to ensure the public are protected and cared for, and we call on you to do so again to ensure that the most vulnerable in society can safely and confidently access vital medical care during this extraordinary period.
We believe suspending charging regulations, and associated immigration checks and data sharing, at the very least for the duration of the crisis is a sensible and necessary step in the fight against COVID-19. To make this change effective we also urge you to launch an information campaign to assure the public - including all migrants and NHS staff - that NHS care will be free for everyone in the UK.

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