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Delays and Destitution: New Report on Health Charges

Doctors of the World has published a new report on the NHS charging policy, “Delays
& Destitution: An Audit of Doctors of the World’s Hospital Access Project (July 2018-20) October 2020. It shows patients face long delays in receiving healthcare. It has been covered by The Guardian (press release here).  The report highlights the dire consequences of health charging.

Key findings:

  • 44.4% (12/27) of service users had a refused asylum claim and 37% (10/27) had an outstanding human rights or asylum application, or appeal.
  • In total, 44.4% (12/27) of service users could not be removed from the UK due to an outstanding legal case, for example, an outstanding human rights application or appeal, an outstanding asylum claim or appeal, or an outstanding judicial review, which meant they could not be removed from the UK until their case had been closed.
  • 96.3% (26/27) of service users were destitute, which meant they did not have adequate accommodation or any means of obtaining it or could not meet their other essential living needs.
  • The average delay in receiving treatment was 37.3 weeks. 51.9% (14/27) of service users experienced a delay of over six months (26 weeks) and the longest delay was 4.1 years (224 weeks).
  • 59.3% (16/27) of service users required an ‘urgent’ or ‘immediately necessary’ NHS service, with an average delay in receiving treatment of 36 weeks. The longest delay for treatment for a life-threatening or serious health condition was 2.5 years.
  • In 22.2% (6/27) of cases requiring ‘urgent’ or ‘immediately necessary’ treatment, the NHS trust did not follow the guidance and apply a charging exemption and the service user was wrongly charged for their treatment.

Here are some key quotes to note:

  • “Migrants in England who need NHS care are being denied treatment for an average of 37 weeks, despite suffering from conditions such as cancer, heart problems or kidney failure, according to research.”
  • “The delays are in stark contrast to the maximum 18-week waiting times within which people in England should be treated by the NHS. Until the Covid pandemic, 80% were being seen within that timeframe.”
  • DOTW’s Head of Policy and Advocacy, Anna Miller said: “Migrants needing healthcare struggle to understand why one day a doctor tells them that their treatment is urgent and needs to start tomorrow and the next day they receive a letter from the hospital’s overseas visitors office seeking many, many thousands of pounds upfront, which obviously being destitute they can’t do.”
  • “Dr Chaand Nagpaul, chair of council at the British Medical Association, which represents doctors, said: “It is alarming and disturbing that this report highlights the scale of delays and obstruction to urgent care facing migrants who are seeking asylum in our nation, including those who are entitled to free NHS care. Safeguards must be in place to protect people in vulnerable situations from inhumane delays to treatment, as well as ensuring that those who need immediate treatment aren’t deterred from seeking it.”

What you can do:

See the full report for recommendations and please consider sending the report to your MP and ask them to support these  to ensure health and safety for everyone:

1. The definition of ‘ordinarily resident’ is changed to include all individuals living or
resident in the UK regardless of immigration status.
2. Introduce an exemption for individuals on low, or no, income.
3. Establish an independent, transparent process whereby individuals can challenge the decisions made by NHS trusts under the charging regulations and resolve cases within two weeks.

Please also check out the Hands up for our Health Campaign for case studies, resources and sign up your group to this new coalition.

Use Social Media to raise awareness and show your support. Here are some great tweets:

Detention Forum


Maternity Action

And this great one from Detention Forum: