Hostile health care: why charging migrants will harm the most vulnerable.

Abstract

In 2013, the number of international migrants worldwide reached 232 million.1 With ever-increasing human mobility, migration is a leading policy issue of the 21st century.2 In the UK, migrants’ access to NHS health care is to be further restricted by the proposed health reforms as part of the Immigration Act. The Home Secretary, Theresa May described it as seeking to create a ‘ hostile environment for illegal immigrants ’.3 The Immigration Act provides the foundation for a substantial and concerning change in policy on migrants’ access to health care: a policy devised, consulted on, and intended to be delivered by both the Home Office and Department of Health (DoH).4 The proposals include a health surcharge to be paid by migrants from non-European Economic Areas (EEAs), eligibility testing to be implemented in primary care, charging for accident and emergency (A&E), extra prescription fees, and higher rates for using opticians, dentists, and other community services. These proposals will harm the most vulnerable groups including pregnant women, threaten public health, and will ultimately lead to widening health inequality in the UK. The Royal College of General Practitioners (RCGP) states that: ‘General practice should remain the main access to health care within the NHS ... GPs have a duty of care to all people seeking health care ... [and] should not be expected to police access to health care or turn people away when they are at their most vulnerable.’ 5 As a volunteer for Doctors of the World (DOTW) I see many vulnerable migrants who are regularly turned away by general practices. DOTW UK is part of the Medecins du Monde network, an international humanitarian medical organisation with projects world wide. In the UK, we run a volunteer-led clinic and advocacy project in east London helping people access health …