GHAP Asylum Reading
National Health Service (Charges to Overseas Vistors)(Ammendment) Regulations 2004
Introduction
In 2004, regulations restricting access to most NHS secondary health care for some vulnerable migrant groups were implemented. You can read the regulations here. They were coupled with guidance about implementing the regulations. You can download a table detailing the entitlement different groups of patients have to various NHS services here.
Soon after this change in the regulations, the Government publicly consulted on proposals to extend the charging regime to primary care. You can read original consultation document here. We summarised a sample of responses to this consultation (which was never published) in our report.
Enforcing the Rules (2007) is a Home Office document that again suggests that primary care regulations should be brought into line with those governing access to NHS secondary care.
Human Impact
You can read an interview with Yusef Azad, from the National AIDS Trust, which outlines the impact that charging for secondary care has had upon vulnerable migrant groups (the article is on page 22 in this newspaper (pdf file)).
The Refugee Council's paper First Do No Harm contains many case studies demonstrating the impact the regulations are having.
A recent Refugee Action document demonstrated the destitution in which many failed asylum seekers lives as a consequence of Government policy.
Public Health
The debate has centred around HIV care. An independent expert panel have found that denial of care makes little sense and is likely to impact adversely upon public health and NHS finances.
Workability
The only impact assessment of the proposals to charge 'overseas visitors' for NHS primary care was completed by Newham PCT. They found the proposals to be unworkable.
Health Tourism
When the regulations were implemented the Government claimed they were needed because there was a growing problem with "health tourism". In February 2005, Melanie Johnson, then Minister for Public Health was asked to provide evidence. She stated that “I do not have any figures to supply you with on this. I concur with the point that it is difficult to measure it, and we do not have reliable information”.
A recent Home Office Document stated (page 13) "Illegal migrants are unlikely to place a great strain on the NHS as most are thought to be young and therefore relatively healthy...a sampling exercise last year at one airport suggested that health tourists were being detected at the rate of about 15 per month. This primarily involved heavily pregnant women arriving in the UK with an intention of using NHS maternity services."
Research by the Terrence Higgins Trust demonstrates that migrants presenting with HIV related illnesses were unlikely to know their HIV status at the time they came to the UK.
‘The decision-making of asylum seekers’ (2002) is Home Office research examining the factors influencing decision-making of asylum seekers and their reasons for choosing the UK in preference to other destinations - it demonstrates low levels of knowledge regarding entitlement to services.
The BMA document 'Asylum seekers: meeting their healthcare needs' (October 2002) shows that the health of migrants is more likely to deteriorate in the first 2-3 years after arrival in the UK.
Project:London is an East London outreach clinic that provides assistance to vulnerable groups who experience barriers to access to care. Their Annual Report 2007 finds no evidence of health tourism, and data show that the Government's proposals would create unnecessary administrative burden with no cost benefit to the NHS.
Human Rights
Please try to read the Joint Committee on Human Right's devastating verdict on healthcare charging (chapter 4 of their report). Doctors for Human Rights have demonstrated the ways in which the 2004 Charging Regulations break international human rights agreements (available via Athens).
Last updated on Saturday 22 November 2008 at 14:00.
