Migrant rights campaigners can celebrate this week. It seems that ongoing lobbying has led the Department of Health to kick plans for new primary care charges for migrants into the long grass... Now we need to make sure they don't return in the autumn to haunt us.
February 16, 2015 BY Ruth Grove-White
The threat of a new, tougher system for regulating migrant access to healthcare has been looming for some time. Over the past two years heated talk from politicians has been supposed to warm us up to the prospect of tough new measures to tackle (the largely unevidenced existence of) 'health tourism' and to increase migrants' contributions towards the cost of their actual and/or potential use of NHS care here.
Controversially, among the Department of Health (DoH) package of measures have been proposals to claw in money from migrants accessing some primary healthcare and A & E services in the UK. These services are currently free and - at providers' discretion - are provided on the basis of need rather than ability to pay. The prospect of charging migrants for primary care services is not a new one and was also put forward by the last Labour government before re-emerging under the Coalition. The strong individual and public health arguments against primary care charging have managed to defeat these proposals in the past, but it was not clear what the outcome would be this time.
Campaigners (including MRN through the Entitlement Working Group) have been fighting hard against the prospect of primary care charges over recent months. Groups have collectively made the case to DoH that universal access to basic and emergency healthcare must be protected - and that introducing such charges would effectively shut out many vulnerable groups from receiving care, including pregnant women, children and refused asylum seekers. In fact, accounts from health charities suggest that there is already an air of suspicion towards migrants within some GP surgeries as a result of the publicity on this issue over recent months. In some cases this has reportedly led to a delay or unwillingness among GPs to refer migrants on for appropriate secondary care.
The good news, confirmed at a meeting of the DoH last week, is that the introduction of new primary care charges - has now apparently been 'deprioritised'. It seems the proposals have been temporarily shelved whilst the DoH focuses on delivering its existing plans to improve cost recovery in secondary care - including the new pre-entry charge for temporary migrants and streamlining of NHS systems to recoup costs from individuals and other EU governments. In addition, an independent Major Projects Authority review will be undertaken into the impacts of charges on vulnerable groups - suggesting that there is real unease across the government about these possible impacts.
According to the DoH, the issue of potential primary and A & E charges will apparently be subject to further public consultation in the autumn, with no plans to extend these charges for the time being. Even the running of such a consultation will depend upon the will of the new government elected in May to take the plans forward. Given the unpredictability of the 2015 general election, there is good reason to hope that these proposals may quietly disappear altogether.
As ever, though, there is no scope to be complacent. This can and should be chalked up as a win - for now - for migrants' rights campaigners. The next challenge will be to make sure that this doesn't reappear on the agenda of the next government. If you are concerned about this issue and are lobbying your prospective local MP candidates ahead of the next election, make sure to pursue a commitment to protect primary healthcare for all so that we can shore up resistance to these measures across the parties.
And when the dust has settled after 7th May, it is likely to be much clearer whether we have something more reliable to celebrate on this critical issue.