Access to Primary Health Care for migrants is a right worth defending
Wayne Farah is Chair of the Migrants’ Rights Network, as well as Vice Chair for Newham Primary Care Trust. He has been a Visiting Lecturer at London Metropolitan University where he helped develop the Certificate in Education Partnership for refugee teachers. He is on the Board of the Mental Health Mentoring Project for the Migrant & Refugee Communities Forum as well as Vision Care.
As Nye Bevan explained when he created the NHS:
“One of the consequences of the universality of the British Health Service is the free treatment of foreign visitors. This has given rise to a great deal of criticism, most of it ill informed and some of it deliberately mischievous… The whole agitation has a nasty taste. Instead of rejoicing at the opportunity to practice a civilized principle, Conservatives have tried to exploit the most disreputable emotions in this among many other attempts to discredit socialized medicine.”
The evidence suggests that abandoning Nye Bevan’s civilised principle by excluding migrants from the NHS will increase costs and undermine the integrity of the NHS. It will also leave all of us at greater risk of ill health, and undermine the social inclusion strategies needed to reduce health inequalities.
However, across the UK migrants are already experiencing difficulties registering with a GP because of widespread confusion over the differences between the primary care rules on eligibility and the secondary care rules on entitlement for overseas visitors.
The NHS is not a “public fund” as defined by the “recourse to public funds rules”. There are regulations to charge some people who are not ordinarily resident in the UK for some hospital treatments. Eligibility for free primary care is unaffected by these regulations and there is no law that requires anyone to be ‘resident’ for any length of time, or have a visa etc., in order to access free NHS primary care.
GPs have complete discretion to register whomever they wish (Paragraph 17, Schedule 6 and Paragraph 16, Schedule 5 NHS Regulations 2004). They can refuse to register someone on reasonable grounds but they must not discriminate because of health status, race, social class etc. Many GPs demand proof of immigration status before they will register some patients. However, as immigration status does not affect eligibility to primary care such checks are unnecessary and refusing to register a patient because of their immigration status would be unlawful and unethical.
Migrant’s rights campaigners therefore need to make greater use of the law to ensure that GPs do not deny migrants access to primary care. They should also support the campaigns against the Government’s plans for the NHS and lobby health professionals to support the European Declaration of Health Professionals – Towards non-discriminatory access to health care.