Report says hostile environment likely to have contributed to disproportionate Covid-19 BAME deaths
Medact, together with Migrants Organise and the New Economics Foundation (NEF), released a new report on Friday looking at migrants' access to healthcare during the coronavirus crisis.
The 34-page report can be downloaded here.
For the report, Medact, Migrants Organise and NEF surveyed 53 different organisations in England and Wales providing support to migrants.
The groups say that Covid-19 has "laid bare the UK's structural inequalities and injustices". They note that the pandemic has seen a disproportionately high number of Black, Asian and minority ethnic (BAME) deaths, both among healthcare workers and the population at large.
The report finds that the coronavirus exemption from charging is not working and migrants are not coming forward for healthcare because of the Government's 'hostile environment' immigration policies.
Medact, Migrants Organise and NEF said: "Our research builds on this existing evidence, finding that policies enacted under the umbrella of the Hostile Environment are deterring migrants from seeking and accessing healthcare and that this remains the case during the pandemic. 57% of survey respondents report that their members or clients have avoided healthcare due to fears of being charged for NHS care, data sharing, or other migration enforcement concerns. Furthermore, in response to an open question about barriers faced by those they support, 35% list barriers directly connected to the Hostile Environment, including fears of being charged for treatment, fears of data sharing and the denial of care."
As well as fear of accessing services, the report finds instances where care has been denied because patients are unable to pay for their treatment upfront or because they have been unable to prove their eligibility for free care.
The report states: "One of the concomitant effects of the Hostile Environment is the proliferation of a culture in the NHS that prioritises the questioning of a persons' entitlement to care, over and above their clinical need. In practice this often leads to racial profiling, with increasing reports of assumptions about a person's entitlement or immigration status based on how they look, how they sound, or their name."
According to the report, the coronavirus exemptions from charging are not widely known and are not working well in practice. Only 20% of survey respondents felt that migrants were aware of the exemption, while 56% said they had not seen any information from public bodies raising awareness of migrants' rights to healthcare during the coronavirus crisis. "I don't think [the exemption] has been clearly explained or advertised at all," one respondent said.
Medact, Migrants Organise and NEF conclude that it is clear that the hostile environment is incompatible with the role and functions of the NHS. The groups say it creates and reinforces the perception that certain groups of people are not entitled to access vital public services.
"Through misinformation and misapplication, and the mobilisation of fear, the policy creates a hostility that discourages people from seeking care. This hostility, and the structural nature of the exclusions it establishes, are likely to have contributed to the disproportionate number of BAME deaths during the coronavirus crisis," the report states.
Medact, Migrants Organise and NEF call on the Government to:
- Withdraw all NHS charging for migrants, in particular the National Health Service Overseas Visitor Charging Regulations 2015 and 2017 and the Immigration Health Surcharge.
- End all data sharing between the NHS and other health services, and the Home Office.
- Launch an information campaign to ensure both NHS staff and the public are aware of these changes and that it is safe for people to seek care.
Aliya Yule, the healthcare organiser at Migrants Organise, said:
"The awful stories highlighted by this report reveal the everyday racism faced by migrant and BAME communities at the hands of the Hostile Environment. These policies mobilise fear and discrimination to exclude people from accessing essential public services, like the NHS. The devastating impact of these policies is reflected in the disproportionate number of migrant and BAME communities who are dying because of coronavirus.
"At a time when structural racism is making headlines in Britain and around the world, it is imperative that the Government acts to ensure everybody can access NHS care, by ending the Hostile Environment. Everyone must be able to access healthcare safely and freely during the pandemic – and the Government is responsible to ensure that no one is left out."