New research paper finds regulations are unworkable and are harming the health system
The Royal College of Paediatrics and Child Health (RCPCH) said last Wednesday that the current NHS charging regulations for migrants are "unworkable" and are having a detrimental impact on the wider health system.
Image credit: UK GovernmentBMJ Paediatrics Open (an official journal of the RCPCH) last week published an important new paper following a survey of over 200 RCPCH members on their experience of the impact of the regulations over a two-month period in January and February 2019.
The paper entitled Healthcare access for children and families on the move and migrants found that a majority of respondents were not confident in interpreting and applying the charging regulations.
The charging regulations were found to have direct and indirect impacts on migrant children and pregnant women, with evidence of a broad range of harms. One-third or respondents reported examples of the regulations impacting patient care, and the survey recorded 12 cases of delay in accessing care leading to worse health outcomes, including two intrauterine deaths.
The paper concludes: "Healthcare professionals are increasingly being asked to fulfil roles they are not mandated or trained for, and to potentially compromise their own values and beliefs. They have told us that they are seeing harm to the NHS, and to patients – many of whom are particularly vulnerable – as a result of policies introduced to create a 'hostile environment' for migrants. Our survey results also highlight a breach of the UK's commitment to the UNCRC, as we have recorded clear examples of violations to Article 24 on children's right to good health and healthcare access.
"We believe there is sufficient evidence of harm to health and well-being for the current NHS charging regulations to be revoked, thereby restoring the UK's commitment to universal health coverage. The current government should urgently suspend the charging regulations and commission a transparent independent review of their impact, using any harms that have been identified as a basis for a policy environment that upholds migrants' health and human rights."
The BMJ Paediatrics Open paper notes that "[t]he UK differs from comparable European countries, including France, Spain, Sweden and Italy, as being more restrictive in healthcare access for undocumented migrant children, with several European countries providing equal health rights to all children regardless of migration status. An exemption from charging for all children and pregnant women would bring the UK into line with neighbouring countries and reduce the significant safeguarding implications of the current policy."
Dr Alison Steele, Officer for Child Protection at the RCPCH, said: "This policy has, sadly, placed vulnerable groups at risk of worsened health outcomes as they choose to delay or deter seeking treatment. Our members tell us they know personally of patients that have been adversely impacted by overseas charging regulations.
"Paediatricians also don't feel confident in identifying patients that should be exempt from charges. Only 12% of respondents to our survey had been given training on this. These regulations are not workable for health care practitioners on the front line of our NHS.
"The RCPCH is calling on the Government to reverse all overseas charging regulations to protect our most vulnerable patients."
Meanwhile, Home Secretary Priti Patel said on Saturday that the Government is reviewing the immigration health surcharge for foreign doctors and nurses who work in the NHS.
At the daily press briefing on the government's response to the Covid-19 pandemic, Patel was asked by ITV's Paul Brand if it was the right time to end the surcharge.
The Home Secretary responded: "You'll be aware of many changes we have already made around the immigration status and the visa status for NHS workers for extending their visas already if they were coming up for expiry.
"We have a range of measures that are, like most things in Government, under review, and we are looking at everything including visa surcharge.
"That is something that obviously I am working with my colleague Matt Hancock in the Department of Health and Social Care because that is a joint policy with Matt's team, and we are looking at everything we can do to continue to support everyone on the front line in the NHS."
The £400 a year surcharge is set to rise to £624 this October.
On Thursday, ITV News highlighted how one nurse said it would mean she will need to pay more than £11,000 for herself and her five family members over the course of a three-year-visa.
Dr Chandra Kanneganti of the British International Doctors Association told ITV News that it did not seem fair that migrant health workers who already pay tax and national insurance are asked to pay twice.