 Imminent changes are being made to health services in England that will negatively affect refugees, people seeking asylum and other vulnerable groups. We are asking you to take urgent action to challenge these damaging and unworkable proposals which will cause unnecessary human suffering, and add additional pressure to our over-stretched NHS. We are certain these changes will worsen health inequalities and prevent vulnerable people getting the care they need. So please join us in taking action! Full details of how you can help below.
What are the changes?
In August, the Government proposed to amend the ‘NHS Charging Regulations’, which govern how people access healthcare in England and when they have to pay for it. While there are already processes in place for hospitals to identify and bill ‘chargeable’ patients for their care, these regulations introduce two significant changes.
Firstly, under the regulations, charges have been introduced for services provided by all community health organisations in England, except GP surgeries. A wide range of health services will be affected, such as school nursing, community midwifery, community mental health services, termination of pregnancy services, advocacy services, and specialist services for homeless people and asylum seekers. Community-interest companies and charities will also now be expected to check whether the people using their services are eligible for free care, and charge accordingly. Public health services commissioned through Local Authorities, which include mental health and drug and alcohol services, are also likely to be affected.
Secondly, the regulations introduce up-front charging which means that every hospital department in England will be legally required to check every patient’s paperwork before treating them. If a patient cannot prove that they are entitled to free care (and if they do not qualify for free care under a treatment based exemption), they will receive an estimated bill for their treatment and will have to pay it in full before they receive any treatment other than that which is ‘urgent’ or ‘immediately necessary’, as defined by doctors on a case-by-case basis. The regulations require trusts to record that a patient is not entitled to free NHS secondary care against that patient’s NHS number. This measure, and up-front charging, were not included in Department of Health’s 2016 consultation on NHS cost recovery and as such have not received public scrutiny.
Why are we worried?
These regulations have been laid without evaluation of their impact on health outcomes and health inequalities and without sufficient Parliamentary scrutiny. Refugees and asylum seekers, although eligible for free care, will likely be deterred from accessing healthcare due to widespread confusion over who is chargeable, and because they will be asked to provide identity documents that they cannot easily access. This already happens under the current system and will be made worse by the regulations. Refused asylum seekers not in receipt of Home Office or Local Authority support will have to pay up-front before accessing parts of secondary healthcare.
Others will be deterred from even approaching health services because they fear they will be charged. We also believe that the regulations will prove unworkable and costly to the NHS. You can find Asylum Matters’ full briefing on the regulations here. |
