The immigration applications of NHS debtors can now be refused


I blogged about this issue when the Statement of Changes to Immigration Rules was before Parliament, and NAT was asking MRN members to write to the Public Health Minister pointing out the disastrous public health impact of the new rules. Many did, and thank you to those who have already raised their voice on this issue.

Since then the rules have passed, but not without some scrutiny from the House of Lords Merits of Statutory Instruments Committee. The Committee was highly critical of the UKBA for not providing a full explanation of the consequences of the rule change and downplaying the likely controversy associated with this. They pointed to the submissions made by NAT and the BMA indicating significant outstanding concerns about the impact of the new restrictions.

The Merits Committee’s comments led to a debate in Grand Committee on the new rules and the failure of the UKBA to fully represent the balance of comments made on the proposals both during and after the consultation process. Speakers in the debate made clear that the rules will have an unfair impact on individuals and a negative impact on public health. But as the Statement of Changes to Immigration Rules is secondary legislation, they were as a matter of course passed without a vote.

One outcome of the added scrutiny, though, was that the UKBA was forced to provide more information on the implementation of the rules. Their response made it clear that when it comes to concerns about health and discrimination, there will be no discretion shown beyond their existing human rights obligations:

“Decision makers will apply the existing guidance on managing human rights and medical claims, and are afforded discretion to take account of exceptional compassionate factors and their obligations under human rights legislation and equality legislation.” – Minister for Immigration in response to the Merits Commitee

This means that the ability to mitigate the impact of these rules now lies firmly with the Department of Health. NAT is calling on the Department of Health to develop guidance on the sharing of NHS debt. We have written to the Minister for Public Health to say that the following must happen – at a very minimum – to ensure that these rules do not undermine public health:

The Department of Health must produce joint guidance on the implementation of the rules. These should be consulted on publicly, or at least with the involvement of expert groups who have raised concerns about the proposals.
The NHS must have discretion in reporting debt to UKBA, so that debt information is only passed to UKBA where there is compelling evidence that a migrant is a ‘health tourist’.
The rules should not apply to anyone who has incurred a debt while accessing ‘immediately necessary’ treatment.
In addition, the Department of Health must produce comprehensive guidance on the writing off of debts, including a consistent approach to identifying destitute migrants and promptly writing off the debt.

I urge MRN members to also get behind this campaign. It must be clear to the Department of Health that this isn’t only an issue for people living with HIV but a wide range of migrants who incur large debts for maternity care, cancer treatment, care for disabled
children and a full range of essential health needs.

Sarah Radcliffe (MRN)
Sarah is Senior Policy and Campaigns Officer at NAT (National AIDS Trust). NAT is the UK’s HIV policy charity. We champion the rights of people living with HIV and campaign for change. Sarah works on policy issues around migration and asylum, access to healthcare, poverty and welfare.
Please write to the Public Health Minister to tell her this impact, and to show your support for these basic principles for fair implementation of these highly problematic rules.

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