In the wake of
proposals to radically reduce migrants’ access to England's National Health
Service (NHS), we question how much consideration has been afforded to the
wider public health implications of these proposals, and to what extent they
are evidence-based, cost-effective, or even safe.
Under current
rules, individuals who are not citizens of the European Economic Area (EEA) can
be charged for secondary care if they are not deemed ‘ordinarily resident’ in
the UK and do not fall within certain exempt groups. Provision of primary care
is at the discretion of the general practitioner (GP). Certain key provisions
including accident and emergency (A&E), family planning, sexual health, and
HIV services are freely accessible, as are treatments for specific communicable
diseases.
However, the new
Immigration Bill and the Government's response to the consultation on migrant
access to the NHS look to change this practice. The Bill will allow for a
health-care surcharge for all non-EEA temporary migrants. This is in addition
to changing the ‘ordinarily resident’ qualification from those living in the UK
with a ‘settled purpose’ to those with ‘indefinite leave to remain’ (the latter
taking on average 5 years to achieve). The Department of Health estimates that
this move will affect 1.4 million people including many students, workers, and
vulnerable groups.
