In its 2013 report, Growing Up in a Hostile Environment, Coram Children's Legal Centre highlighted that restrictions on access to free healthcare for migrants was a significant barrier to the promotion of children's wellbeing in the UK. The introduction of further restrictions last month have deepened these concerns, with migrants in the UK who do not have "settled status" (i.e. do not have "indefinite leave to remain") now facing charges for secondary health care and an Immigration Health Charge when they apply to extend their time in this country.
Secondary healthcare is available on the NHS for anyone who is "ordinarily resident" in the UK but the definition of "ordinarily resident" changed under the Immigration Act 2014. Therefore, any migrant with no permission to be in the UK, or with limited leave to remain in the UK, may have to pay for care provided in hospital. Treatment in accident and emergency, family planning services, treatment of specified infectious and sexually-transmitted diseases (including HIV), and treatment for torture, female genital mutilation, domestic violence or sexual violence, will all continue to be provided free of charge.
Treatment that is immediately necessary (i.e. needed to save a patient's life, prevent a condition from becoming immediately life-threatening or to prevent permanent serious damage) must be provided even if the patient has not paid in advance. However, this does not mean that it will be free of charge - instead payment will be sought after treatment has been provided. NHS bodies can also share data with the Home Office on patients with a debt of £1,000 or more that has been outstanding for three months and the Home Office can then deny any future immigration application the person with the debt might make. The inability to pay is a huge deterrent for migrants accessing care, a concern noted in a recent report by Doctors of the World that found many pregnant women were too scared to access care, sometimes leading to them suffering complex problems in childbirth.
In addition, from April 2015, any non-European economic area national making an application for limited leave to enter or remain in the UK for more than six months will also have to pay a "health charge" alongside their application fee - £200 a year for every year of leave granted (apart from students and their dependants who will be charged £150 a year). If no fee is paid, then the application will be deemed to be invalid and will not be processed.
Exemption from charges
Refugees, those applying for asylum, victims of trafficking and children looked after by a local authority are all exempt from these charges. However, migrant children in families and care-leavers who are "unlawfully in the UK" will be negatively affected. Many families who are in receipt of local authority support under section 17 of the Children Act 1989 because they are destitute have enforceable rights to remain under the family and private life rules but do not have indefinite leave to remain. Furthermore, the exclusion of undocumented migrants from receiving free secondary healthcare means that hospitals and practices are obliged to check the immigration status of patients.
The link between status and the provision of services may deter those whose status is precarious and who fear engagement with the Home Office from accessing any care at all, not even registering with a GP.
Healthcare professionals have already lamented the Home Office's "invasion of public services", which undermines the trust between public service providers and users, a trust that is particularly important given many migrants' fear of detection. These changes will leave the health of migrant children at further risk and it is vital that any professionals working with this group are aware of their rights.
- For more information, see the Migrant Children's Project fact sheets on healthcare: http://bit.ly/1bOJ89S
Do you work with young refugees and migrants?
- The Migrant Children's Project offers FREE legal advice to frontline practitioners and carers on the rights and entitlements of refugee and migrant children and young people
- Call the Migrant Children's Project Advice Line on 020 7636 8505, open 10am-6pm, Tuesday to Thursday.
Legal Update is produced in association with experts at Coram Children’s Legal Centre ?www.childrenslegalcentre.com
?For free legal advice on issues relating to migrant children call 0207 636 8505
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