Crackdown on migrants forces NHS doctors to "act as border guards"

A medical charity has launched a campaign against government guidance which “makes border guards of doctors” by allowing the Home Office to access details of undocumented migrants who seek NHS treatment.

Doctors of the World runs clinics for undocumented migrants, victims of trafficking and asylum seekers. It has assisted numerous patients, some pregnant and some with cancer, who are afraid of accessing NHS healthcare due to concerns that a visit to the doctor could lead to deportation.

The organisation has joined forces with the human rights charity Liberty and the National Aids Trust to launch a petition aimed at reversing a data-sharing policy between the NHS and the Home Office implemented this year. They want the government to “stop using NHS patients’ personal information to carry out immigration enforcement”.

Lu Hiam, a GP and Doctors of the World adviser, said: “Confidentiality is the cornerstone of the doctor-patient relationship. Deterring sick people from getting healthcare has serious consequences. Putting this data-sharing agreement in place without consulting doctors is nonsensical, given what a huge impact it has on our professional role.”

The government and NHS Digital, the body that stores patient information, published the agreement in January. The pact makes it clear that NHS Digital is legally required to hand over non-clinical patient details – including addresses and dates of birth – to the Home Office.

Use of NHS data has allowed immigration officials to locate, arrest and deport visa overstayers and undocumented migrants.

Doctors of the World has produced a “safe surgeries” toolkit that outlines practical methods doctors can use to keep patients’ addresses off NHS records, helping them circumvent the Home Office memorandum of understanding on data sharing.

The kit suggests ways to register patients using the address of the local GP practice and informs medical staff that they do not need to ask for a passport or proof of identity when registering patients. The pack also includes posters telling patients that they are not legally required to provide such information.

Martha Spurrier, the director of Liberty, says: ‘Fostering fear of the doctor in this way is a whole new dangerous and irresponsible low. Photograph: David Levene for the Guardian

Prompted by similar unease, the National Union of Teachers this week passed a motion condemning the Department for Education’s requirement, introduced last September, that parents must supply details of pupils’ nationality and country of birth to schools. The DfE may subsequently pass on this information to the Home Office. The request also forms part of a drive by Theresa May to create a “hostile environment” for illegal immigrants.

Miriam Beeks, a GP at Lower Clapton Group Practice in east London, has put up posters telling patients they can register as “no fixed abode”.

“Doctors, in general, hate the idea that they are being used as immigration officers. Doctors should feel confident about standing against this. We are backed up by both NHS and GMC confidentiality rules – our interactions with our patients are confidential,” she said.

Figures released this year show the number of Home Office requests to NHS Digital has tripled since 2014. Department of Health data reveals the Home Office made 8,127 requests for patient details in the first 11 months of 2016, which led to 5,854 people being traced by immigration enforcement.

Martha Spurrier, director of Liberty, said: “This government has made border guards of teachers, landlords, bank clerks and now even doctors – all as part of a misguided and counterproductive obsession with creating a ‘hostile environment’ for undocumented migrants.

“Fostering fear of the doctor in this way is a whole new dangerous and irresponsible low. It will put the health of the most vulnerable in society at risk, including children and victims of trafficking and torture.”
Deborah Gold, chief executive, of the National Aids Trust, said the decision must be reversed. “Without any consultation, NHS Digital have agreed to share important personal information with the Home Office. They have betrayed their responsibility to safeguard the confidentiality of NHS patients. They have also harmed public health as people are deterred from healthcare,” she said.

A government spokesperson said no clinical information would be shared. “We share non-clinical information between health agencies and the Home Office to locate individuals suspected of committing immigration offences. Access to this information is strictly controlled, with strong legal safeguards.

“Immigration officials only contact the NHS when other reasonable attempts to locate people have been unsuccessful. Anyone in genuine need can always receive treatment from the NHS – urgent or necessary care is never withheld.”

In its clinics providing basic healthcare to undocumented migrants, Doctors of the World has encountered numerous patients who have avoided seeking medical help because of their irregular immigration status.

The charity said it recently helped a woman who visited their east London clinic in labour. She had avoided seeking antenatal care because she feared being reported to the Home Office and was concerned about the cost of treatment.

Doctors of the World also highlighted the case of a young Ugandan woman who was almost six months pregnant and had not sought antenatal care because she was too scared to visit the doctor. She has lived in the UK for five years, her partner is a UK citizen and they are in full-time work, but she does not have a visa.

“I feel trapped. I’m in a situation where I need to go to the hospital but I can’t, because I feel my information might not be confidential,” the woman said. “I can’t imagine being separated from my partner. Maybe they would make me go back without my baby too. I would be separated from one or even both of them.”

Doctors of the World has also been contacted by a woman from the Philippines who has lived here for several years without a visa. She found a lump on her breast last September and was concerned because of a family history of breast cancer.

The woman, who worked as a cleaner, received an appointment for a biopsy but did not attend amid concerns that the hospital would share her details with the Home Office.

She said: “I felt like I was carrying the weight of the whole world. I was worried that if I went to the hospital and the immigration authorities know about it they might get me and deport me. But if I didn’t go to hospital, then what about the lump?”

She said she forced herself to go to a second appointment and the lump was eventually removed. She said: “In the end, I thought I must go. The lump was getting bigger, it was over 4cm by then. I was so scared at the hospital – my pulse was going so fast!”

The woman remains concerned about the risks of seeking medical help. “For years I had just tried to protect myself from getting sick – like by always wearing warm clothes – because I thought it wasn’t safe to go to the doctor,” she said.

Crackdown on migrants forces NHS doctors to "act as border guards"

NHS saves £600m in crackdown on agency fees

The NHS has slashed more than £600m from the billions it pays every year for temporary doctors and nurses by cracking down on fees paid to “rip-off” staffing agencies, new figures reveal.

Gaps in hospital rotas sent the bill for temporary staff soaring from £2.2bn in 2009-10 to £3.6bn last year. But hospitals have halted the relentless increase in recent years of the rates for stand-in personnel needed to ease chronic understaffing and ensure patient safety on wards.

Data compiled by NHS Improvement, which regulates the health service in England, shows that hospitals spent £613m less since the blitz on agency staff began on 15 October last year, compared to the 12 months before caps on hourly rates were brought in.

In August, for example, NHS trusts spent £252m on agency staff – £61m (19.5%) less than the £313m they paid out in the same month the year before. Similarly, in July they spent £256m compared to their £331m outlay in July 2015.

If maintained, the NHS stands to meet its target of spending £1bn less a year on temporary staff, which would be key to its ambition to reduce hospitals’ collective overspend of £2.5bn last year to £580m. Hospitals are now paying 18% less on average for nurses whom they hire through agencies which NHS England boss Simon Stevens last year criticised for “ripping off the NHS”. The limits on fees for stand-ins have also succeeded in reducing the cost of locum doctors, but only by 13%.

Jim Mackey, NHS Improvement’s chief executive, will cite the figures as proof that the NHS is making progress at controlling its costs when he, Stevens and health secretary Jeremy Hunt give evidence to MPs on the Commons health select committee on Tuesday.

Simon Stevens, chief executive of NHS England, has accused staffing agencies of ripping off the NHS. Photograph: Felix Clay for the Observer

Medical organisations reacted with alarm to disclosures that Theresa May, the prime minister, has told Stevens that, despite mounting concern that the NHS is under dangerous strain, it would not receive any extra funding when Philip Hammond, the chancellor, presents his autumn statement on 23 November. “If these reports are true, the prime minister needs to explain how exactly the NHS will keep up with rising demand without the necessary investment.

“Theresa May talks about injecting £10bn into the NHS, yet in reality the increase in health spending is less than half that,” said Dr Anthea Mowat, a spokeswoman for the British Medical Association.

“The NHS is already the most efficient healthcare system in the world. The notion that the funding crisis can be solved with further efficiency savings is a myth, and these are not savings, they are year-on-year cuts that have driven almost every acute trust in England into deficit, led to a crisis in general practice and a community and social care system on the brink of collapse,” added Mowat.

Two-thirds of the acute, mental health, community services and ambulance trusts covered by the new rules on agency staff had cut the amount of money they spend on them, NHS Improvement said. Since April trusts have only been allowed to pay 55% more than the usual rate for the job for temporary workers, though they are allowed to breach that supposed ceiling “on exceptional safety grounds” in order to ensure that patients do not come to harm because of staff shortages.

However, Mackey recently told trusts that, despite the progress on agency fees, “across the sector we are falling short of what is needed and must do more to reduce over-reliance on agencies”. The regulator will soon start to publish quarterly updates on how much each trust has spent on such staff in what some in the NHS see as a crude “naming and shaming” exercise designed to embarrass trusts into spending less and do not take account of high vacancy rates which force them to turn to agencies in the first place. It also plans to phase out altogether hospitals’ use of expensive interim senior executives, whose temporary costs can see them being paid over £1,000 a day. “Reducing spending on the agency bill is fundamentally important for NHS finances. But it’s not a panacea,” said Anita Charlesworth, chief economist at the Health Foundation thinktank, Hospitals are still heading for an overspend of £580m this year despite receiving £1.8bn of “sustainability and transformation” funding, and NS England has made only “slow progress” at finding its promised £22bn of efficiency savings, she warned.

“Reducing the agency bill will help but it’s not the solution. The NHS needs a comprehensive plan to improve efficiency,” she added.

“The NHS has saved over £600m since we introduced our agency price cap system. Most NHS trusts have responded well to the caps, using them to significantly reduce their agency spending and improve their workforce management,” said Dr Kathy McLean, NHS Improvement’s executive medical director.

NHS saves £600m in crackdown on agency fees

Stop this crackdown on abortion in Poland | Krystyna Kacpura

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As Poland’s rightwing ruling party seeks to tighten an already restrictive abortion law, there is a growing solidarity among women in the struggle for our reproductive rights

In my desk drawer, I have the signatures of 1,500 Polish women who support liberalising our country’s abortion law, which bans the procedure except in cases of rape, incest, foetal anomalies, or when the pregnant woman’s life is in danger. The signatures arrived too late – the day after our petition to support a more liberal law was due to be delivered to the Sejm, the lower house of parliament, but I won’t throw them out. I know what they represent – the growing solidarity among Polish women (and many men) in the struggle for our reproductive rights, a struggle once left to feminist groups working at society’s margins.

No longer. On Wednesday our fight will come up against another draft law – the “Stop Abortion” law – which has been put forward by the ruling Law and Justice party. Supported by the Catholic church, it would ban abortion in all circumstances except to protect the life of the pregnant woman.

Related: Thousands protest against proposed stricter abortion law in Poland

Continue reading…

Stop this crackdown on abortion in Poland | Krystyna Kacpura

Crackdown on student pub crawls

The Home Office is providing £90,000 for the first year of the scheme, which will take place at Loughborough, Nottingham, Manchester Met, Liverpool John Moores, Swansea, Brighton and Royal Holloway universities.

“Some students find themselves encouraged to participate in alcohol-fuelled activities which can damage health and in some cases spill over into disorder and anti-social behaviour.

“The NUS Alcohol Impact project, backed by the Home Office, will help participating universities to encourage responsible drinking leading to safer and more productive places to study and live.”

He added: “Accreditation should become a badge of honour for universities, and another factor which helps promote their world class teaching and research to prospective domestic and international students.”

Institutions will be expected to run responsible drinking campaigns and provide formal training for university staff on spotting the harm caused by alcohol.

Crime rates will be tracked during the pilot to assess its impact.

Colum McGuire, an NUS vice president, said: “We hope that the work of the project will allow us to create a social norm of responsible consumption by students at the pilot institutions, changing attitudes and behaviours towards alcohol, leading to safer and more productive places to study and live.”

Under the accreditation scheme, universities must prove they have taken action to “moderate or prevent” alcohol-related initiation ceremonies and tackle commercial pub crawls or “social media drinking games”.

Students’ unions, if they have a licensed bar, must not run “irresponsible drinks promotions” and actively refuse to serve drunk customers, the rules state.

Crackdown on student pub crawls

Labour programs for a crackdown on drinking, smoking and unhealthy meals

Contained in a report to the “society” sub-group of the shadow cabinet, the document states: “Up to 35 per cent of all A&ampE attendances and ambulance charges could be alcohol related and up to 70 per cent at weekend peak instances.”

It goes on to advocate a minimal cost for alcohol and restrictions on where drinks can be offered in supermarkets, stating: “The positioning of alcohol retail room in supermarkets must be regulated, for illustration, becoming restricted to a single defined spot physically distant from the doors.”

There would also be measures to tackle smoking so that “children born in 2015 will become the first smoke-free generation for hundreds of many years.”

The strategy would involve a ban on smoking in vehicles with young children present, a measure that has currently been backed by MPs, and the introduction of plain packaging.

The Mail on Sunday mentioned measures to combat obesity could end result in a ban on some high-sugar breakfast cereals and an finish to sweets at the supermarket checkout.

“They should not be permitted to stock confectionery and other unhealthy foods adjacent to checkout tills,” the document states.

Recommending an finish to drinks firms sponsoring sporting occasions by 2020, it goes on: “The promotion of alcohol via the sponsorship of sport need to be phased out for the duration of the course of the Parliament.”

Outlawing all promotion by drinks organizations would price the sporting planet £300 million a year, it was claimed.

The ban would influence 11 Premiership football teams and spell the end for Budweiser’s sponsorship of the FA Cup, Heineken’s branding of the European Cup rugby tournament and Crabbie’s assistance of the Grand Nationwide.

One Labour MP opposed to the plans informed the Mail on Sunday: “Issuing diktats on consuming and consuming and strangling supermarkets and drinks companies with much more regulations is a return to the failed Old Labour strategy.

“It is no much more reasonable than pondering you can management people’s gas and electricity expenses or how considerably rent they pay.

“We need to demonstrate enterprise we are on their side – and cease meddling in each factor of people’s lives.”

A Labour spokesman denied the proposals had been official celebration policy but mentioned the document “represents a wide assortment of choices”.

He explained: “Improving public overall health is crucial to people’s high quality of existence. Which is why we’ve rightly pressed the Government to finish their opposition to plain cigarette packaging.

“This paper represents a wide selection of choices and not Labour celebration policy.” Conservative Party chairman Grant Shapps stated: “It’s the identical old Labour. They claim they’re worried about prices but want to place up the value of a drink.

“Not only would that make a drink after operate more pricey, it would hit pubs hard, placing a lot of out of enterprise.

“It truly is turning out to be clearer every single day that Ed Miliband just offers much more of the very same outdated Labour, and no economic prepare to safe Britain’s future.”

Labour programs for a crackdown on drinking, smoking and unhealthy meals

Jamie Oliver calls for crackdown on junk meals being offered close to colleges

Jamie’s School Dinners in 2005 exposed how a lot unhealthy meals pupils had been served at school at lunchtimes. Photograph: Joerg Carstensen/DPA/Corbis

Campaigning chef Jamie Oliver has demanded a crackdown on the “crazy” policy of fast meals premises opening close to schools, as element of a renewed drive to tackle childhood weight problems.

Outlets currently being licensed to commence offering unhealthy items near colleges was completely at odds with the government’s investment in foods schooling and school lunches, Oliver said.

“I do find it entirely crazy that we do all this tough function in a single part of government while at the exact same time you’ve received other parts of government locally and nationally which are still permitting any old junk meals operator to open up inside of spitting distance of a school,” said Oliver. “That, to me, is madness.”

He also urged ministers to draw up a hard new blueprint to reverse the trend of growing weight problems and to appoint a figurehead to drive via changes.

“Optimistic social change is not that far away and I consider it truly is not that difficult but what demands to be done is for about 50 or 60 separate decisions and initiatives to happen at when, all followed by a 5-year strategy. The one particular point that will make a change is tons of changes.”

In an appeal for “leadership and vision” from all political events on what he known as “the shocking rise in diet-connected diseases and weight problems”, Oliver added: “Let’s see if we have one particular pioneer, one particular visionary who’s going to place prevention [of childhood weight problems] at the heart of its campaign”.

Oliver’s Channel four series Jamie’s School Dinners in 2005, which exposed how considerably unhealthy meals pupils have been served at college at lunchtimes, prompted the Labour government to introduce much more nutritious school meals in England.

Jamie Oliver calls for crackdown on junk meals being offered close to colleges