Rather than use World Health Day to draw attention to global health priorities, this year, healthcare providers are being asked to implement racist government policies and compromise our professional values. Earlier this year, health minister Jeremy Hunt announced that, from April 2017, NHS trusts would be legally obliged to check patients’ eligibility for NHS services upfront, and to demand payment before providing care.
These checks lead to racial profiling and will prevent those most in need of care from getting the treatment they need. This is already evident with pregnant women delaying or avoiding seeking necessary medical advice or treatment because of fears they will be unable to pay or will be reported to the Home Office.
As doctors, we are acutely aware of the devastating impacts of delayed medical attention. In my field – obstetrics and gynaecology – we know that getting the right care at the right time is critically important for the health of women and their babies. In 2014, a woman thought to be carrying a dead foetus declined induction of labour because she feared she would be denied re-entry into the UK if she was unable to pay her bill of thousands of pounds.
The amount of money [lost to "health tourism"] is a drop in the ocean for the NHS
Dena Bryant, a lifelong resident of Grantham, had her eligibility for care at her local hospital questioned by a nurse who justified her questioning because Bryant was “not white” and did not “look English”.
The reality is that these policies represent yet another instance of the government attempting to blame migrants for the devastating impact of their austerity agenda. The Department of Health’s own estimate is that “deliberate health tourism” costs at most 0.3% of the NHS budget annually. This amount of money is a drop in the ocean for the NHS, while a £5,000 charge may be everything to a patient seeking treatment.
We should be concerned about the sustainability of NHS funding, but this focus is a distraction from the real issues, such as the billions of pounds spent annually on PFI repayments. Checking passports at the point of care will not rectify budget concerns, and directly contradicts the values on which the NHS was founded. We are being asked to prioritise recouping costs over providing care to those who need it.
Docs not Cops, a group comprised of NHS staff and patients, has been campaigning against these changes. On Wednesday, the group blocked the entrance to the Department of Health with a makeshift immigration checkpoint. We believe everyone has a right to access the healthcare they need, regardless of their immigration status or ability to pay. NHS workers should not be forced to police the people we treat.
The relationship between the doctor or health professional and a patient relies on respect and trust. A policy that demands we verify eligibility and report ineligible patients prioritises money over care, and jeopardises the relationship between a patient and their care provider. As a doctor, the Declaration of Geneva and the International Code of Medical Ethics require that my patient is my first consideration, and declares that I owe my patients complete loyalty. Policing people seeking my care would directly contravene these guidelines that say we cannot allow race, ethnic origin, or social standing, among other characteristics, to intervene between our duty and our patient.
As NHS staff and patients we will continue to fight divisive policies that fuel racism and threaten the values on which our NHS was built. Docs Not Cops is working with groups around the country to build a network of sanctuary GP surgeries, hospitals and wards. These would be sites of non-compliance with ID checks. We encourage wards, GP surgeries and individuals to sign a pledge to never ask to see ID or deny anyone healthcare, and to sign our petition calling for an end to bedside charging.
The National Health Service was built on the principle that healthcare is a right not a privilege. Almost 70 years after its inception, we are here to demand that this core principle remains.
Passport checks for patients is an abandonment of NHS principles | Zoe Stewart
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