“A modest thoughtfulness”BMJ 2008; 336 doi: https://doi.org/10.1136/bmj.39506.606215.94 (Published 06 March 2008) Cite this as: BMJ 2008;336:535
- Iona Heath, general practitioner, London
In March 2007 the UK Home Office published Enforcing the Rules: A Strategy to Ensure and Enforce Compliance with our Immigration Laws, to “ensure that living illegally becomes ever more uncomfortable and constrained until they leave or are removed.”
This followed the Department of Health consultation document Proposals to Exclude Overseas Visitors from Eligibility to Free NHS Primary Medical Services,published in May 2004. The results of the public consultation have never been published, but over the intervening nearly four years the rhetoric has shifted from the need to curb the perceived abuses of “health tourism” to an apparently deliberate intention to make the lives of people who have been refused asylum intolerable.
No one knows exactly how many refused asylum seekers are living in the United Kingdom, but the National Audit Office’s estimate in 2005 was between 155 000 and 283 500. Some people have been wrongly refused. Appeals against decisions have a high rate of success (more than 40% for Somali, Eritrean, and Zimbabwean nationals in 2006), indicating that the original processes were flawed. Increasing the limits on the availability of legal expertise and support are only likely to compound this. Some people …