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The Court of Appeal ruling limiting access to NHS services for
refused asylum seekers is bad news for everyone [1]. It is bad news for
refused asylum seekers, as we know from bitter experience that, despite
safeguards, they will come to harm [2]. It is bad news for other
vulnerable migrants with a poor understanding of or ability to communicate
their entitlement to free NHS healthcare, who will be charged in error
[2]. It is bad news for public health as, although many infectious
diseases will be exempt from charging, doctors will be unable to diagnose
them promptly if communities are not routinely accessing services. It is
also bad news for the public purse, as treating emergencies is much more
costly than preventative medicine.
There is no evidence of significant levels of ‘health tourism’ [3-5]
and no justification for charging vulnerable migrants for NHS Services
whilst they await removal from the country. Health professionals should
press the Government to amend the Health Bill, which is currently going
through Parliament, to restore access to NHS services for vulnerable
migrant communities. This is likely to be the fastest way to rectify the
damage done by the Court of Appeal ruling.
1. Dyer C. Government must give guidance on care of failed asylum
seekers who cannot return home. BMJ 2009; 338: b1345.
Lizzie Moore (Defend Primary Healthcare Campaign), Marion Birch (Executive Director, Medact), John S Yudkin (Emeritus Professor of Medicine, University College London), and Sir Alexander Macara (Chairman of Council, British Medical Association, 1993-1998)
Bad news for everyone
The Court of Appeal ruling limiting access to NHS services for
refused asylum seekers is bad news for everyone [1]. It is bad news for
refused asylum seekers, as we know from bitter experience that, despite
safeguards, they will come to harm [2]. It is bad news for other
vulnerable migrants with a poor understanding of or ability to communicate
their entitlement to free NHS healthcare, who will be charged in error
[2]. It is bad news for public health as, although many infectious
diseases will be exempt from charging, doctors will be unable to diagnose
them promptly if communities are not routinely accessing services. It is
also bad news for the public purse, as treating emergencies is much more
costly than preventative medicine.
There is no evidence of significant levels of ‘health tourism’ [3-5]
and no justification for charging vulnerable migrants for NHS Services
whilst they await removal from the country. Health professionals should
press the Government to amend the Health Bill, which is currently going
through Parliament, to restore access to NHS services for vulnerable
migrant communities. This is likely to be the fastest way to rectify the
damage done by the Court of Appeal ruling.
1. Dyer C. Government must give guidance on care of failed asylum
seekers who cannot return home. BMJ 2009; 338: b1345.
2. Kelley N, Stevenson J (2006). First do no harm: denying healthcare
to people whose asylum claims have failed. Available from
http://www.refugeecouncil.org.uk/policy/position/2006/healthcare.htm
(accessed 3 April 2009).
3. Johnson M (2005). Evidence to Third Report from the Health
Committee: patient and public involvement in the NHS. Question 211.
Available from
http://www.publications.parliament.uk/pa/cm200405/cmselect/cmhealth/252/...
(accessed 3 April 2009).
4. Robinson V, Segrott J (2002). ‘The decision-making of asylum
seekers’, Home Office Findings No 172. London: Home Office.
5. Project London (2008). Report and Recommendations 2007: Improving
Access to Healthcare for the Community's Most Vulnerable. Available from
http://www.medecinsdumonde.org.uk/doclib/104524-report2007light.pdf
(accessed 3 April 2009).
Competing interests:
None declared
Competing interests: No competing interests