Intended for healthcare professionals

Rapid response to:


Extending migrant charging into emergency services

BMJ 2016; 352 doi: (Published 09 February 2016) Cite this as: BMJ 2016;352:i685

Rapid Response:

Open letter calling on the BMA to denounce the Immigration Act in healthcare and recognise the value that migrants bring to the NHS


We support the British Medical Association in denouncing planned charges for primary care and A&E services as we are concerned about the impact for vulnerable migrants using the NHS.

These charges risk worsening anti-immigration sentiment by falsely blaming the crisis in NHS funding on migrants who already contribute to society. The charges create a two-tier system that distinguishes between migrants and British citizens, and could jeopardise free care at the point of delivery in the future.

The complexity of the charging system makes it impossible for staff to make decisions on who should pay without discriminating. Those who should be exempt from the charges, such as trafficked people and refugees, will continue to be caught up in the charging process. And for those who know that they might be charged or even deported for accessing NHS care, it means delaying seeking help, as in the tragic case of Dalton Messam, who died as a consequence.

The charging programme requires doctors to make decisions about eligibility. Clinicians are even asked to “bear in mind individuals’ ability to pay” when considering a management plan. The BMA is holding a conference in Belfast on 19-23 June. We are appealing for them to promote the value that migrant workers bring to the NHS and stop forcing healthcare workers to act as border guards (


Ruth E Atkinson (Public Health student and member of DocsNotCops)

Reem Abu-Hayyeh (Migrants' rights campaigner and member of DocsNotCops)

Ellie Rea (medical student and member of DocsNotCops)

Sophie Willams (medical student and member of DocsNotCops)

On behalf of DocsNotCops and the following organisations and individuals contacted by DocsNotCops

Brighton Migrant Solidarity
Doctors of the World
Hummingbird Project
Lesbians and Gays Support the Migrants
Maternity Action
Migrants’ Rights Network
Momentum NHS
NHS Solidarity
People’s Health Movement
Positively UK
Sanctuary on Sea
Sophia Forum
South Yorkshire Migration and Asylum Action Group
Tower Hamlets Keep Our NHS Public

Dr Allyson Pollock (Professor of Public Health Research and Policy, QMUL, and Director of Global Public Health Unit, QMUL)
Dr David McCoy (Global Health Teaching Director, QMUL and Director of Medact)
Dr Elias Kondilis (Senior Lecturer in Health Systems, QMUL)
Dr Henrique Carvalho (Assistant Professor, School of Law, University of Warwick)
Professor John Moxham (Director of Clinical Strategy for King’s Health Partners and Professor of Respiratory Medicine, Kings College London)
Dr Kambiz Boomla (Clinical Lead in the Clinical Effectiveness Group, QMUL)
Professor Martin McKee (Professor of European Public Health, LSHTM)
Dr Nicholas Hopkinson (Reader in Respiratory Medicine, Imperial College)
Dr Sarah Steele (Lecturer in Global Health and Law, QMUL)

Dr Aislinn Macklinn-Doherty (on behalf of NHS solidarity)
Dr Alind Srivastava
Dr Angharad Spencer-Matewere
Dr Ann McCormack
Dr Anna Livingstone (GP Tower Hamlets and Secretary of Tower Hamlets Keep Our NHS Public)
Dr Clare Gerada (GP and former chair of the RCGP)
Dr Coral Jones (GP, Tower Hamlets)
Dr David Wrigley (GP in Carnforth, on BMA Council and chair of Doctors in Unite)
Dr Francesca Silman (GP ST3)
Dr Emily Dobell
Dr Emma Glass
Dr Evan Edmond
Dr Hidigo Dulane
Dr Hugh Grant-Peterkin MRCPsych
Dr Jackie Applebee (GP, Tower Hamlets)
Dr Jane Stratton
Dr Jeeves Wijesuriya
Dr Jij Chow
Dr Jonathan M. Clarke
Dr Julia Patterson
Dr Kailash Chand
Dr Kelly Cruikshank
Dr Lai Ling Tan
Dr Lauren Gavaghan
Dr Marcello Scopazzini
Dr Megan Parsons
Dr Mita Dhullipala
Dr Mona Kamal Ahmed (NHS Solidarity)
Dr Neil Tiwari
Dr Nina Dutch
Dr Pete Campbell (BMA JDC Northern secretary)
Dr Ruhe Chowdhury
Dr Selvaseelan Selvarajah (GP Partner, Bromley by Bow Health Partnership, Tower Hamlets, London)
Dr Thabo Miller
Dr Tomasz Pierscionek
Dr Veronika Wagner (SAS Doctor)

Other signatories:
Emma Runswick (medical student)
Joanna May Sutton-Klein (medical student)
Khalil Secker (medical student)
Salma Yaqoob (Manager at Birmingham and Solihull Mental Health Foundation Trust and Head of Birmingham Stop the War Coalition)
Sam Easdon (medical student)
Shohaib Ali (medical student and BMA representative for Imperial College)
Stephen Naulls (medical student)

Competing interests: No competing interests (REA, RA-H, ER, SW)

21 June 2016
Ruth E Atkinson
Reem Abu-Hayyeh, Ellie Rea, Sophie Willams