Intended for healthcare professionals


Doctors’ leaders join MPs to demand transparency in migrant health policies

BMJ 2019; 365 doi: (Published 01 April 2019) Cite this as: BMJ 2019;365:l1527
  1. Harriet Pike
  1. Cambridge, UK

Senior doctors, politicians, and academics have joined forces to demand that the government improves transparency around its policies on charging migrants for healthcare.

The heads of the Academy of Royal Medical Colleges, the Faculty of Public Health, and several medical royal colleges, as well as a number of Labour and Green Party MPs, have written to the secretary of state for health and social care calling for charges for migrant patients to be suspended, pending an independent review of their effect and the immediate publication of evaluation work already conducted.

In 2017, the government introduced new measures to support the collection of fees from patients from overseas who were accessing the NHS and who were not entitled to free care.1 It subsequently announced a review into the impact of the changes.2 The findings have not been made public, although in December 2018 health minister Stephen Hammond said that the government had found no evidence that the changes had deterred overseas patients from seeking treatment or had any effect on public health.3

In their letter, the 83 signatories said that much greater transparency was needed and that the decision not to publish the review’s findings risked damaging trust in the Department of Health and Social Care. They also highlighted two further reviews commissioned by the government. In February 2018, Public Health England called for evidence to evaluate the impact that sharing patient data with the Home Office had on health seeking behaviour and health outcomes of the migrant population. It had a commitment to report in January 2019.4 The third review was an independent evaluation of a pilot that sought to test the impact of requesting two forms of identification from all patients in hospital departments across 20 NHS trusts, conducted in late 2017.

“The evaluations are a valuable source of information that would support parliament, stakeholders, NHS practitioners and the general public to understand the impact of NHS migrant charging and data sharing policies on patients and enable wider public scrutiny of decision making,” the letter, dated 27 March 2019, stated.

Helen Stokes-Lampard, chair of the Royal College of GPs and one of the signatories, said that the college had fed its concerns around charging migrant patients into government consultations. “It would be useful to see the results of these exercises,” she said.

“We recognise that the NHS must not be abused and measures need to be taken to tackle health tourism—but our view is that it should not be the role of doctors or other healthcare professionals to police this. We are also concerned about the risk of ill patients not seeking medical care because they cannot afford treatment—something that has the potential to affect some of the most vulnerable in society.”

The joint letter follows a call made in December 2018 by senior public health physicians and medical royal colleges to suspend the NHS charging regulations.5


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