BlogPatients Not Passports

In August 2021, the Greater Manchester Patients Not Passports coalition called for signatures to an open letter to the NHS Trusts in Greater Manchester, alongside the Greater Manchester Health and Social Care Partnership and Mayor of Greater Manchester Andy Burnham. It called for support in ensuring that everyone has access to healthcare, regardless of immigration status, ID or proof of address. Here is an update from the campaign on its progress.

The letter, signed by 33 Organisations and many individuals, was sent to the Board of Governors for each Acute Trust in Greater Manchester, as well as to the Christie Hospital, and to the Greater Manchester Mayor in January 2022. Accompanying our letter was an offer to provide any further information, or a speaker, if that would be helpful.

As the Boards of Governors only meet at intervals, and that has been somewhat disrupted by the Pandemic, we were prepared for some delay in response.

However, so far only 5 Trusts have replied.

We have, shockingly, heard nothing from the Greater Manchester Mayor, Andy Burnham, although we had confirmation early on that this would reach his desk.

Update on Current Campaign Developments

Statement that letter will go to Governors – but hasn’t yet:

Wrightington, Wigan and Leigh Trust have assured us it will go to the Governors although we have not been told the date at which it will be considered. We have heard nothing further from WWL despite polite enquiries.

No response at all:

Bolton Trust and the Northern Care Alliance (covering Salford Royal/Hope Hospital, Bury, Rochdale and Oldham hospitals) have simply not replied. These are public bodies which have had a matter of public concern addressed very properly to their Boards of Governors – one of whose roles is to represent the public – so this is particularly shocking. We continue to pursue a reply.

‘Nothing to do with us’

The Christie has recently replied, stating that they were bound by the rules of the NHS, but that they would always treat a patient that came through their doors and deal with other matters later. A reply from GMPNP is in draft – as this is similar to the response received by two other Trusts and does not address the issues.

Two more Trusts, Stockport and Tameside, initially gave a similar perfunctory responses, both indicating (in almost identical terms) that this would not go to the Board of Governors ‘because it was a national policy’.

Accordingly, we wrote back to them with a detailed response explaining that by not raising concerns when it is clear to them that the Trust is pursuing a policy which causes harm to members of the public which it serves, the Council of Governors is failing in their statutory duties to represent the interests of the public and to hold the directors to account. Our letter explained that the Trust does have considerable control and discretion as to how they operate these policies and that these matters are not simply nationally defined matters over which the trust has no influence or control. It also pointed out that the charging of vulnerable migrants and families for health care is contrary to the principles and ethos of the NHS to provide universal health care on the basis of clinical need, that is free at the point of delivery. It is also contrary to the inclusive values of the NHS to provide health care regardless of ability to pay and regardless of race, gender, religion, or sexual orientation. We also suggested various actions, including that they join their voices to that of the NHS Confederation (which is ‘the membership organisation that brings together, supports and speaks for the whole healthcare system in England, Wales and Northern Ireland’) in raising concerns.*

The Trusts each said that they would consider the matter further and respond, but we recently received responses which said little more than the first letters. We are in process of responding appropriately.

Detailed discussion

Lastly, we can report that Manchester Foundation Trust (covering Wythenshawe, the Central Manchester group of hospitals, Trafford General and North Manchester General) could not put the Open Letter on the agenda for the Governors meeting at the time the letter was received, but set two Directors and a representative from the OVM (the erroneously-titled “Overseas Visitors” Management) team to talk to GM PnP in the meantime. It was clear that the Trust, while firmly stating that its aim is to be as inclusive as possible, had not considered the detail of these policies and their effects.

We had a very positive meeting and we were able to present a lot of information about the law, the harm these policies cause, sources and resources, and suggestions for action which we confirmed, at the Trust’s request, in a follow-up letter. They have promised to consider and come back to us for a further meeting.

We hope that this update is helpful. We recognise the difficulties NHS bodies are faced with in this current period, which is why we have left a considerable period for them to respond, before making responses public. Should you feel able to address a courteous letter to any of the Chairs of Trusts, or the Greater Manchester Mayor, to encourage that the matter be addressed, that might be very helpful: I fear that in the present climate, in order to progress this campaign we need all of us to actively follow up their support for this campaign. But be that as it may, we will continue to pursue this and, with your support, we hope to make a difference.

Frances Kelly for Greater Manchester Patients Not Passports

*The NHS Confederation report recommends that government,

“Review the potential for policies such as eligibility checks and overseas visitor charges to be a vehicle for promoting institutional racism. Such policies facilitate the hostile environment, disproportionately impacting BME staff, patients and service users.”

and also that

“The independent Race and Health Observatory, hosted by the NHS Confederation, will be a key in this respect” (i.e. structural health inequities, institutional racism and Covid-19.)