From the 27th of October 2020 the Immigration Health Surcharge will increase from £400 to £624 per year. This price hike is unjust in the face of an economically destabilising pandemic, but is perfectly in step with the Home Office’s increasingly iniquitous attitude towards migrant healthcare. Although the Immigration Health surcharge contributes only 0.18% of the NHS budget, the existence of migrant health charges betrays a deeply troubling government attitude towards the NHS.
The coronavirus pandemic has put huge numbers of jobs at risk, casting many into financial insecurity. The surcharge rise may make visa renewal an impossibility for people in vulnerable economic situations. Those who have lived in the UK for years could find themselves without a legal means of remaining. What if they need to seek critical medical care? They will have to pay up to 150% of the cost price, and might end up in a situation similar to that of Simba Mujakachi.
In 2004 Simba’s family fled political persecution in Zimbabwe and settled in the UK. Successive UK governments have refused them asylum, and last year Simba almost died of a stroke from underlying health conditions. Having survived political persecution and official rejection, he now has another problem to overcome: because he is a ‘refused asylum-seeker’ he is obligated to pay his medical expenses in full.
Those expenses – £6000 for a few appointments – drove Simba to end medical treatment for a blood-clotting condition. This condition later led to a stroke; a coma; and upon waking, a crippling £93,000 bill for “the life-saving treatment he had been given”. Like many others in his situation, he has become the victim of divisive, controversial Home Office policies that actively militate against people without asylum, forcing healthcare professionals to act against the Hippocratic oath by denying people access to care.
Nye Bevan, founder of the NHS, famously claimed that “Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised, but a misfortune the cost of which should be shared by the community”. Healthcare should be free for all at the point of delivery. By forcing medical staff to engage in migrant health charges and data sharing with the Home Office, the government abrogates its duty of care and adherence to the principles of confidentiality laid out in the NHS constitution. This is a world where people like Simba can’t afford treatment for life-threatening conditions. This is a world where migrants eschew healthcare for fear of their privacy being breached. Perhaps the government would prefer article 2 of the NHS constitution to read “Access to NHS services is based on clinical need and immigration status, not an individual’s ability to pay”.
Bevan also explained that it would be “unwise as well as mean to withhold the free service from the visitor to Britain. How do we distinguish a visitor from anybody else? Are British citizens to carry means of identification everywhere to prove that they are not visitors?”. Doctors of the World’s recent audit concludes that charging policies are “too complex for NHS trusts to apply correctly and many NHS trusts are failing to correctly assess when an individual can reasonably be expected to leave the UK”. Through such mistakes, patients are regularly denied necessary care. Migrants are waiting an average of 37 weeks for NHS treatment, compared to the NHS’s 18-week maximum target. All too often people in this situation are destitute, unable to work or claim government support. Simba’s case is emblematic – a family fleeing political persecution yet continually denied asylum. Surely this goes against everything Bevan stood for: no one in this situation could pay £100,000 for life-saving healthcare.
Migrants pay for the NHS as everyone does – through taxes. On the 10th of October activists from the GMIAU joined others from We Belong, Keep Our NHS Public, Docs not Cops, Migrants Organise, Stand Up to Racism and more in cities across the UK to protest against the spectre of increasingly punitive NHS charges. We must stand together against this price rise and the principle behind it, while striving for a complete end to migrant health charges and NHS data sharing. The NHS is one of the few remaining institutions that the UK takes pride in – let’s make sure it stays public and accessible to all.
Please donate to Simba’s healthcare fund here.
Hashtags to use: #JusticeForSimba #immigrationhealthsurcharge #PatientsnotPassports #ScraptheSurcharge