To all Greater Manchester Hospital Trusts,

In 2017 the UK Government introduced an Immigration Health Surcharge for overseas visitors. Since then, those unable to prove ‘Ordinary Residency’ are chargeable for their healthcare upfront.

The impact of these healthcare charges on migrants, Black, Asian and minority ethnic (BAME) people, the homeless and other marginalised groups has been well documented. These policies introduce immigration checks into healthcare, discouraging people from seeking the medical attention they need, despite often being entitled to access such care. The resultant delay to medical treatment causes direct harm to individuals, communities, and a significant cost to the taxpayer.

NHS data sharing agreements with the Home Office have been used to reject immigration applications, undermining the patient-practitioner relationship, and introducing soft borders into the NHS. There is no specific requirement upon Trusts in legislation, to engage in any of these instances of data sharing with the Home Office.

COVID-19 has highlighted the importance of access to healthcare for all, regardless of immigration status. Migrants, who are predominantly from BAME groups, have experienced the effects of the Government’s Hostile Environment immigration policies acutely during the pandemic. One-third of people in Greater Manchester are BAME and over 20% of the UK asylum population live in the North West. Regionally, BAME people are more than twice as likely to die from Covid than White people.

We welcome the government’s concessions in waiving charging of migrants for the treatment of COVID-19 and for suspending the health surcharge for Health and Social Care professionals. We also recognise the efforts of local NHS organisations to reach out to at-risk populations, particularly in the vaccination campaign. However, temporary measures are not enough – more needs to be done.

Manchester has a long history as a welcoming city for everyone and we want to ensure that this inclusive environment continues into the future. As the COVID-19 pandemic has shown, nobody is safe unless everybody is safe. As such, we ask you to stand with us and call on the Government to end migrant charging within the NHS.

We ask that you:

1. Guarantee a firewall preventing any healthcare data being shared for the purposes of immigration enforcement.

2. Publicly and practically oppose all NHS charging for migrants, in particular the National Health Service Overseas Visitor Charging Regulations 2015 and 2017.

3. Promote a welcoming environment for all patients, regardless of immigration status, including removing hostile publicity around healthcare charging and providing adequate information and advice for all.