Stop changes to NHS up-front charging!

We call all Eastern Europeans, our supporters and all members of the general public to sign in the petition to stop changes to the way how NHS charges for health services. To add your name to the list of signatories before the 2nd of October 2017 please go here. Do not wait – it is in your interest.

The Rt Hon Jeremy Hunt, MP, Secretary of State for Health lays before the Parliament the changes to the way how NHS charges people with no right to free health services. We believe that many of Eastern Europeans can be adversely affected by these changes.

What do these changes mean?

Changes mean that the NHS will apply up-front charges to everyone who may be not eligible for free NHS treatments. GP and A&E services would stay free for everyone. We believe that there is a significant group of people who would suffer from these changes. Among them are disadvantaged and vulnerable people, such as older people, mental health sufferers, people fleeing domestic violence and modern slavery, and those who are excluded and exploited.

A patient approaching a NHS service will have to evidence that they have right to use services without cost. It means, for example, presenting residency documents, visas, proof of living and working in the UK and so on.

We believe that there are other, more efficient ways of ensuring that patients have or don’t have a right to the free NHS services. We, as well as many of our friends in other charities, civic organisations and members of the general public, would be happy to consult with the government on how to enable fair access to the free NHS services. We don’t think that up-front charging is the right approach.

There is a number of issues with this approach.

Firstly, some non-British citizens may have problems evidencing their right to free NHS service. Among those may be older people, the homeless, people with mental health issues and learning disabilities, young migrants and refugees, victims of human trafficking, and others who experience disadvantage or vulnerability.

For example, a Polish woman who is fleeing domestic violence may feel she is not eligible for the free health service because for the last few years she has been a stay-at-home mum supported by her partner, so now her right to reside can be challenged. It shouldn’t matter but she doesn’t know the law well and fears that whatever she does, she would be charged. She may have left all her documents at the premises she fled from so she can’t even evidence that she is an EU national. If she suffered physical and mental traumas as a result of domestic violence, she needs to access specialist services.

Secondly, we believe that not every non-British citizen living in the UK would know what paperwork is necessary to prove the right to free health service. It may mean that many of them would voluntarily pull out of the health system. It’s not potentially dangerous only for them but also for all of us.

For example, a Lithuanian man who suffers from TB may have doubts if he is eligible for the free service and to avoid high up-front charges he may choose not to go to the specialist service. TB is a highly infectious disease. TB sufferers who are not treated spread the disease to all of us.

Thirdly, we believe that the pressure put on the NHS personnel would adversely affect the services’ capacity to provide treatments and care needed. The NHS staff will, in effect, be required to conduct immigration checks on potential patients. To avoid unintended racial profiling (i.e. making judgements about person’s nationality and race based on superficial indicators, like the colour of skin, an accent or sounding of the name) NHS people would have to check everyone. Time and effort consumed by this exercise should be spend in providing high-quality services to patients. There is a risk it would cause additional queuing and delays.

For example, a Slovak man has been residing in the UK for the last 12 years. Because his name indicate an origin other than British and he may speak with feint Slovak accent, the NHS staff may be poised to control his immigration status to establish if he needs to be charged up-front or not. As he is an EU national, he doesn’t have a visa or other immigration document (he doesn’t need to) so he needs to present a portfolio of documents proving his work and residence. Regardless of how well trained the NHS person dealing with him is, the process would take at least half an hour to an hour. If he has a patchy employment history, for example a bit of employment and a bit of self-employment, and he moved house a lot, this process can take two or more hours. This is time that could have been spent on supporting other patients.

We have faith that there are other ways of ensuring that the free NHS services are accessed only by those people who have a right to do so. But up-front charging is not one of them. Please sign the petition here – let’s work with the government to find a better way.