New research exposes extent of Hostile Environment in Welsh NHS

Two years after the introduction of Hostile Environment policies in the NHS, new research published today by Docs Not Cops Swansea shows how migrants are being left in thousands of pounds of debt for accessing healthcare that they need – despite their care accounting for only 0.016% of the Welsh NHS budget.(1)

Data from Freedom of Information requests submitted to the seven Welsh Health Boards by the campaign group shows that in the financial year 2017/18:

  • 1,208 patients were identified as ‘overseas visitors’ – people considered not ‘ordinarily resident’ in the UK. This could include people who may have lived in the UK for many years but are unable to prove their eligibility for NHS treatment, such as members of the Windrush generation, as well as survivors of trafficking and domestic workers whose employers have failed to renew their visa.(2)
  • 285 patients were charged a total of almost £1.1m for NHS care due to being designated a ‘overseas visitors’ – an average of £3,787 per patient. Aneurin Bevan University Health Board’s Overseas Visitors Policy states that it charges 150% of the cost of treatment, meaning that patients are being charged more than it costs to provide their care.
  • Over one-third of the charges (£399,426) remain outstanding, suggesting that many patients are unable to afford to pay for the treatment they need. Unpublished guidance from the Welsh Government released in response to the requests states that health boards should seek payment before treatment starts, meaning that some patients may be declining treatment that they need because they can’t afford it or are concerned about getting into debt.

Christine Haigh from Docs Not Cops Swansea said:

“Two years after being introduced in the NHS with devastating consequences, this research shows that the Hostile Environment is alive and well in Wales, denying people access to healthcare or pushing them into debt to get the treatment they need.

The Welsh Government must firmly reject this racist Westminster policy and make it clear that NHS care is available to all in Wales on the basis of need – as its Welsh founder, Aneurin Bevan, always intended it.” (3)

The Docs Not Cops campaign is a UK-wide campaign calling for an end to checks on patients’ immigration status and charging patients for NHS care. There are many examples of patients who have died or suffered harm as a result of the policy, including:

  • Nasar Ullah Khan, who died after being denied treatment for heart failure. (4)
  • Elfreda Spencer died because she could not pay £30,000 upfront for chemotherapy. (5)
  • Kelemua Mulat died following a six-week delay in her breast cancer treatment while the hospital decided if she would have to pay. (6)

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Notes to editors:

  1. The total charged in 2017/18 was £1,079,236 out of a total Welsh NHS budget of £6,563,488,000 (source:
  2. Examples could include survivors of trafficking, those on spousal visas whose relationship has broken down, domestic workers whose employers have failed to renew their visa, and people who came to the UK as children whose parents did not have documentary evidence of their immigration status. It also includes short-term visitors to the UK whose country of origin may have a reciprocal healthcare agreement with the UK enabling them to access care for free or at a reduced cost.
  3. Welsh founder of the NHS, Aneurin Bevan, wrote in 1952: “One of the consequences of the universality of the British Health Service is the free treatment of foreign visitors. This has given rise to a great deal of criticism, most of it ill-informed and some of it deliberately mischievous. Why should people come to Britain and enjoy the benefits of the free Health Service when they do not subscribe to the national revenues? So the argument goes. No doubt a little of this objection is still based on the confusion about contributions to which I have referred. The fact is, of course, that visitors to Britain subscribe to the national revenues as soon as they start consuming certain commodities, drink and tobacco for example, and entertainment.” (In Place of Fear (1952) by Aneurin Bevan)
  4. Source: My patient has been denied life-saving treatment because of where he was born
  1. Source: Cancer patient died after NHS demanded £30,000 for treatment
  2. Source: Home Office prevented asylum seeker’s urgent cancer treatment

Healthcare workers blockade NHS England and hold vigils at six Hospitals to protest charging for migrants in the NHS

six people in scrubs with hands tied by rope, 8 holding signs reading "NHS - Our Hands Are Tied By The Hostile Environment"
  • On Wednesday 23rd October doctors, nurses, patients, and community groups will stage a national day of action to protest immigration checks and charging in the NHS.
  • This marks two years since the introduction of upfront charging for care in the NHS, part of the ‘hostile environment’ policies that have been widely criticised by healthcare workers since their introduction into the NHS.
  • Campaign group Docs Not Cops will blockade the offices of NHS England for their role in passing patient data to credit check agencies to check their entitlement to care.
  • In the evening, healthcare workers and local campaign groups are holding vigils at 6 hospitals around the country to stand in solidarity with the people impacted by NHS charging.
  • Since the introduction of the policy in 2017, a number of people have died after being charged for care or denied treatment, as a result of their immigration status. 

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On 23rd October 2017, the Government made it a legal duty for NHS Trusts to charge up-front for treatment for people who are unable to prove their entitlement to free NHS care, and increased the chargeable amount to 150% of the cost of the treatment. This was a significant change in the way the NHS administered charging for care, and has increased the need for hospitals to check IDs and immigration status before providing care.

The impact has been wide ranging, impacting migrants, UK citizens, and groups of people supposed to be exempt from charging as evidenced by the Windrush Scandal, research by the Equality and Human Rights Commission, and the Government’s own review. The policy has faced harsh criticism from the healthcare community with members of the BMA overwhelmingly voting in favour of scrapping the policy and both the Academy of Medical Royal Colleges and the Royal College of Midwives calling for the policy to be suspended pending a formal review of the impact. Last week the charity Maternity Action launched a court case challenging the discriminatory impact of charging migrant women for care.

The Human Cost of Charging 

Since the introduction of the charging policy, there have been many cases of people who have died as a result of delayed treatment or being denied care. In a number of cases, it was found that their treatment had been wrongly denied or charged. 

  • Nasar Ullah Khan – a 38 year-old Pakistani national living in Birmingham – died after being denied a heart transplant as a result of not having indefinite leave to remain, and was presented with £32,000 in care costs. 
  • Elfreda Spencer – a Jamaican-born grandmother living in London – was told she had to pay a £30,000 upfront deposit before her chemotherapy for breast cancer could begin. She waited for a year before being treated, by which time her cancer had become terminal. She died aged 73 in London last year.
  • Kelemua Mulat – a 39 year-old mother of one from Ethiopia – was denied treatment for six weeks for advanced breast cancer while the hospital tried to work out if she was eligible for care. She eventually started treatment, but by that time the cancer had spread. She died one month ago. 
  • Saloum –  a 53 year-old Gambian man forced to flee his home as an outspoken oponent of FGM – collapsed in December 2018, and was found to have terminal brain and lung cancer. He was unable to access free NHS care and was turned away from hospital because he could not pay the £8,397 bill, eventually becoming homeless. He died in April 2019
  • Other stories of people impacted by the charging regulations include Albert Thompson, Esayas Welday, Pauline Pennant, Beatrice, Bhavani Espathi, and Evette White


Campaign group Docs Not Cops [1] has organised a national day of action to mark the two year anniversary of the introduction of upfront charging and highlight their calls for an end to charges for NHS care.

This morning they will stage a blockade at NHS England, to highlight their role in running a pilot scheme in which NHS Trusts were encouraged to share patient data with Experian to check their entitlement to care.

In the evening, vigils will be held at 6 hospitals across the country: Brighton, Birmingham, Bristol, Manchester, and in London at the Royal London and Lewisham Hospitals. The vigils will see thousands of healthcare workers, patients, and community groups come together to stand alongside people who are affected by the Hostile Environment, and share stories of the impact of NHS charging.


Luke Costello, Senior NHS Nurse , said:  

“I started working in the NHS because I believed in its founding principles, that care should be given on the basis of need, not ability to pay – but the charging regulations brought in under the Hostile Environment have completely overturned that. It’s becoming increasingly impossible for me to care for and build trust with my patients when they know I might ask them to pay. The government must put an end to charges for care, and commit to the founding principles of the NHS: that it is a service free to all who need it.” 

A Children’s Doctor who works at the Royal London Hospital, who asked to remain anonymous, said:

“As a children’s doctor, I know that having rapid access to healthcare saves lives. I’m furious that barriers are being put up which prevent my patients and their families seeking and receiving the care they need. If their birth was complicated, or the babies need intensive care, the cost very quickly goes into the hundreds of thousands – and parents only have three months to sort out the paperwork before they’re expected to pay. I’m demonstrating at the Royal London today because it was revealed that 35 children were charged here in 2018/19 for their healthcare.”

Aliya Yule – an organiser at Migrants Organise, who are co-hosting the vigils, said:

“The introduction of charging for migrants has meant that many people are scared to seek the care they need. They are fearful of healthcare providers reporting them to the Home Office and landing them with extortionate bills, rather than helping them when they are unwell. Everybody who cares for the NHS should be worried, as this is the start of a charging regime which will accelerate privatisation for everybody – this is why communities are fighting together against the policy and the Government’s attempt to divide our us by blaming migrants.”

James Skinner, Access to Healthcare campaigner at the charity Medact, who are also c-hosting the vigils, said: 

“Our research has shown that not a single NHS Trust in the country in monitoring the impact of NHS charging policy. It’s inconceivable that the Department of Health and Social Care can force healthcare workers and NHS Hospitals to start charging people up-front without assessing how it will affect patient care, and when all the evidence we do have clearly demonstrates devastating harm.”


Aliya Yule, Migrants Organise – 07960 163915 – 


[1] Docs Not Cops is a group of NHS staff and patients that work to combat racism in the NHS. They believe no one should be afraid to access the healthcare they need, either because they can’t pay or might be punished, and that NHS workers should not be forced to police the people they treat.

#NHS70 – No Borders in Healthcare


Campaigners from the campaign groups Docs not Cops and the NHS Anti-Swindle Team have today “dropped” a banner in Westminster calling on the government to end the Hostile environment in healthcare.

  • Upfront charging for hospital care was introduced in October 2017. Members of the Windrush generation, including Albert Thompson who was told he needed to pay £54,000 to start cancer treatment, have been caught up in this discriminatory policy (1)
  • So called ‘Health tourism’ only accounts for 0.3% of the NHS budget (2).
  • Migrants are charged 150% of the cost of care, which means that a complications-free pregnancy costs around £5,000-£7,000. For a pregnancy with complications the cost can be 3-5 times more than this(3)
  • The trial role out of ID checks in hospitals found a fraction – just 50 in 8,900 (1 in 180 people) – were ineligible for free care. Some hospitals would raise as little £2,500 from their checks.(4)

Evan Luckes – A&E Nurse and member of Docs not Cops says,

“On the day that many of us up and down the country will be celebrating the 70th anniversary of the NHS, we’re sending a message to the government to remind them of the founding sentiment of the health service: free, for all, forever.

The introduction of upfront charging for hospital care hasn’t helped solve the NHS funding crisis, instead it has lead to denial of treatment for those who need it most and racial profiling for those made to produce their passports to receive care.

As a nurse , I think it’s unacceptable that the NHS has become a site of the hostile environment. It completely undermines our ability to provide non-judgemental  care for all – we should be treating patients, not passports.”

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I’m a Nurse – Not a Border Guard! #InternationalNursesDay

International Nurses Day is celebrated around the world every May 12. This year the International Council of Nurses have chosen “Nurses A Voice to Lead – Health is a Human right” as their theme.
We agree with them that “healthcare should be accessible to all”.
But – as part of their Hostile Environment policy this Government have been making it more and more difficult for people to access the NHS services they need.
Join our “I’m a Nurse Not a Border Guard” twitterstorm on Saturday 12th May 12noon-2pm and tell @Jeremy_Hunt why #ThisNurse believes in #PatientsNotPassports! Full details below.
12/05/18 International Nurses Day - I'm a Nurse Not a Border Guard - Send Jeremy Hunt a selfie for #InternationalNursesDay telling him why #ThisNurse believes in #PatientsNotPassports
It is now mandatory for NHS trusts to check people’s immigration status before providing secondary care and for them to charge upfront for treatment in many cases. The Immigration Health Surcharge prices people out of visa applications – and is going to be increased even further.
Already these policies are leading to discrimination and racial profiling, to people being too scared to access the care they need, and are turning healthcare workers into border guards. This week the government announced it would suspend data-sharing between NHS Digital and the Home Office in most cases – but we need to keep pushing to ensure no one will have to fear immigration enforcement when seeking medical care
As Nurses we must stand up for our patients and advocate for their right to free, universal, non-judgemental healthcare.
Join us in celebrating International Nurses day by telling Jeremy Hunt it’s time to end prohibitive healthcare charges for migrants, scrap ID checks in hospitals and community care, and time to kick the Hostile Environment out of the NHS.
Tweet a selfie of you and your colleagues (ideally in uniform – but you don’t have to identify yourself) holding a sign saying:
“We treat patients not passports.
I’m a Nurse not a border guard ”
Send it at midday and make sure you @Jeremy_Hunt. Here are some sample tweets to get you started:

1. “We’re nurses not border guards! @Jeremy_Hunt time to kick the hostile environment out the of the NHS! We’re joining @DocsNotCops to say #PatientsNotPassports

 2. “I’m a nurse not a border guard!
#ThisNurse is telling @Jeremy_Hunt that we want to treat #PatientsNotPassports. End the Hostile Environment!”
3. “Health is a human right and we’re nurses not border guards.
For #InternationalNursesDay, I’m telling @Jeremy_Hunt to end NHS charges for migrants – #PatientsNotPassports!”
(not on twitter? Why not take part on Facebook – share our I’m a Nurse Not a Board Guard Facebook event and invite your friends – mention us @Docs Not Cops)
Read an article by a nurse member of Docs Not Cops in IndyVoices: “The NHS has stopped sharing data with the Home Office – now it must halt passport checks on patients
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Docs Not Cops Statement on Home Secretary Amber Rudd’s resignation:

Britain's institutionally racist border enforcement system remains

As Amber Rudd has resigned from the position of Home Secretary, Docs Not Cops notes that she resigned over misleading parliament regarding knowing of Home Office targets rather than over the scandalous treatment of British citizens and other people caught up in the immigration removal system. As some of our members are both part of and work directly with communities affected by the detention and deportation regime, and as up to 50 people wait to be forcibly deported via charter flight to Jamaica this week, we are doubtful that her departure signals a significant change to the Hostile Environment policy.

Our doubts are founded on the glaring fact that there has been no acknowledgement by this government – nor the opposition – that no-one should be punished with death or debilitating health because of their immigration status.

“The UK has committed an atrocious barbarism. It is time for doctors’ leaders to say so – forcefully and uncompromisingly”. That was The Lancet’s response to the deportation of Ama Sumani, a terminally ill cancer patient, to Ghana against the wishes of the Welsh community she lived in. Her deportation and subsequent death happened in 2008 – under a Labour Government. Ten years on it is becoming routine to deny cancer patients treatment: Sylvester Marshall (known as Albert Thompson in media coverage, was denied radiotherapy for six months because he couldn’t prove his immigration status, nor pay upfront – requirements introduced by Jeremy Hunt in October 2017. He will now receive treatment for prostate cancer without having to pay £54,000 – but only after a six month delay, a media scandal, and 420,000 petition signatures.

Docs Not Cops was created in response to the introduction of policies that restrict migrants’ access to free healthcare. This undermines a core principle of the NHS: treatment on the basis of need, not financial ability. We know that the imposition of borders within the NHS are only one facet of a complex and ever-expanding system. However, as healthcare workers and anti-racists, we see NHS restrictions as particularly symbolic of the inhumanity of our migration system.

This government’s attitude toward working class and particularly racialised migrants is to treat them with suspicion, presumed undocumented and a social parasite on the public purse until proven otherwise. It is this dehumanising culture, rather than particular targets, that has driven the growing presence of ID checks to restrict access to: healthcare; housing; employment; welfare; and even the ability to open a bank account. The Hostile Environment policy seeks to turn every UK citizen into a border guard, to encourage them to racially profile and police their neighbours, patients, students and tenants.

These policies have put documentation and the false idol of “secure borders” over the health of sick and vulnerable people, who deteriorate to their death. One woman with precarious immigration status died too frightened to seek treatment for pneumonia. Another man denied treatment at an early stage, died after his lung cancer progressed. Theresa May’s Home Office issued an “end of life plan” to deport Isa Muaza, while he suffered from multiple organ failure. Until the regulations requiring NHS Trusts to check ID are repealed, thousands of people will face upfront bills they cannot pay. Until data-sharing between NHS Digital and the Home Office is dropped, people will fear providing their details. Until the Immigration Health Surcharge introduced in 2014 is abolished, people will struggle to afford visas – people could be deported because of this.

The Windrush scandal reveals that determining individuals immigration status is often complex, and that it is regularly onerous for people who are legally resident to prove this. But the scandal also shines a light on Britain’s institutionally racist border enforcement system, showing it to be incredibly violent for anyone ensnared by it. The political consensus that allows this must be reversed, Docs Not Cops will continue to organise and work to build a popular culture where no-one is stigmatised as a drain on public resources but instead Britain acknowledges its wealth was built on the stolen labour and resources of its former colonies and subjects.

Xenophobia and racism should be regarded as an abominable relic of history not guide public policy. Many of us affected by this systemic violence are aware of this and fighting to make it a reality. We encourage all who agree to join us into making it a reality.

Regardless of status, we believe that no-one should be denied their fundamental right to healthcare. If you want to join us in campaigning to end prohibitive healthcare charges for migrants, the Immigration Health Surcharge on visas, ID checks in hospitals and community care, and for healthcare for all: email docsnotcops AT gmail DOT com. We are particularly keen to hear from health workers, and patients affected by the hostile environment in the NHS.


DocsNotCops on the Bang Bus: “Don’t F**k with the NHS” for World AIDS Day 2017

DocsNotCops was born out of Act Up and the intersectional campaign for universal access to HIV medications. In the run up to World AIDS day on 1 December 2017, we join Act Up, Queer Bus Tours and other activists in the ongoing fight for access to healthcare for all, and celebrate, remember and claim, from the top of a bus, a history for HIV-positive people in London.

a group of campaigners in front of a bus

Our tour starts from Soho. Voices from the bus talk about sexual liberation and the claiming of queer space in the 1970s. We hear of activists rampaging down Charing Cross Road, overturning tables of the book Everything You Always Wanted to Know About Sex* (*But Were Afraid to Ask) for only showing heterosexual sex and ignoring gay women.

A group of people on an open top bus

Trudy Howson, LGBTQ poet laureate recites her poem written to mark 50 years since the partial decriminalisation of homosexuality, remembering the time before: “There is danger in dark places/For men like us, there are no spaces/ Where we can be proud, where we can be free/ Where I can love you and you, can love me”

trudy howson speaking on the bus

We set off from Soho to the old Middlesex Hospital, once a specialist unit for people, mostly young men, dying of AIDS. We’re asked to “turn to someone you don’t know and tell them about a person that you are remembering, a person you are thinking of today”. A former nurse talks of her experience of nursing those young men dying when the disease wasn’t understood: “we nursed them wearing plastic gowns, masks, they used paper plates – it took away their dignity”.

A banner that reads: 'hands off our NHS'

Those were days of mourning, but also organising. The fightback produced one of the most successful civil rights movement of the past 30 years: the incredible advances in HIV treatments were won through the bravery of individuals and the power of movements like AIDS Coalition To Unleash Power (Act Up), popularising the message that Silence = Death. But however great the success story was here in the Global North, access to anti-retrovirals globally in 2016 was only at 46%. Remembering the history of the movement is key to renewing the political project at the centre of HIV activism: healthcare as a right for all.

But in the NHS this right is being eroded. As from 23 October 2017, the latest phase of the implementation of the 2014 Immigration Act introduced upfront charging for hospital inpatient and outpatient services and some community services. This is being enforced with immigration checks at hospital appointments and in A&Es, building on a longer term political project to obfuscate the funding crisis of the NHS and blame migrants instead.

A banner attached to the back of a bus that reads 'No room for racism in the NHS'

While HIV services are technically still free for all, regardless of immigration status, the confused implementation entrenches racial profiling, detaches hospital staff from a duty of care and frightens patients from accessing the services they need. Major HIV advocacy organisations, such as the National AIDS Trust have been very vocal about their concerns, recommending that the legislation be withdrawn.

A photo of people on an open top bus

They are among the growing number of organisations calling for upfront charging to be removed from the NHS. Among them, DocsNotCops is committed to fighting the hostile environment that turns hospital staff into border guards – agents of this government’s migrant scapegoating. DocsNotCops fights to promote free healthcare for all, available without judgement, prejudice or fear.

As we continue our bus tour, we hear the experiences of those whose HIV came from using drugs and the stigma they faced. We hear the stories of HIV-positive women, the effect on their families, their loved experience at the intersection of race, gender and HIV status. We hear the damage the 1989 public health campaign “Don’t Die in Ignorance” did to those it shamed for their sexuality. “Don’t ever let that happen again”.

A group of people on a bus with a disco ball in the front of the view

London is experiencing an unprecedented fall in new infections, which one Dean Street support worker attributes to, among increasing campaigning and countering stigma, also the improved access to PrEP (Pre-Exposure Prophylaxis) an antiretroviral that at risk, HIV-negative individuals can take to stay that way. It’s been trialled very effectively in young men, but the NHS has not made it universally available across the UK. For many, PrEP remains only available if they pay for it themselves. We hear from a representative of the National AIDS Trust that PrEP trials are not focusing enough on other at risk groups, particularly at-risk women. Act Up is campaigning for greater access to PreP for all those at risk of transmission.

A person standing in front of a giant banner that reads 'Out of the closet onto the streets'

Most touchingly, we hear the testimonies of those with their own stories to tell, the stories of love, of drugs, of sex, of their moment of diagnosis. The bus, covered in the banners of Act Up, Docs Not Cops, statements of freedom of sexuality and choice for our bodies, pulls up at Dean Street – but the struggle continues.

a tray of cupcakes, each topped with a looped red ribbon

#PatientsNotPassports – NHS workers and patients protest hospital immigration checks

At 8.30am on 5th April, the entrance to the Department of Health (DoH) was blocked by a makeshift immigration checkpoint, manned by NHS patients and staff protesting plans to introduce upfront charging for care throughout the NHS.

The disruptive action, organised by campaign group ‘Docs not Cops’ comes after Jeremy Hunt’s announcement that, as of April 2017, NHS trusts would be legally required to check patients’ eligibility upfront and demand payment before providing secondary care.

Although the government positions this as a cost-saving measure, the figures don’t add up. The DoH’s own estimate is that ‘deliberate health tourism’ costs only 0.03% of the NHS budget annually. Docs not Cops believe this policy will lead to discrimination and racial profiling, and will destroy patients’ relationship with NHS workers.

These checks will prevent those most in need of care from getting the treatment they need. This is already evident in the case of pregnant migrant women, where some destitute refugee women are being frightened away from maternity services due to NHS trusts issuing letters demanding payment of thousands of pounds. Docs not Cops, a group formed by NHS workers and patients to combat racism in the NHS, encourage all healthcare workers to sign up to their pledge to refuse to comply with the new policy.

We believe no one should be afraid to access the healthcare they need, either because they can’t pay or might be punished, and that NHS workers should not be forced to police the people they treat.

“This policy will completely undermine patients’ trust in the NHS, which in turn will put people’s lives at risk. We are calling for a campaign of non-compliance because it’s the right thing to do for our patients and for the future of the NHS.”

  • Zoe,  Academic Clinical Fellow Obstetrics & Gynaecology at Addenbrooke’s and The Rosie Hospitals, Cambridge.

“Jeremy Hunt keeps saying this will balance the NHS budget, but the numbers just don’t add up. This shameful exercise is about Jeremy Hunt shifting the blame and the cost of austerity onto the most marginalised and vulnerable people.”

Helen, Docs Not Cops Organiser

Twitter Storm: Protest the government’s immigration checks in the health service, they are endangering people’s lives!

This April the changes documented in the Government’s ‘Making a fair contribution’ proposal will come into force.

They are the latest round of measures introduced into the NHS to extend UK borders inland, and ask doctors, nurses, and allied healthcare professionals to question their patients’ immigration statuses.


As of April:

  • NHS trusts will be legally obliged to check people’s passports and eligibility before they receive care not deemed ‘immediately necessary’.
  • People will be charged up front and care not paid for will be denied or withdrawn.
  • GP Surgeries will be responsible for identifying people not eligible for free secondary care.
  • Non-NHS NHS-funded services in the community will identify
    non-eligible patients and be chargeable. This includes mental health services, hospices, and termination of pregnancy services.


These measures will make people afraid of accessing the care they need.


They are based on racist ideology, not evidence. They will lead to racial profiling and discrimination within the NHS. They are violent.

These changes will build upon the already harmful effects of the government’s Immigration Act 2014, which has seen hundreds of migrant women made terrified of accessing antenatal care and threatened by the very hospitals they need to help them.


No racism in the NHS! 

Keep immigration checks out of the NHS!


Join us on Wednesday 5th April in creating a Twitter and email storm between 10am-12pm (but please start earlier and continue after should you wish!). We’re asking people to tweet the Department of Health (@DHgovuk), NHS England (@NHSEngland), and the Health Minister Jeremy Hunt (@Jeremy_Hunt) using the hashtags #PatientsNotPassports and #DocsNotCops. We’ve included some sample tweets below which we welcome you to customise as you see fit:

Sample tweet 1:

Sample tweet reading: 'Midwives for maternity care, take your racism elsewhere!'

Sample tweet 2

Sample tweet reading: "Doctors check blood pressure not immigration status. No borders in our NHS! #DocsNotCops #PatientsNotPassports @DHgovuk"

Sample tweet 3

Sample tweet text that reads: " Why would you deny sick patients the care they need? No passport checks in our NHS! #DocsNotCops #PatientsNotPassports @DHgovuk @NHSEngland"

Sample tweet 4:

Sample tweet that reads: " Universal healthcare is a right, here to stay, here to fight! We treat everyone. #DocsNotCops #PatientsNotPassports @DHgovuk @NHSEngland"

We know that some trusts such as St George’s NHS Trust (@StGeorgesTrust) have piloted these schemes and Barking, Havering, and Redbridge Unversity Hospitals NHS Trust (@BHR_hospitals) have sent threatening letters to women unable to pay for their maternity care, we welcome you to ask them why they are complicit in these racist acts of violence.


We’ve made some graphics to help the storm get more attention. We welcome you to share or post any of the images below on your social media page (click to enlarge and save):

Drawing of a heart with the slogan 'patients not passports'

Drawing of a pregnant person whose hands are tied with rope, with the slogan: "No borders in Maternity care, take your racism elsewhere!"

Drawing of a stethoscope that ends in a snake's head with the slogan 'Hospitals are for healthcare"

Please help us to highlight the insidious introduction of immigration checks to the health service. These measures are racist, these measures are violent, these measures will cost people their lives.


Can you help?

If you are an NHS worker, patient, or anybody else who believes passionately that the care you receive should not be dictated by your place of birth or immigration status follow us on twitter @DocsNotCops, or contact us via email:


Please join our twitter storm and hold the government to account, we are Docs not Cops!

PRESS RELEASE: Concerns at NHS charging system recommendations

In response to the House of Commons Public Accounts Committee report on NHS charging for overseas patients:

FEBRUARY 2017: The Migrants’ Rights Network (MRN), Docs Not Cops and health professionals are concerned by the recommendations of the Common Public Accounts Committee (PAC) in their report (1 Feb 2017), which states a need for a more radical approach to recoupment of charges for NHS treatment of overseas patients. We believe this report, besides admitting that the government is failing to meet its own targets, outlines an unworkable, impractical and discriminatory system – one that needs eliminating not expanding.

The report outlines the failures of the NHS charging system to recoup costs incurred by EEA patients through reciprocal agreements, as well as the low levels of return on bills sent to non-EEA patients. They are not even managing to reach the figure they intend to recoup – £500 million, actually a tiny figure at less than 0.5% of the overall NHS budget.The PAC report argues that these low “gains” are due to a lack of identification of chargeable patients, although it admits that forcing patients to prove their eligibility or entitlement is likely to penalise and discriminate those that are in need of dire medical attention. Discrimination in the NHS charging system has been well documented, and we believe that drawing more health professionals into the system to identify chargeable patients is not the answer.

The PAC recommends that GPs are recruited to identify chargeable patients. GPs, a group who are already overstretched because of an under-resourced NHS and additional responsibilities should not now also be pushed to identify patients who ‘may’ be chargeable, because they are ill-equipped to understand and apply the entitlement rules for free NHS care because of the complexity of the current UK immigration system. Their inclusion fundamentally undermines medical professionalism and confidentiality and will only lead to more discrimination and inappropriate refusal of treatment, or charging people in error.

Dr Philip Abiola, GP said: It is unfair to blame overseas patients as the cause of the stresses on NHS resources, this is clearly due to an inefficient system that is unable to recoup costs through its reciprocal agreements, as well as a wider picture of underfunding. Pursuing patients in GP surgeries to prove they are allowed to access healthcare will drive them into emergency services, which are more costly than primary care. Any expansion of this system to involve GPs, will undermine my professional duties and deter vulnerable and ill patients from accessing healthcare they are entitled to.”

Dr Aislinn Macklin-Doherty, cancer doctor and researcher, said: “This overblown blame on Health Tourism for the current NHS crisis is evidence of yet more spin from this Government to distract from the real problems facing the NHS. The £500 million quoted spent on Health Tourism is dwarfed by the £22 billion being intentionally cut from the NHS by the current Government by 2020 and the 10s of £billions that leak out of the NHS into the bank accounts of private companies every year. Introducing charges or checks for eligibility we know would cost more than the relatively small amount it would recoup, and would also undermine the universality of treatment by forcing doctors to focus on “policing” who they care for rather than delivering care. My duty is to treat patients, not to be a border guard.” ()

Fizza Qureshi, Director of MRN said “Scapegoating migrants, when the real issue is systematic underfunding, is unreasonable and divisive, as is expecting healthcare professionals to act as the unofficial border police.”

For further information, please contact Fizza Qureshi on 020 7336 9407 or us at; and

Call To Action: Join Us!


Our Tory government seeks to create a “hostile environment” for migrants in the UK. This means that they have devolved border control from the Home Office into every corner of our lives: employment, renting, and healthcare. They are essentially creating an army of informants to dob in the most vulnerable, those who often have no legal protection.

We have seen this happen at Byron. We are also seeing it happen in the NHS.

Under the Immigration Act, non-EEA patients are chargeable at 150% of NHS costs. Patients with outstanding bills have their details shared with the Home Office, which can lead to requests for leave to remain being denied, or even to detention. This is an increasingly popular tactic: this year, the Home Office requested three times as much data from the NHS than in 2013, as shown below.

Graph of number of requests for NHS data by Home Office

Vulnerable people are less likely to access health services if they fear charges or punishment on the grounds of immigration status. This constitutes a public health and human rights issue.

Byron colluded with the Home Office to avoid a massive fine. It seems they knew who was working for them illegally, and set them up for their own benefit. Healthcare workers are different. Ideally, they provide free access to sensitive, non-judgemental care. They cannot be asked to police instead of treat.

The Home Office is turning us all in to border guards, policing each other and fuelling fear and racism. We can’t allow this to happen! At DocsNotCops, we are working to repeal the Immigration Act within healthcare. The BMA stands with us, and you can too! Find us on FacebookTwitter or