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 Unpublished guidance from the Welsh Government released in response to the requests states that health boards should seek payment before treatment starts, meaning that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)

For more information, please contact

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

Leave a Reply

Your email address will not be published. Required fields are marked *