We, the undersigned, are concerned about the the impact of the charges for migrants using NHS services laid out in the Immigration Act 2014 and its proposed updates. We support the British Medical Association (BMA) in renouncing the Bill at the forthcoming conference.

Currently, many non-EU residents pay a health surcharge (on top of their NI and tax contributions) to access NHS secondary and tertiary care; still more people living and working in the UK are now required to pay per-service, as the Act outlined charges at 150% of what it costs the NHS and made collection of debts by NHS trusts mandatory. A government consultation put out earlier this year has suggested extension of these policies so that primary and emergency care, as well as ambulance services, will also be chargeable.

The Act is inflammatory, pandering to anti-immigration sentiment, and falsely blaming the crisis in NHS funding on migrants who already contribute, or who could contribute to society. The charges and top-ups create a two-tier system that, for now, distinguishes between migrants and British citizens, but in the years to come could be used to distinguish insured from non-insured.

The legislation is discriminatory, and it must be recognised that decisions on who should be paying are often made on the grounds of racial profiling. There is no consistency on the interpretation of the eligibilities for care, and many who should be exempt are being charged falsely or opportunistically. Moreover, those that are eligible are confused as to what services they can and cannot access. And for those who know that they might be charged, or if undocumented, even deported for accessing NHS care, it means delaying accessing care, and often delaying too long, as in the tragic case of Dalton Messam who died as a consequence.

The Act states that doctors should be responsible for making decisions about eligibility. The Act even asks clinicians to, quote “bear in mind individuals’ ability to pay” when considering a management plan. This fundamentally undermines the founding principles of the NHS to provide universal healthcare that is free at the point of access.

A commonly applied argument against this case is that of preventing health tourism, which costs, according to Government estimates that have been strongly criticised by The King’s Fund, anything from £70 million to £2 billion. We argue that these figures fail to recognise the net gains that immigrants living and working in the UK provide to our country, especially when one considers the number of NHS workers who were born and trained abroad. In any case, migrants are not the largest drain on NHS resources, compared to PFI debts and competition between NHS and private providers.

DocsnotCops is a coalition of concerned medical professionals, journalists and laypeople. We seek to raise awareness of this damaging Act and ultimately to repeal it. The BMA is holding a conference in Belfast on 19-23 June. We are appealing for them to promote the value that migrant workers bring to the NHS and stop forcing healthcare workers to act as border guards. The full text of the motion is reproduced below. The motion is currently on the secondary list, so there is a chance it may not be heard. Please add your support to raise awareness of this important issue and put pressure on the BMA to debate it!

We have to fight for civilized principles, to defend our NHS, and that’s why we have to defend migrants, and everyone’s access to free care at the point of need.


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