‘To stop treating patients in the knowledge that they are being sent home to die is an unacceptable breach of the duties of any health professional.’
– The Lancet
Britain committed ‘an atrocious barbarism’ in the words of leading British medical journal The Lancet when Ama Sumani was deported to Ghana in January in the middle of life-saving treatment in a Cardiff hospital. She died on 19 March, having been unable to afford treatment for her cancer and related kidney disease. Ama had been in Britain for five years, had been receiving treatment including kidney dialysis for one year and was ruthlessly removed from her hospital bed in a wheelchair by officers from the Border and Immigration Agency, whose head, Lin Homer, said that this case was ‘not exceptional’.
Reducing access to health care
In 2003, the Department of Health scrapped the rule that anyone in Britain for over a year was entitled to free health care. The plans were that everyone should be treated and staff would afterwards establish if they should be charged; if they couldn’t pay, the hospital would write off the debt. Asylum seekers would be entitled to free care while their claims were processed and all emergency care would be free.
The outcome has been that many vulnerable asylum seekers are unclear as to whether treatment is available to them; there is great confusion about what constitutes emergency care and the inherent racism of immigration controls results in black and Asian British people being challenged to prove their right to treatment.
Currently asylum seekers are entitled to NHS treatment without charge for as long as their applications, including appeals, are under consideration. Those whose appeals have been refused can register with GPs at the surgery’s discretion. There are many documented cases of asylum seekers being turned away from surgeries. Secondary care, including treatment underway, can be charged for from the date the asylum claim is deemed to have failed.
Denial of free treatment
The Refugee Council has documented cases of asylum seekers being billed, being turned away or having operations cancelled and of people subsequently going underground having not received the treatment they need. In 2006, it documented 17 cases of women denied access to maternity care. Eight were told, against all rules, that they would get no care unless they paid up front.
Maternity services should, according to the Department of Health, always be classed as ‘immediately necessary treatment’ and provided even if the woman can’t pay. Only after a battle by health care workers, has treatment to prevent transmission of HIV from mother to child been classified as maternity care. If the woman is chargeable, ‘reasonable steps should be taken to recover the debt’ says the government.
In many cases the treatment bills are so terrifying that people disappear. In 2006 a Chinese woman, having been turned away during her pregnancy by her NHS Trust on grounds of needing to pay in advance, delivered her baby at home unsupported; she then needed admission for medical complications but fled after the bills appeared and could not be found for further post-natal checks.
Inhumane and uncivilised
In 2002 a British Medical Association report Asylum Seekers: meeting their healthcare needs concluded that in many cases the health of asylum seekers actually worsens after arrival in Britain and that Britain is failing vulnerable people who have been subjected to persecution, including torture and rape.
In March 2008 the Independent Asylum Commission issued a damning report, stating that Britain‘s treatment of asylum seekers ‘falls seriously below the standards to be expected of a humane and civilised society’.
Hannah Caller
FRFI 202 April 2008 / May 2008
