NHS 'hostile environment' and charges limiting care to children of migrants in breach of UN pledges, doctors say

NHS charges introduced as part of Theresa May’s "hostile environment" agenda are preventing migrant children from accessing healthcare in violation of United Nations commitments, doctors have warned.

Paediatricians and policy experts said that changes introduced since 2014, which require NHS organisations to check patients are UK residents and charge upfront for some procedures posed risks to children’s health.

These measures, justified as a move to combat “health tourism”, have created barriers to accessing non-emergency care for the estimated 600,000 undocumented migrants in the UK – which include 120,000 children.

Undocumented migrants include many from the so-called Windrush generation, as well as victims of trafficking and modern slavery and those yet to seek, or refused, asylum in the UK.

Migrant children now have to pay a £400 NHS surcharge on immigration applications, and no longer automatically qualify for citizenship if they are born in the UK.

“Children are thus at risk of losing ‘entitlement’ to NHS care depending on the immigration and financial status of their parents,” write Dr Neal James Russell, from St George’s University, and co-authors in the journal Archives of Disease in Childhood.

As well as the financial barriers to accessing treatment the NHS refers those with unpaid debts to the Home Office and, until last year, would share personal details with immigration officials to trace offenders.

“Families may face legitimate concerns that seeking care for their sick child may result in immigration enforcement such as detention, deportation and even family separation,” the authors said.

There have been several cases of patients with uncertain immigration status putting off healthcare.

Dexter Bristol, 57, who came to the UK from Grenada aged eight, was sacked and denied benefits because officials did not believe he was here legally.

A coroner’s report after his death from heart failure found he had not accessed healthcare for two years, which his lawyers said was due to migration concerns.

These fears create safeguarding risks for children who may be more vulnerable to neglect and abuse that would otherwise be picked up at health checks, the authors wrote.

“Charging be particularly detrimental for newborns,” the editorial adds, as maternity service cost as much as £6,000 for an uncomplicated delivery – and more if it is complex – which is still payable if the child dies.

“NHS charging regulations undermine the government’s stated commitments to child health and our obligations to children under the United Nations Convention on the Rights of the Child and contradict recommendations outlined in the UN Global Compact for Migration, signed by the UK in December 2018,” they added.

The Department of Health and Social Care was approached for comment.