Rights and Entitlements to Healthcare for Migrants in the UK

Access to healthcare is a fundamental human right, and migrants in the UK are entitled to healthcare services regardless of their immigration status. However, many migrants may not be aware of their entitlements to healthcare services, and they may face structural barriers to accessing healthcare. This guide aims to provide a comprehensive overview of the rights and entitlements to healthcare for migrants in the UK, including information on the NHS entitlements, registration, and payment options. Additionally, this article will explore the challenges that migrants face in accessing healthcare services and the policy implications of addressing these challenges. By understanding their rights and entitlements, migrants can access the healthcare services they need and deserve, and the UK can continue to provide equal and free healthcare to everyone in the country.

NHS principles and migrant healthcare rights

The National Health Service (NHS) was established in the UK with the ideal that healthcare should be available to all, regardless of wealth. The NHS Constitution for England states that the NHS maximizes its resources for the benefit of the whole community, and makes sure nobody is excluded, discriminated against, or left behind. The founding principles of the NHS were that services should be comprehensive, universal, and free at the point of delivery, based on clinical need, not ability to pay.

Migrant workers have been used by the NHS since its inception, with the Willink Report of 1957 recognizing the importance of overseas recruitment to the NHS. From the 1950s, hospitals increasingly looked overseas for staff, recruiting particularly heavily in Britain’s colonies. By 1965, there were more than 3,000 Jamaican nurses working in British hospitals and in 1977, 12% of student nurses and midwives came from overseas, 66% of them from the Caribbean, with substantial numbers also coming from the Philippines and South Asia.

Non-EEA nationals who are subject to immigration control must have the immigration status of indefinite leave to remain at the time of treatment and be properly settled, to be considered ordinarily resident. People not ordinarily resident in the UK are in general not entitled to free hospital treatment, with some exceptions such as refugees.

Categories of Migrants and NHS Entitlements

Groups eligible for free NHS care:

• Refugees: Refugees who have been granted refugee status in the UK are entitled to free NHS healthcare.
• Asylum seekers: Asylum seekers can access free NHS healthcare, including primary care services.
• Victims of trafficking: Victims of trafficking are eligible for free NHS care.

Groups with limited entitlements:

• Students: Students from outside the European Economic Area (EEA) who are studying in the UK for more than six months are required to pay an immigration health surcharge, which entitles them to access NHS healthcare.
• Workers: Migrant workers who are employed in the UK and have a valid work visa are entitled to free NHS healthcare.
• Family members: Dependents of certain individuals, such as members of the UK’s armed forces or applicants for a visa for the Isle of Man or the Channel Islands, may be exempt from charges for NHS healthcare.

Migrants not eligible for free care:

• Short-term visitors: Visitors to England who are not ordinarily resident in the UK are generally not entitled to free NHS healthcare, unless they fall under one of the exemption categories.
• Undocumented migrants: Undocumented migrants are not entitled to free NHS healthcare unless they are victims of trafficking or have been granted refugee status.

Primary, Emergency, and Maternity Care

Rights to register with a GP and receive primary care:

• GP and nurse consultations in primary care, as well as treatment provided by a GP and other primary care services, are free of charge to all, regardless of immigration status or ability to pay.
• All women in the UK, regardless of nationality or immigration status, are entitled to NHS maternity care.

Accessing emergency care and treatment:

• Refused asylum seekers can receive free NHS hospital treatment for accident and emergency services and the diagnosis of infectious diseases.
• The NHS Constitution for England states that individuals have the right to access NHS services and will not be refused access on unreasonable grounds.

Antenatal and maternity care rights:

• The NHS must provide maternity care to all women, regardless of immigration status or ability to pay.
• All women in the UK, regardless of nationality or immigration status, are entitled to NHS maternity care.

Secondary Care Access

Referrals from GPs for hospital treatment: In general, referrals from GPs for hospital treatment are free of charge for all, including migrants.

Challenges migrants face getting secondary care:

• UK law restricts people who have been refused asylum and undocumented migrants in England from accessing most NHS secondary care (hospital and community).
• The evidence suggests that fears of charging and data sharing can deter some migrants from accessing healthcare, including secondary care.

Charging migrants not entitled to free care:

• Refused asylum seekers are not necessarily entitled to secondary NHS care free of charge in England.
• Migrants who are not entitled to free NHS care may be charged for secondary care services, such as hospital treatment.

Prescriptions, Dental, Optical Care

Prescription costs and exemption eligibility:

• Prescription charges in England are currently £9.35 per item.
• Prescription charge exemptions are available for certain people, including those on low incomes, people with some long-term medical conditions, and pregnant women or women who have had a baby in the previous 12 months with a valid maternity exemption certificate.
• People with certain medical conditions can get free NHS prescriptions if they have a valid medical exemption certificate (MedEx).

Limited dental and optical care rights on the NHS:

NHS dental treatment is not free for everyone in England, and charges apply for most treatments. Some people are entitled to free NHS dental treatment, including those under 18, those under 19 and in full-time education, and those who are pregnant or have had a baby in the previous 12 months with a valid maternity exemption certificate.
NHS optical care is not free for everyone in England, and charges apply for most treatments. Some people are entitled to free NHS optical care, including those under 16, those under 19 and in full-time education, and those who are over 60 or have certain medical conditions with a valid medical exemption certificate.

Mental Healthcare Access

Rights to mental health services on the NHS:

Migrants who have paid the Immigration Health Surcharge and some other vulnerable migrant groups are entitled to free NHS mental health services. In Wales, refused asylum seekers can have free NHS hospital treatment, including mental health services.

Difficulties migrants face accessing these services:

• UK law restricts people who have been refused asylum and undocumented migrants in England from accessing most NHS secondary care, including mental health services.
• Fears of charging and data sharing can deter some migrants from accessing healthcare, including mental health services.

Children’s Healthcare Rights

All children in the UK have rights to NHS care, including:

• Free healthcare from the National Health Service (NHS) that is comprehensive and available to all, regardless of immigration status or ability to pay.
• School health services, including vaccinations and check-ups.
• The right to expect quality care while in hospital, with hospital staff and parents having a special duty of care to children and a legal responsibility.
• Over 40 specific rights, including the right to life, survival, and development, the right to have their views respected and to have their best interests considered at all times, the right to a name and nationality, freedom of expression and access to information about them, the right to live in a family environment or alternative care and to have contact with both parents if possible, health and welfare rights, including rights for children with disabilities, the right to health and health care and social security, the right to education, leisure, culture, and the arts, and special protection for refugee children, children in the juvenile justice system, children deprived of their liberty, and children suffering economic, sexual, or other forms of harm.

Reporting Denials of Care

Avenues to report wrongful denial of care:

• Patients who feel they have been wrongfully denied care can make a complaint to the NHS. The NHS has a complaints procedure that patients can follow to raise their concerns.
• Patients can also contact advocacy organizations such as Doctors of the World UK, which provides support and advice to vulnerable migrants who are struggling to access healthcare.

Organizations supporting migrant health access:

• Doctors of the World UK provides support and advice to vulnerable migrants who are struggling to access healthcare.
• The Migrants’ Rights Network is a UK-based charity that works to support migrants’ rights and access to healthcare.
• The British Red Cross provides support to refugees and asylum seekers, including access to healthcare services.

Finally

Migrants in the UK are entitled to healthcare services regardless of their immigration status. However, many migrants may not be aware of their entitlements to healthcare services, and they may face structural barriers to accessing healthcare. This article has explored the challenges that migrants face in accessing healthcare services and the policy implications of addressing these challenges. It is essential to ensure effective communication with migrant patients, including offering professional language interpreting and translation services. By understanding their rights and entitlements, migrants can access the healthcare services they need and deserve, and the UK can continue to provide equal and free healthcare to everyone in the country.