Key arguments

Healthcare workers aren’t border guards and healthcare shouldn’t be a hostile environment

  • Healthcare workers have a primary duty of care to patients. This is being compromised by the charging regulations and by the NHS-Home Office data sharing agreement.
  • Charging introduces a points-based system for migrants that purposefully deters some of the most vulnerable in society from seeking crucial treatment, and the duty on the NHS to implement this makes all healthcare workers complicit.
  • The requirement for healthcare workers to ask for details of someone’s history of migration and residency status for the purpose checking their eligibility for treatment is unethical.
  • These regulations are unworkable in a clinical setting, with individuals making subjective decisions about whether a patient is eligible for treatment that may put patients’ health at risk further down the line.

Public health

  • Access to healthcare is a human right enshrined in the UN Universal Declaration of Human Rights.
  • Charging deters people from seeking care or attending screening. This has already been documented amongst migrants living with HIV, despite the fact that HIV treatment is exempt from charging.
  • Those deterred from seeking treatment, particularly those who have recently migrated, already face barriers to seeking treatment, such as a lack of knowledge around entitlements to healthcare, language barriers and fear of having information shared with the Home Office. Financial barriers and complications compound this.
  • Research by Doctors of the World shows that 2 in 3 pregnant women who attend their clinic have not had an antenatal appointment by the recommended 10 weeks, and 1 in 4 haven’t been seen at all by 18 weeks. Considering BAME women face significantly higher rates of maternal and infant mortality in the UK, placing further barriers to accessing antenatal care such as fear of being charged risks the health of pregnant women.


  • The government scapegoats migrants for the problems facing the NHS, despite the fact that by the government’s own figures, deliberate ‘health tourism’ only accounts for 0.3% of the annual budget.
  • On the other hand, privatisation of the NHS through Private Finance Initiatives has resulted in £billions in debt; in 2016/17 PFI projects cost the NHS an estimated £2bn; 2% of the NHS budget.
  • Migrants are not an economic pressure on the NHS: they are less likely to use the NHS than their UK resident counterparts, and the NHS relies on overseas staff, who make up 12.5% of the workforce.