The new banners hanging up at Surrey’s Frimley Park Hospital’s reception stand taller than many patients. “NHS healthcare is not free for everyone,” they proclaim.
One warns that people registered with a GP, holding a British passport or paying national insurance might not be “here on a lawful and settled basis”.
Another points out that a stay on a ward could incur costs of £1,000 a night for European Economic Area (EEA) nationals and £1,500 for others.
New Tory rules will require NHS trusts to check patients’ eligibility for NHS care up front.
In preparation for this, Frimley Park Hospital has installed a card reader in its accident and emergency (A&E) department to charge those without the right papers.
On the counter leaflets addressed to “overseas visitors” carry a chilling threat in block capitals.
“IF YOU FAIL TO PAY FOR NHS TREATMENT,” they say, “IT MAY RESULT IN A FUTURE IMMIGRATION APPLICATION TO ENTER OR REMAIN IN THE UK BEING DENIED.”
This is no empty threat. The leaflet adds that information may be passed through the Department of Health to the Home Office for this purpose.
Some 5,854 people were traced by immigration enforcement officials in this way in the first 11 months of 2016.
In Frimley, a small town in rural Surrey, many of the staff and patients are from migrant backgrounds.
Debbie, a local resident originally from Switzerland, told Socialist Worker, “I don’t agree with this policy at all—it really pisses me off.
“How are they going to tell someone isn’t a resident—can they tell by looking at me?” she asked.
“Because despite my accent I don’t think it’s me who will be asked. It’s someone who ‘looks like’ they might be a non-resident.”
Officials insist that they respect equalities and discrimination rules, meaning they ask everyone the same questions. But the experience of migrants using NHS services is often very different.
The Tories justify checks with the lie that migrants and foreign “health tourists” are a drain on the NHS.
Debbie said, “It’s a load of rubbish—the people who could really be called ‘health tourists’ are a tiny figure. This is just pandering to the Daily Mail.”
Many people can be persuaded by such arguments. But even those who buy into the lies at an abstract level are often horrified at what the policies look like in practice.
Marcie, originally from South Africa, was visiting the hospital for her physiotherapy appointment. She thought it was wrong to “let all these people in” but she didn’t agree with the leaflet.
“I lived in South Africa during apartheid and I can see something like that happening here,” she said. “There’s a lot of racism, and it’s all been orchestrated by the government to manipulate the masses.”
There is potential to push back the government’s drive to turn NHS hospitals into border checkpoints.
It has already delayed the introduction of the new rules from April to July.
But in the meantime hospitals are second guessing what is required of them—and some patients are already being told to pay up or risk deportation.
Socialist Worker has sent Freedom of Information requests to NHS trusts asking about their policies on checking passports.
The vast majority that have responded so far said they are still waiting for guidance from the government about its new rules. But some are already preparing for the new system.
Moorfields Eye Hospital in London said it expected to spend £25,500 putting the new checks in place.
Many hospitals already pay a relatively senior staff member on a high salary to chase “overseas’ visitors” fees—while most NHS workers endure a pay cap.
The preparations are being made with no real understanding of the consequences.
Oxford Health told Socialist Worker that “the trust believes” the consequences of up front eligibility checks are “not expected to be significant”. But the government has done no serious study to justify that conclusion.
Pilot schemes are running in some trusts, most prominently in St George’s in south London.
It refused to share any data until the pilot is complete. But a pilot run by Coventry and Warwickshire Partnership mental health trust produced worrying results.
Some 347 patients using its wheelchair service were asked to fill in declarations and give proof of eligibility.
Of these, 130—over 37 percent—did not go on to receive care.
NHS helps to trap migrants
The threat of being reported to the Home Office and deported is already pushing people in need away from health services. Several shared their chilling stories with the Doctors of the World charity.
Patricia, a young Ugandan woman, is six months pregnant—but as of last month she hadn’t had any antenatal care.
“I feel trapped,” she said. “I need to go to the hospital but I can’t because I feel my information might not be confidential.”
Patricia is an undocumented migrant. She has been in Britain for five years, yet the NHS doesn’t consider her to be “ordinarily resident”.
She said, “I can’t imagine being separated from my partner. Maybe they would make me go back without my baby too. At this time of carrying a child, the last thing you want to worry about is being separated from that child.”
Maria from the Philippines works as a cleaner. “For years I tried to protect myself from getting sick because I thought it wasn’t safe to go to the doctor,” she said.
That changed last September. Maria’s father had died of cancer, her sister had had breast cancer—and one morning Maria discovered a lump on her own breast.
Everyone in Britain is eligible for GP care, but this isn’t always enforced. Maria’s local surgery turned her away because she couldn’t show them a valid visa.
When she finally got an emergency biopsy, she couldn’t bring herself to attend.
She said, “I felt like I was carrying the weight of the whole world during those days. I was so worried that if I went to hospital, the authorities would know about it—maybe they would deport me. But if I didn’t go to hospital, then what about the lump?”
Maria eventually got the surgery she needed.
But it’s impossible to say how many people are suffering from treatable diseases in 21st century Britain because of Tory racism.
Unions can defy checks
Building opposition among health workers and their unions is crucial to pushing back the racist passport checks. Professional bodies and trade unions in the NHS such as Unison have slammed plans to make their members "border guards".
Anti-racism was a major theme at the Unison health conference last week. Leading figures denounced Theresa May for refusing to guarantee European Union migrants’ rights.
Deputy general secretary Roger McKenzie told a Stand Up To Racism fringe meeting, “This is the time to stand together.”
But the leadership refused to discuss opposing the passport checks. A motion from Yorkshire and Humberside region was ruled out of order.
David from Yorkshire and Humberside said this was done on the grounds that “it might be encouraging members to breach contracts”.
He added, “Our members becoming immigration officers is stirring up racism and division. But what do we say to members if they’re disciplined for refusing to do this?”
Stephen McLean from Sussex said many health workers don’t want to implement checks because “they’re racist and contravene nurses’ code of conduct”.
Health workers are right to refuse to be border guards—and Unison should give them its full backing.
It should boost workers’ confidence to defy the racist policy and make it unworkable.
Stephen added, “We need to go back and campaign—and we have to back any member who refuses to implement this.”
David asked, “If Rosa Parks had come to us, would we have told her to stand at the back of the bus?”
Privatisation and private care to blame
The crisis in the NHS is fuelled by cuts and privatisation, not immigration. But there are some people at Frimley crowding out NHS patients. Like many hospitals, it has set up a private hospital-within-a-hospital, the Parkfield Suite.
Its two wards and 38 rooms offer “private experience, NHS excellence”—allowing those who can afford it to jump the queue in style. Like the eligibility checks, small scale privatisation like this is supposed to be about saving the NHS money.
But like the eligibility checks, its real effect is to undermine the principle of free universal health care that the NHS was founded on.