Photograph: Flickr

An open letter to Hackney’s MPs, City & Hackney Clinical Commissioning Group, councillors and Homerton University Hospital Trust regarding NHS Charges:

At this critical time when it is vital that there is unfettered access for all to the NHS, we are writing to you to urge you to take action to remove from our NHS all barriers to health care faced by overseas workers, migrants and anyone with undocumented status living in the UK.

The pandemic has highlighted that people born outside the UK account for almost a quarter of all staff working in hospitals and a fifth of all health and social care staff in the UK. Not only are our health and social care systems disproportionately reliant on overseas workers but staff from black and minority ethnic communities are dying from Covid-19 at a much higher rate than others and almost half of those staff who have died were born overseas.

By its concession that overseas health and care workers should be exempted after all, the government has acknowledged that there is an uncomfortable and unjust disjuncture between the selfless work of staff from overseas who pay the same taxes as we do and the fact that they have to pay hefty fees to use the NHS. But the same argument applies to other frontline workers, such as in transport, cleaning, retail and delivery services who also should not have to pay twice, once through fees and once through taxation. These fees are currently over £400 per year but the government has been planning to raise them to £624 and this applies not just to the staff member but to each member of their family: so for example, a cleaner from abroad with a partner and two children will have to pay almost £2,200 a year plus visa fees. These fees were part of hostile environment legislation designed to deter immigration to the UK. This at a time when the NHS and the social care sector were desperately short of staff, a problem which has added to the difficulties these sectors have faced in recent weeks.

Creating barriers to using the NHS for migrants and other undocumented residents in the UK is unsafe for all of us as well as generating fear and anxiety. Although treatment for Covid-19 is free, this has not been well publicised, and fear of charging for any long term or secondary effects of the infection, and of being reported to the Home Office by health authorities, deters those people with uncertain citizenship status from using the NHS. The government has not been clear about whether treatment of complications arising from the infection would also be exempt, and indeed this boundary is open to arbitrary interpretation.

The pandemic shows the wisdom of policies that are orientated towards promoting public health. Everyone has to feel confident to seek treatment as needed and to aid in tracing contacts of anyone identified as infected with the virus – a strategy the World Health Organisation is urging all countries to adopt. Ireland, Portugal and South Korea have already taken action to remove barriers. In the UK, 60 cross-party MPs have written to the health secretary calling for the immediate suspension of charging for migrants and all associated data-sharing between the NHS and the Home Office. It follows a similar demand to government from medical groups including the British Medical Association and Doctors of the World UK.

We believe that now, more than ever, it is vital to end the hostile environment in the NHS and ensure unfettered access for everyone to free health care. We are one community!

We therefore call on our MPs to urge the government to:

– Drop surcharges for health care on ALL workers from overseas.

– Stop all migrant charges and publicise this widely to encourage people to use the NHS when needed.

We call on Homerton University Hospital Trust to:

– Make a public statement about the damaging effect of excluding vulnerable parts of the population from health care that the pandemic has exposed.

– Publicise as widely as possible in City and Hackney that Covid- 19 assessment and treatment is freely available to the whole population.

– Urgently clarify, given that Covid-19 infection clearly sometimes has some quite disabling longer term health effects on different parts of the body – which elements of Covid-19 treatment would actually be free of charges, or for them to give guarantees that the whole illness and all the health care needs arising from it, however long term, would be covered.

– Pause any efforts to charge existing patients or to pursue past users of services by debt collectors, as this is a waste of much-needed public resources during this health crisis.

We call on City and Hackney Clinical Commissioning Group to:

– Advise all primary healthcare institutions that they must register all people seeking primary care, and must provide such care, whatever those people’s citizenship and whether on not they have a fixed address.

– Publicise that any information provided by users of primary care services will not be disclosed to the Home Office.

– Ensure that this availability of care is indeed delivered by every primary care practice, and that this is widely publicised.

We call on Hackney Council to:

– Do all in its power to support and encourage ending health charges to migrants and health surcharges on staff from overseas.

– Mobilise its public health officials to speak out about the damaging effect of excluding vulnerable parts of the population from health care that the pandemic has shown us all.

– Publicise as widely as possible in Hackney that Covid-19 assessment and treatment is freely available to the whole population.

We call on trade unions, political party branches/constituencies and community organisations to:

– Endorse and publicise this letter to your members and use your political influence to pursue these demands.

Signed on behalf of Hackney Keep Our NHS Public, Hackney Trades Council, Hackney Migrant Centre, Homerton Hospital UNISON branch, Hackney Unison local government branch, Hackney Unite local government branch. Hackney GMB branch, and Homerton Patients Not Passports group.

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