NHS ethics are being compromised by the government’s hostile policies

According to a report released by the Guardian earlier this year, at least three-quarters of NHS trusts have assigned patient debts in the last, most of which belonged to destitute asylum-seekers and migrants, to private debt collector firms. According to the report, from 2016-18, 8,468 patient debts were assigned to independent firms – decisions which went against guidance from the Department of Health and Social Care, stating that NHS trusts can write off any debt if ‘it is clear that a person is destitute or genuinely without access to any funds.’ These firms employed various forms of intimidating tactics, including daily phone calls, door-steps visits and even property possession. Despite the use of these aggressive and, many would argue unethical tactics, only 7% of the unpaid debts were recovered.

This is not the only example of a UK service provider having to compromise its ethics in an attempt to keep up with hostile governmental policies. Last month, the Right to Rent Scheme – which required landlords to carry out immigration checks on potential tenants and refuse those who cannot prove their status in the UK – came under fire. The scheme was initially introduced as part of the larger ‘hostile environment policy’ which aimed to make the UK so inhospitable to ‘illegal immigrants’ that they would leave. The policy became progressively cruel and included the use of ‘Go Home’ adverts; the physical removal of homeless Europeans; and the harassment and deportation of hundreds of legitimate Windrush-generation citizens.

The Right to Rent Scheme was introduced as part of the 2014 Immigration Act, which introduced the idea that service-providers should be responsible for carrying out immigration checks and refusing their services to those they deem ‘illegal’. However, the Joint Council for the Welfare of Immigrants (JCWI) conducted a survey which found that the scheme encouraged discriminatory attitudes and practices. According to JCWI’s findings, 42% of landlords surveyed said that they would be less willing to rent to anybody who did not have a British passport since the scheme was initiated, while 27% admitted they would avoid negotiating with anyone who had a ‘foreign-sounding’ name or accent.

Equally, the women’s rights charity SafeLives found data to suggest that police forces were also compromising their morals in order to meet the expectations of hostile policies. According to a report they released in in 2015, black, Asian and minority-ethnic, migrant women were likely to stay quiet 1.5 times longer than British-born, white women when being abused by their partner. SafeLives attribute part of this blame to the victim’s concern that they will no longer meet the Spouse Visa requirements if they leave their partner and inform the police of their situation, ultimately being reported and deported by immigration officials. Unfortunately, this fear is not unfounded; an undercover data-sharing ring was uncovered by women’s rights campaigners this December, which found that all 43 police-force in England and Wales had reported abuse victims to immigration officials. This resulted in the first ever super-complaint being launched against the police in the UK.

While the ‘hostile environment policy’ was technically denounced in the wake of the Windrush scandal last summer, and has been hushed throughout Westminster ever since, it continues to impact the processes of various service-providers across Britain, including the NHS.

Hostile policies which encourage the NHS to refuse care to those who cannot prove their status in the UK are causing various asylum-seekers to be refused essential, urgent and palliative care. One particularly tragic case this January saw an Eritrean asylum-seeker cut off from his Leukaemia treatment after he could not produce the correct paperwork at the hospital. Doctors have come forward to argue that these sorts of scenarios go against both their personal and professional ethics, including their Hippocratic oath, which states that they must ‘treat the ill to the best of [their] ability’.

Ultimately, the blame for these events does not lie with the NHS, which has received various cuts over the last decade and is still experiencing a severe staff shortage, which looks set to worsen after Brexit. Instead, it lies with the government to clarify its position on such policies, and ensure that they are adjusted in order to address these issues. The NHS must be allowed to continue functioning as a universal, non-discriminatory service.

– This article has been written by Luna Williams, the political correspondent at the Immigration Advice Service (IAS). IAS is a team of immigration solicitors, that provides free support for asylum-seekers, domestic abuse victims and trafficking survivors.