A couple of years ago, I met a with a patient with end-stage organ damage, who was nearing the end of his life. A fellow medical student and I had perched ourselves in the corner of his cubicle, listening and learning about his illness. Like many patients, he welcomed the opportunity to share his stories with us, reminiscing about the joys and pains of his past. While he was speaking, a woman popped her head through the gap in the hospital curtain, sighed and then walked away. A few minutes later, she returned, this time with a senior nurse and asked us to leave so that she could speak to the patient.
As we stepped aside, the conversation I overhead made my stomach churn.
“I already showed you my passport, what more do you need?” the patient cried.
“A British passport does not prove you have the right to free NHS treatment. We need evidence that you are a resident.”
“Can you not see that I am unwell? Please, leave me alone.”
The Immigration Act 2014 introduced charges for secondary care of certain immigrants. This meant that patients could be interviewed by a member of an ‘overseas visitors’ team to determine whether or not they were exempt from charges, which could be 150% of the actual cost of treatment. As I learnt on that hospital ward two years ago, these interviews and demands for evidence can take place in the hospital, at the bedside.
2015 saw the introduction of NHS surcharges of up to £200 for anyone from outside Europe who lawfully applies to work or study in the UK. It typically takes over five years to become a permanent resident in the UK, meaning that people can be legally employed, paying taxes and still have to pay to access the NHS.