Government fails to exempt people receiving social services' support from NHS charging

21 December 2018

No change to secondary healthcare charging regime following review

The Minister of State for Health has announced that the ​Department of Health and Social Care (DHSC) review of the NHS charging regulations in England, which were amended last year to extend the types of secondary healthcare services that may be charged for and to introduce upfront charging for non-urgent treatment, is now complete. In a written statement to Parliament, he states:

'..the evidence received demonstrated that there is no significant evidence that the 2017 Amendment Regulations have led to overseas visitors being deterred from treatment or that the changes have had an impact on public health.' 

Local government has long expressed concerns regarding the impact of charging for secondary healthcare on communities, particularly with regards to how this affects families, adults and care leavers with no recourse to public funds (NRPF) who are receiving social services' support 

In our submission to the review, made jointly with the Association of Directors of Children's Services (ADCS), we highlighted how the Regulations can create additional pressures on local authorities, who are spending at least £43.5 million per year providing accommodation and financial support to safeguard the welfare of children and vulnerable adults who are excluded from mainstream benefits and housing due to their immigration status.  

It is very disappointing that our request for a charging exemption for people receiving social services' support who are without leave to remain has yet again been refused without a full explanation. Our data shows that the majority of people with NRPF receiving social services' support will go onto obtain leave to remain, usually on the 10-year settlement route, so have long-term futures in the UK. Excluding this vulnerable group from free secondary care is in direct conflict with local authority duties to safeguard the welfare of children and vulnerable adults.  

The Royal College of Physicians, the Royal College of Paediatrics and Child Health (RCPCH), Royal College of Obstetricians and Gynaecologists (RCOG) and the Faculty of Public Health (FPH), are now calling for charging to be suspended pending an independent review of the impact of charging on individual and public health. A further opportunity to submit evidence would be welcomed.  

There have been two other changes regarding access to healthcare:

  • The recent announcement by NHS Digital that data sharing with the Home Office for the purpose of immigration enfo​rcement will no longer take place whilst the Memorandum of Understanding is reviewed.
  • The Immigration Health Charge (IHC) will be increased on 8th January 2019 from £200 to £400 per year for most leave to remain applications. This means that the cost of an application for leave to remain on the 10-year settlement route (on family or private life grounds) will increase from £1533 to £2033 (£1033 application fee + £1000 IHC).

We will continue to gather evidence about the impact of NHS charging on local authorities and people receiving social services' support. Loc​al authority practitioners are requested to complete ​and return this ​evidence form to us whenever an appropriate case study is identified. We will also be updating our factsheet, which sets out what healthcare is free and what is chargeable to certain migrants, to reflect the changes outlined above. 

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