1234 About us East London Clinic Entitlement to healthcare Advocacy Summary

About us 1 234

Our Vision A world in which vulnerable people affected by war, natural disasters, disease, hunger, poverty or exclusion get the healthcare they need regardless of income or status. About us 1

Médecins Du Monde Network 300 Projects70 countries 3000 volunteers About us 1

Our Programmes Conflict & Crisis Women & GirlsPeople at risk of harmVulnerable migrants About us 1

Our London Clinic

London clinic 124 We help people excluded from healthcare including: Undocumented migrants People working in exploitative conditions Refused asylum seekers People who have been trafficked Sex workers 2 3

Vulnerablities in Health 4 Living in the UK for an average of over 5 years before accessing healthcare Less than 1% included ‘personal health reasons’ amongst their reasons for migration 94.1% not registered with a GP 54.8% perceived themselves to be in poor health 76.3% had reported violence in their lifetime 44.3% had no-one they could rely on for emotional support 90% live below the poverty line 75% of pregnant women accessing AC care later than recommended 2

Our Patients Bangladesh India Uganda Philippines China Nigeria Vietnam AfghanistanPakistan Ghana Algeria Sri Lanka Bulgaria 2

Entitlements to Care 124 3

Entitlements to healthcare Entitlement to Primary Care All GP’s have the discretion to accept or refuse any person as an NHS patient (but they must not discriminate). There are currently NO regulations regarding charging/eligibility. Therefore: Immigration status & ordinary residence are irrelevant when registering with GP. No legislation or statutory guidance suggests people must be resident for a minimum length of time or have a visa in order to access primary care 3

Entitlements to healthcare Entitlement to Secondary Care Department of Health regulations restrict free access for overseas visitors where an overseas visitor is someone who is not considered ‘ordinarily resident’. Immediately necessary and urgent treatment must be given, regardless of someone’s eligibility to care or their ability to pay. Exceptions include: Asylum seekers and Refugees Survivors of trafficking (NRM only) Children in care of LA’s EEA Nationals Certain visas Treatment for infectious diseases Sectioning under the Mental Health Act 3

Advocacy

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The documented effects of crisis and austerity throughout Europe Impact on women’s and children’s health Policies based on fear and intolerance instead of evidence based policies Some positive changes in national policies, rare and all the more noteworthy 4

Immigration Bill £200 health levy on non-EEA migrants Restrictions around who is entitled to secondary care – only ILR Department of Health proposed changes – from 2015 Charging migrants for A+E Restricting certain aspects of Primary Care (but not GP/nurse consultations) Also – the Home Office are proposing that data sharing should enable people’s NHS numbers to be matched with their HO records – potentially legalising immigration enforcement action when someone accesses healthcare UK Immigration Act & Department of Health migrant and visitor cost recovery plan 4

‘The government should: consider setting up triage clinics impose blanket exemptions for children who need NHS care establish a principle of one-way information sharing educate the administrators impose a rolling impact assessment’ Demos 4

What has changed? Surcharge and exemptions EHIC card Immediatley Necessary and Urgent Treatment must always be provided Primary care remains free for all 4

What has changed? Consultation in the autumn ‘Deprioritised’ 4

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Thank You Details: Contacts: Phil Murwill, UK Programme Officer