An NHS trust has apologised for charging ‘overseas’ patients for healthcare in accordance with UK immigration rules. Lewisham and Greenwich NHS trust (LGT) said it was ‘sorry for any instances where people weren’t treated with compassion or in a way that was consistent with the values of the trust.
According to an official report, the LGT’s practice of charging overseas patients for healthcare may have scared people away from seeking medical treatment and left domestic violence survivors with bills amounting to thousands of pounds and even left one patient ending up on the streets.
The official report, compiled by a panel of trust officials and local campaigners, made 39 recommendations to the LGT, and it’s understood that the trust has accepted all but one of those recommendations.
The report was commissioned amid a controversial pilot scheme in which credit reference agency, Experian, played a part in checking the eligibility of the LGT’s patients for free, non-emergency healthcare.
A number of UK immigration activist groups welcomed the report, but warned that similar situations to the one exposed at the LGT existed across many NHS trusts as part of government rules to charge patients for non-emergency healthcare who are ‘not ordinarily resident in the UK’.
The charges for healthcare ‘often affect those whose UK immigration status is unclear or under review’, the report said. In the report, the LGT said: “Ethical financial and clinical tensions arising from the charging regime are unlikely to be fully resolved without radical redesign of the current patient charging framework, which is set by the government.”
According to the report, the panel had been notified of several instances where the LGT’s approach to charging patients may have resulted in those seeking medical care feeling scared or unable to seek timely treatment and/or opting to go to other hospitals for their care.
In a report published by The Guardian, the case of a pregnant woman dating back to 2019 revealed that she was charged for antenatal care. When she told the LGT that she couldn’t pay, she agreed to a repayment plan with a deposit she had to borrow from a friend.
In the latter stages of her pregnancy, she told how she became destitute and was forced to live on the streets. The woman was prohibited from working because of her UK immigration status.
Another case involved a domestic abuse survivor, who arrived in Britain in 2016. She wasn’t notified of potential fees when she began receiving antenatal care. However, five months after giving birth in June 2019, she received a letter from the LGT out of the blue, demanding £15,480.
She told The Observer: “It was not something I was expecting. When I opened it to read I remember slumping on the foot of the stairs and just screaming. I had a panic attack at that point because I was like, ‘How do I afford this? Where do I start from?’”
She offered to repay at a rate of £30 per month, but the trust reportedly refused to accept anything less than £100 per month at a time when her income was £500 per month, which she received from her local council to cover her and her new born daughter’s living costs.
She said: “A representative of the trust’s overseas visitor team was unsympathetic. I just remember her giving me the vibe like ‘it’s none of my business, you just need to pay this amount’. And I remember feeling like, ‘what do you actually want me to do?’”
The woman has since secured extended leave to remain in the UK and found employment.
She said: “At the time, I couldn’t afford the £100 monthly payment, but I’m here now, I’m working, I’m paying my taxes, I’m contributing to the economy. My daughter is doing very well, as well. So if I wasn’t given the care at the time or if we didn’t have that access, I wouldn’t be here contributing to the economy.”
Campaign group involvement
Campaign group Maternity Action got involved in the woman’s case and the LGT eventually agreed to waive the fee. However, it could still affect any future UK visa and immigration applications the woman makes to the Home Office.
Hera Lorandos of the Lewisham Refugee and Migrant Network said: “The charging practices of Lewisham and Greenwich NHS trust do not exist in a vacuum; they mirror the practices of many other trusts across the UK. The practices are an inherent result of the hostile environment legislation which forces NHS trusts into becoming border guards.”
“Trusts now have to demand documentation, force people into crippling debt, deny treatment and share patient information with the Home Office. This only serves to break the promises of universal healthcare, inevitably spreading fear and distrust that prevents many from getting lifesaving healthcare,” Lorandos added.
Lorandos went on to welcome the measures that the LGT has taken to reduce the impact of the policy, but said that the Lewisham Refugee and Migrant Network remains committed to ending the discriminatory and harmful policy completely.
A spokesperson for the LGT said: “Over the last 18 months, we have worked closely with patient groups and partners to review our arrangements for charging patients who are not always eligible for free NHS treatment.”
“We’ve made a number of changes to ensure that we act in an empathetic, compassionate and supportive way towards these patients, and apologise for any instances in the past where this was not the case,” the spokesperson added.
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