"Drowning in bureaucracy": The unintended consequences of NHS charging policies for the provision of care to migrant populations

Barclay, Ella Grace

Abstract

Over the past decade, the NHS has come under increasing scrutiny, with critics claiming the UK’s healthcare system is “drowning in bureaucracy” due to the introduction of multiple contradictory social policies (Torjesen, 2015, p. 1). This is particularly apparent following the implementation of the 2014 and 2016 Immigration Acts. In an attempt to disincentivise immigration, access to a wealth of social services has been restricted for non-citizens, marking the UK’s shift towards a deliberately hostile environment (Farrington et al., 2016; Kirkup & Winnett, 2012; Weller et al., 2019). More specifically, Theresa May, the then Home Secretary, positioned the rights of migrants as inferior to the rights of others, choosing to limit access to healthcare for those not ‘ordinarily resident’ within the state (Liberty, 2019). Subsequently, these individuals are charged at a rate of 150% for the cost of all non-primary healthcare, and this bill must be paid before they may access NHS support. Although these legal barriers to the accessibility of care pose obvious issues for the wellbeing of migrant populations (Doctors of the World, 2020; Feldman et al., 2019; Russell et al., 2019; Shahvisi, 2019; Walker & Farrington, 2021), further obstacles arise in the inconsistent and often unsuccessful implementation of these policies, exacerbating the impact of hostile environment policies within the migrant population and beyond.

• Journal Article Type: Article
• Acceptance Date: Sep 22, 2022
• Publication Date: Feb 1, 2023
• Deposit Date: Mar 20, 2023
• Publicly Available Date: Mar 20, 2023
• Journal: The Open Review Journal
• Peer Reviewed: Peer Reviewed
• Volume: 8
• Article Number: 2
• Pages: 33-41
• DOI: https://doi.org/10.47967/TOR2022COL/VOL8.02
• Keywords: NHS; Migrants; Migrant populations; Healthcare
• Public URL: https://uwe-repository.worktribe.com/output/10506245
• Publisher URL: http://www.theopenreview.com/wp-content/uploads/2023/02/Ella-Grace-Barclay.pdf