Secret Home Office policy to detain people with NHS debt at airport found unlawful

[SerendipityJane]

https://www.theguardian.com/politics/2023/may/26/secret-home-office-policy-to-detain-people-with-right-to-live-in-uk-found-unlawfu

my eye was caught by this line:

In a judgment handed down today Mr Justice Chamberlain found that the two women and their young children were falsely imprisoned by the home secretary without justification. He also found that Suella Braverman had breached her duty to consider the equality impact of the policy on women, who are known to be disproportionately affected by NHS charging.

Obviously we expect Suella to have no concerns about the law - either personally or professionally. But I note (again) this policy was almost deliberately intended to be inequal.

I don’t think that’s correct. I work as a midwife and I remember once getting a phone call as a junior midwife from the hospitals overseas patient team asking me if we had any overseas patients. I told them we had a Canadian woman on the ward, they asked for her details which I gave and they told me to go and tell her she owed I think 8k.

In my stupidness I went and told her when really I should have refused to get involved. She was hysterical, she thought because her husband was English she didn’t have to pay but apparently she did as she hadn’t lived here long enough. I rang the overseas team back and told them they’d have to talk to her as i couldn’t explain it all. They did and were firm with her that she owed the money and would have to work out a repayment plan. 🤷‍♀️. That was for antenatal care and labour. Was about 15 years ago.

And I remember seeing a documentary where a woman from Africa had been enroute to Canada but went into labour so was chucked off the plane at London. She had triplets or possibly quads who were all in the NICU. She on paper had a huge bill, hundreds of thousands of pounds and she was hounded by the overseas payment team while in hospital.

in the same programme a foreign man had had a stroke and was really sick in hospital and they were hounding his son at the bedside to pay the bill, literally took a card machine to him and said how much can you pay. I remember being shocked at that, not only the timing but also it wasn’t the son’s bill!

I’ve just read the 2015 regulations as they removed and added exemptions and I now think the woman from Mali, SXB, who had suffered FGM should have zero NHS debt for her miscarriages and stillbirth to the NHS, as the explanatory memo states that “any maternity care” should be covered free of charge for victims of FGM

I wonder why the high court didn’t even look at the validity of these women’s debts?

Yeah, I’ve just realised this morning that I am waaaay out of date, so sorry. 🫣

I have just read the new(er)regulations this morning. In my defence I was stuck in an airport, jet lagged and going slowly mad from fatigue and frustration over delays. So sorry everyone.

It used to be the case that maternity care was covered and for the record I think it should be overturned back to how it was. It’s unfair on women. That is definitely discriminatory.

@ReleasetheCrackHen no worries, I was hoping it might be me who was out of date and that they’d now made an exception for maternity care. Should have known they wouldn’t have done that!

Maybe having medical insurance should be part coming into the country. There is definitely evidence of medical tourism and that needs to stop.

What do you think would happen in other countries who that insurance based medical treatment?
Lots of people on here seem to want to move to an insurance based NHS and maybe they have a point.

If someone has a tax bill they can't pay they are not prosecuted. It's a debt, not a crime.

If someone deliberately evades tax or commits tax fraud they will be prosecuted.

If someone has a benefit overpayment that they can't pay back they are not prosecuted. It's a debt, not a crime.

If someone commits benefit fraud they will be prosecuted.

The difference is not which way the money is moving between government and individual, the difference is the deliberate fraud.

This is what the healthcare surcharge is for. It needs to be paid at the same time as the visa fee. But it's possible for people to fall through gaps in the immigration system and end up not covered for a period of time. I outlined a couple of ways this can happen above.

In those circumstances do you think a woman in active labour should be shown the door?

They get medical care, they don't want to pay for it.

We are not one world government, our government is to look after the interests of our nation like others do.

Tax has to rise during a cost of living crisis for young males coming here for free adventures (evident from the Albanins returned) as we fund hotels, lawyers etc, the UK is being taken for a ride.

Most women don't travel when pregnant.

Maybe you can absorb £4.50 for a dozen eggs in Morisons online and egg shortages, not everyone can, and are pissed off at people taking the piss with taxpayers money. Whilst I feel for them as individuals they are not our problem, we are generous with overseas aid.

Deliberately seeking out and accepting healthcare services, thus incurring charges that you were informed of in advance and then not paying for those services is indeed a type of fraud.

You are wrong about a tax bill that a person “can’t pay” - they are still prosecuted for nonpayment. Usually you are fined but some even go to prison.
https://taxscouts.com/self-assessment-basics/can-you-go-to-jail-for-not-paying-taxes-uk/

https://www.theguardian.com/money/2019/apr/12/woman-jailed-council-tax-bill-she-could-not-pay

This.

Yeah so I can see no one on this thread works in public health. Just a quick rundown of how things work in the real world for you:

• it is far cheaper in the long run to treat anyone that needs it here. If they get sicker and end up in a&e they’ll get treated there. Emergency treatment and hospital stays are very, very expensive for the system compared to preventative treatment.
• there are many communicable diseases that are best to treat no matter what. If your policy is to refuse treatment because no insurance, guess what, it gets passed on to more people.
• The primary cost to the nhs is not migrants, in fact they don’t really factor in that much overall (most people bar some exceptions that make it here are in relatively good health because they come to work, and largely as younger people). The biggest burden is sicker, middle aged to elderly British citizens who have not paid in anywhere near enough over their lifetime to cover the care for the many chronic conditions we seem to have. This is particularly the case for lifestyle induced illnesses such as some forms of diabetes, COPD, heart failure etc (which often preclude further work and thus further paying into the system).
• The recovery rate of funds to the nhs is quite poor and costly to manage. The amount they recover whilst - frankly - hounding sick people on behalf of the British state (getting into morality here, but tell me that doesn’t feel even a little wrong) is barely covering the admin costs of recovery itself. It is performative, and thus pointless.

It really pisses me off that people aren’t able to think through how their views would work in practise. The money we’re talking about is negligible in a) government terms and b) the cost that we would rack up of not treating people.

Anyone advocating for an insurance style system also needs to wake up to the fact that the business model of all insurance is not to pay wherever possible. It doesn’t lead to people getting the treatment they need, because those companies will ensure loopholes are bedded into as much as humanly possible. Health insurance is often a requirement of going into many countries but anyone who has tried to actually access it abroad will know it’s smoke and mirrors. Medical insurance companies are run by ghouls.

Tl:dr, it’s more cost effective to treat everyone regardless of their residency status, and the people advocating for ‘stricter’ rules on this haven’t thought through the reality of what that means. At all. And it’s fucking annoying.

Why don't those who deem it unfair - pay the bills themselves in behalf of the international patients, instead of demanding other people fund it?

Why don't they take in the migrant young men and fund their lawyers.

I am fed up of mean people being generous with other people's money. It's like the environmental lot with gigantic carbon footprints lecturing us all. I have had enough of it.

@RhinoMoveFast someone been watching GB News by any chance? Hint, just because they called it GB News, it doesn’t mean it actually produces news. Like how Fox News is just a mouthpiece for pearl clutching outrage designed to whip up the rage of credulous, stupid people. Indeed, it was founded in that model. Clever of them, isn’t it? Good business model, assuming you’re completely amoral and hate mankind. But it’s not news.

There needs to be some sort of change.

I had a friend (who lives abroad) who had medical insurance and was travelling in the UK. She got an infection and needed to see a GP to get antibiotics and had all her medical insurance details to hand and wanted to pay via her insurance, they refused. I think it was as a result of the paperwork and just too complicated. It shouldn't be hard pressed GP surgeries having to administer this, there should be some easy route for those who want to pay and have insurance to pay.

And yes, there definitely is medical tourism which, with the NHS at the point of collapse as it is, needs to somehow be stopped. I don't have any answers but I just wanted to say it's not easy for someone who has insurance to pay... and when you're ill are you really going to press the point if the doctors are saying they won't take it further?

You should read the taxscouts page carefully. Whether you are prosecuted will depend on your reasons for non-payment. The examples given all involve tax evasion. Even the hypothetical situation at the end of someone who is unable to pay:

So let’s say you’re already in hot water with HMRC for tax fraud, and you’ve been ordered to pay back what you owe, and you fail to pay. Then yes, you could be jailed.

Also, in both this case and the case of the woman jailed for non-payment of council tax, a court has ordered repayment and the individual has not complied with the court order.

That's when things move from civil to criminal justice. The debt itself is not a crime.

People who say things like 'the primary cost to the NHS is not migrants' no one is arguing they are the primary cost but all costs add up and the NHS is always claiming they have no money yet can afford to treat people who fly over 6 months pregnant to have triplets or quads costing NHS so much money. Yet they treat the mother and babies then after three months she leaves without paying a penny. This would not be allowed in other countries so we should not allow it either. Medical insurance for visitors is a must. Visitors must be made to pay up front before receiving treatment like happens in other countries.

This is a really good, clear judgment.

This is a good page on the wider issue of charging migrant women for maternity care:

https://maternityaction.org.uk/campaigns/nhscharging/

Egg shortages are caused by avian influenza and have nothing to do with immigrants. Learn some basic research and critical thinking instead of taking the lazy option of blaming everything on Johnny Foreigner.

All of this.

I'd like to add that the leading cause of home repossessions in the USA remains unpaid medical bills, even after "Obamacare" brought in insurance mandates. Insurance companies will do anything they can to avoid paying out, as anyone who's ever been in a car collision will know.

No really sure that's too helpful when you are in a fact free debate.

Speaking of facts, treating "health tourists" makes up only 0.3% of NHS spending. https://fullfact.org/health/health-tourism-whats-cost/

If we wanted to save the NHS money, we'd be better tackling the obesity and inactivity crises.

Speaking of facts, treating "health tourists" makes up only 0.3% of NHS spending

In the same way benefit fraud is dwarfed by unclaimed benefits. Which in turn is dwarfed by uncollected tax.

But this is 2023, when facts are irrelevant as long as "da feelz" is right.

It used to be a fact that the sun went around the earth. And when I say fact I mean that if you said otherwise you could have a very short but warm retirement.