PERSONAL
17/06/2020 06:00 BST | Updated 17/06/2020 09:45 BST

How The ‘Hostile Environment’ Has Made This Pandemic Harder For Doctors Like Me

To see our government disregard the health needs of migrants at such a critical time in public health is frustrating.

As a doctor, I am incredibly privileged to be able to serve my community during the Covid-19 pandemic. However, the satisfaction that I feel when working on the frontline is tempered by the knowledge that there remain many people who are not receiving the medical attention that they deserve. Like Elvis, a Filipino migrant whose death in mid-April from suspected Covid-19 was covered by the media, many migrants are at an increased risk of ill-health due to Conservative policies that render healthcare inaccessible to them. 

Research published last week by Medact, Migrants Organise and the New Economics Foundation shows that many migrants are too scared to access healthcare for fear of recriminations and charges by the Home Office. Even those with the right to free care are deterred “due to the complex nature of the policies and lack of staff and patient knowledge about eligibility”. I have seen first-hard the impact that the Hostile Environment policy, introduced by Theresa May in 2014 when she was home secretary, is having on our National Health Service – during a global pandemic no less.

We know that the exemption from charges for migrants with Covid-19 is not working. Some 56% had seen no information from public bodies which raised awareness of migrants’ rights to healthcare during the crisis. Only 9% think that ‘information about charging exemptions is reaching all sections of their communities in an accessible format’. Patients are even being asked to prove their right to healthcare while suffering in hospital with COVID-19 symptoms, a dehumanising and traumatic experience. What’s more, additional barriers like inadequate translation and interpretation services and poor access to digital health information amongst patients are prohibiting us doctors from seeing the patients we desperately need to see. 

My colleagues and I are powerless to ensure that as many patients as possible are being seen and treated. This is completely illogical within the context of a public health crisis.

Most of the decisions regarding which patients are eligible for care are made behind the scenes by hospital trusts. When I treat my patients, they have already gone through immigration screening checks before they make it to the ward. My colleagues and I are powerless to ensure that as many patients as possible are being seen and treated. This is completely illogical within the context of a public health crisis, as we urgently want to eliminate the possibility of this virus returning and causing more loss in the UK. It is also disheartening to see some of our nation’s most vulnerable populations – many of whom possess social risk factors for infectious diseases including Covid-19 – being policed at point of entry. 

These exclusionary policies exist within the context of an NHS that has been victim to at least a decade’s worth of underfunding. This includes public health services that have been at the forefront of managing the coronavirus pandemic. According to a King’s Fund report, there has been an 8% decrease in spending on public health services by local councils between 2013/14 and 2017/18. This drop in funding was continued in 2019/20. In short, our NHS, which was once a symbol of our collective ability to contribute to the common good, is now itself a neglected and sickly patient. 

As we sit in the midst of a global pandemic, we have an opportune moment to re-evaluate our priorities as a country.
Vadym Terelyuk via Getty Images
Modern medical beds for injured in hospital. Resuscitation chamber. Coronavirus, virus concept. COVID-19 identification. Pandemic.

We need only look to other nations, like Portugal and Ireland, for examples of how to better serve the health needs of everyone in society. Portugal has been praised for its efficient response to the virus; the country also gave all migrants and asylum seekers full citizenship rights, temporarily, as early as 31 March. In Ireland, early on in the crisis, public authorities confirmed the building of a “firewall’ between health and migration authorities to make sure that any undocumented migrant would not be deterred from coming forward and accessing health care or social supports during the Covid-19 crisis. To see our government, instead, disregard the health needs of migrants at such a critical time in public health is frustrating. Immigration controls ought to be kept separate from matters of public health. I’ve seen how combining the two can have a detrimental impact on the health of the citizens of the entire nation. 

As we sit in the midst of a global pandemic, we have an opportune moment to re-evaluate our priorities as a country. Universal access to healthcare was a founding principle of the NHS and the moral foundation upon which many of us healthcare professionals have chosen to practise medicine. The coronavirus pandemic has laid bare significant health inequalities that plague every corner of our nation and the need for a public healthcare system that serves us all has never been more vital than now. 

Harun is a physician, public health researcher and a member of Docs Not Cops, an organisation that supports an NHS that is free at the point of use for all

Refugee Week, the UK’s largest festival celebrating the contribution of refugees, takes place on 15-21 June 2020. Refugee Week is a partnership project coordinated by Counterpoints Arts. For more information on Refugee Week and to get involved, visit refugeeweek.org.uk