Getting healthcare in the UK 

Legal Updates

Photo of an ambulance speeding along a road, and the background is blurred.

Getting healthcare in the UK can be difficult. If you are a migrant in the UK you may experience additional barriers in getting the healthcare you need. 

This blog is about getting healthcare in the UK as a migrant, and most of the information here is about England. For information about healthcare in Scotland, see information here

At Right to Remain we are developing our resources in our online Toolkit. We welcome your comments and suggestions for resources on migrant healthcare in the UK. Get in touch with us if you have any suggestions of information to include.

How does healthcare in the UK work? 

Healthcare in the UK is delivered by the NHS, which stands for the National Health Service. 

The NHS was set up in 1948, and is based on need, not a person’s ability to pay. A fundamental principle of the NHS is that it is free at the point of use. However, the NHS has changed significantly since 1948, and now not all services offered are free.

There are some services that everyone must pay for, including prescriptions (in England) and dental treatments.

The NHS is made up of multiple smaller organisations called trusts, which serve different geographical areas or specific parts of NHS care, such as the ambulance service.

NHS Charging

Some people may have to pay for some NHS care. This hasn’t always been the case, and was introduced after a number of legal changes.

The Immigration Act 2014 expanded the charging regulations when it became law in 2015. This led to the expansion of charging for overseas visitors, and the introduction of the Immigration Health Surcharge for people applying for visas to enter the UK. It also allowed NHS trusts to start charging up to 150% of the cost of treatment at their discretion (this means their choice).

This was expanded again in 2017 with the National Health Service (Charges to Overseas Visitors) Amendment Regulations, with a new duty on NHS Trusts to check the eligibility of patients before providing treatment in secondary care. 

It is now the job of the health professional to identify who is eligible for treatment, and who might be charged for NHS care.

This expansion of the ability to charge people for vital healthcare is an expansion of the hostile environment.

This complicated system of charging means that many people are put off from receiving medical treatment because they are worried about the effect on their immigration status.

Primary healthcare

There are some services which are free of charge regardless of a person’s immigration status. 

This includes NHS services which are classified as ‘primary healthcare’. Primary healthcare services in the UK include: 

  • GP (General Practice)
  • Nurse services
  • A&E (Accident and Emergency) and Minor Injuries Units
  • Other walk-in centres such as sexual health clinics (not including termination of pregnancy or infertility treatment)
  • Covid-19 services, such as vaccination
  • NHS 111 telephone line
  • Palliative care
  • Treatment of conditions caused by torture, FGM, domestic violence or sexual violence
  • HIV, TB and MERS treatment (see full list here

All of these services listed above are free for all and you should not be charged for any of these services. 

Visiting your GP

GP stands for General Practice, and is usually the first doctor you will go to if you have a health problem or concern. The GP is a form of primary health care, which means that anyone in England, Wales and Scotland can register and visit a GP for free, regardless of your immigration status. 

You must register with a GP in your area. See this page for more information about registering with a GP. 

You do not need to have proof of address, and GP practices are not required to ask for proof of identity, address or immigration status from you. 

If a GP practice refuses you because you do not have proof of immigration status this is against the law. Use this guidance to explain this to them. You can also use this resource from Healthwatch Haringey to register with a GP without proof of address. 

Secondary healthcare

Hospitals and other specialist types of healthcare are secondary healthcare, and may require you to show you have lawful residence in the UK to access for free. The test is ‘ordinary residence’ – which means you are living in the UK legally and you are not a visitor. Being ordinarily resident in the UK includes the following types of status: 

  • British citizenship
  • Indefinite leave to remain
  • Settled status under the EUSS
  • Limited leave to remain

If you paid the Immigration Health Surcharge (IHS) alongside your visa application, you can use the NHS in a similar way to an ordinarily resident person. 

If you do not have indefinite leave to remain, or have not paid the Immigration Health Surcharge, you may have to pay for secondary NHS services according to the discretion of the trust. 

Exemptions from charging

Some people are also exempt from payment for secondary NHS services. You are exempt if you are:

Problems with NHS charging can occur when someone moves from being an asylum seeker to having their asylum claim refused, for example. At this point you may become eligible for NHS charging. This is hugely problematic, as it is often vulnerable patients who are already facing destitution who may receive bills for the healthcare they have received. 

Helpful resources

  • The organisation MedAct set up an campaign called Patients Not Passports. This campaign is about trying to get healthcare providers to stop doing immigration checks.  They maintain that healthcare providers are not immigration officials, and their duty of care is to patients. 
  • Patients Not Passports designed this Toolkit, which is designed to support people facing charges for NHS care. There is also this advocacy guide for community members who are facing charging.

  • Doctors of the World have a Safe Surgeries Toolkit. This is a guide for GP surgeries to take steps to reduce the barriers faced by migrants in accessing healthcare. This includes ensuring that proof of address, or immigration status are not barriers to patient registration.

  • JWCI and Doctors of the World produced this guide to NHS care in England in 2018.

  • For advice around childbirth and maternity services, Maternity Action have know-your-rights resources on charging, and help with registering with a GP. If you have a question about free NHS maternity care, you can request free legal advice.

Campaigns against NHS charging

There have been a number of campaigns against NHS charging and the harm that it causes. See information from Patients Not Passports on how to campaign effectively.

In 2022, the Justice for Simba campaign had a huge victory. After tireless campaigning, Simba finally had his huge NHS bill of £120,000 dropped. Read more about the campaign here

There are many ongoing campaigns against the harms of NHS charging. Give your support to the Help Omisha campaign, and read more about baby Omisha who is being charged for receiving life-saving NHS care for liver cancer.

Please get in touch with us if you have more resources on healthcare you would like us to share. 

As always,

Migration is Life,

These Walls Must Fall, 

No One is Illegal 

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