PATIENTS NOT PASSPORTS: Migrants Access to Healthcare During the Coronavirus Crisis | June 2020 2.2 Other charges still apply While treatment for coronavirus is free, treatment for any other medical conditions, and all treatment received following a negative Covid-19 test result, remain chargeable upfront unless otherwise exempt. As highlighted in the section above, fear of being charged for these conditions remains a clear deterrent. Several respondents note that: there are compound issues where other illnesses could be identified during a screening which may be chargeable” and similarly: even knowing that Covid-19 treatment is free doesn’t mean that you might not end up with charges for something else”. 2.3 Fear and mistrust prevail A decade of Hostile Environment policies mean that fear and mistrust prevail, despite the exemption, and therefore the deterrent effect persists. We have spoken with our residents and made them aware [of the exemption], however there is lack of trust with the system, and they don’t necessarily feel confident that this actually the case, despite our reassurances.” Although I and others try to tell people [about the exemption] and publicise, general fear created by Hostile Environment [is] prevalent within communities” Even [when] we tell them this, their fear dominates”. This is compounded by fears of data sharing and immigration enforcement. The DHSC has made no assurances that patient data will not be shared with the Home Office, including for people undergoing treatment for Covid-19. The government has issued guidance that immigration status checks should not be carried out for people only undergoing treatment or investigation for Covid-19. However, it is unlikely in practice that people will be investigated or treated for Covid-19 in isolation from other health problems, making this guidance impossible to implement. Even if it is exempt, the issue is that they risk becoming known to the authorities, therefore, would rather not risk it unless they absolutely have to.” ...they know that should they access care, they will either get an NHS debt or be reported to the Home Office.” For those who are here without leave, they will always be suspicious of involvement with any form of registering/name taking because it could be used in a different way later. I think it will be hard to overcome that lack of trust because of the inevitable worry that unlawful presence will trigger removal action.” 18