PATIENTS NOT PASSPORTS: Migrants Access to Healthcare During the Coronavirus Crisis | June 2020 INTRODUCTION The rapid emergence of the Covid-19 pandemic has thrown the world into an unprecedented crisis. The unequal impact of the virus has laid bare the UK’s structural inequalities and injustices. One of the most prominent has been the disproportionately high number of Black, Asian and minority ethnic (BAME) deaths, both among healthcare workers and the population at large. The Office for National Statistics confirms that Black people are four times more likely to die than white people, and Bangladeshi or Pakistani groups three times more likely.1 A preliminary study into deaths among the NHS and social care workforce also found vastly disproportionate mortality rates among BAME staff, and among all staff not born in the UK.2 Decades of structural and institutional racism has meant that BAME groups are more exposed to the effects of coronavirus and are less able to protect themselves from contracting it. Government policies which disproportionately affect BAME and migrant communities, along with the existence of structural racism, has resulted in poverty, precarious employment and overcrowded housing being more prevalent amongst BAME groups. These socio-economic conditions are known to drive the comorbidities that increase susceptibility to the virus and make it harder to socially distance effectively. There are concerns that migrants, who are predominantly from BAME groups, are experiencing the effects of such inequalities acutely during the pandemic. The Government’s Hostile Environment immigration policies - which restrict access to public services and criminalise everyday activities - are likely to be contributing to the crisis. A range of organisations and elected representatives have raised concerns about the harmful impact of NHS charging policies and the additional barriers they present to migrants in need of healthcare during coronavirus. These concerns were brought to the fore by the death of a man known as Elvis from Covid-19 on 8th April. Elvis was an undocumented Filipino migrant who had lived and worked in the UK with his wife for more than 10 years. Despite suffering with this illness, he had been too afraid to go to hospital for fear of incurring debts he could not repay and being reported to immigration enforcement. Elvis’s story is likely to be one among many. Migrant organisations up and down the country regularly report cases of their members being denied care or fearing to access care, often with horrific consequences. The criminalisation of migration, through Hostile Environment immigration policies, prevents many people from coming forward and their stories being made public. This lack of public knowledge creates an environment of impunity for inhumane policies, and in the context of the current pandemic, diminishes efforts to protect public health. Shedding light on these practices, therefore, is a matter of crucial public interest as well as a first step in dismantling the structures of exclusion, inequality and discrimination. This report In order to understand and uncover the barriers to accessing healthcare faced by migrants during the coronavirus crisis, Medact, Migrants Organise and the New Economics Foundation have undertaken new research with migrant organisations from across the UK. This report sets out the findings of the research and recommends a series of urgent measures. We hope that this research, along with research and impact assessments conducted by others, will help guide the Government’s response to this devastating crisis. Its devastating consequences will only be curtailed with inclusive measures designed to protect everyone’s right to health.3 5