PATIENTS NOT PASSPORTS: Migrants Access to Healthcare During the Coronavirus Crisis | June 2020 One respondent, who works predominantly with asylum seekers from North Africa, reports that: someone with [a] cough said they can’t ring 111 even when they get worse because the hospital will neglect them because of who they are. So although she’s aware it’s free but thinks she don’t deserve it - that they won’t prioritise her.” Further, the fear of discriminatory treatment has been exacerbated by the disproportionate number of BAME deaths due to coronavirus in the UK, including the disproportionate number of migrants who have died - both amongst NHS staff, and the population at large. In our research, it was clear that this has added to the fears amongst migrants of seeking treatment for coronavirus. One respondent explains that migrants they work with “are scared of contracting coronavirus in hospital … as many migrants are dying from the virus, people feel they will not get good care”. Other alarming responses noted that people are less likely to seek care during the crisis because they “feel that they are not part of the British community”. WHAT NEEDS TO CHANGE This report adds to the growing body of evidence that policies implemented as part of the Hostile Environment are preventing migrant communities in the UK from accessing the healthcare they need. This continues during the coronavirus crisis despite efforts by the government to exempt treatment for Covid-19 from charging. Fear, created through a decade of exclusionary policies, continues to deter people from seeking care. Our findings reinforce the concerns that have been put to the Minister of State for Health and Social Care and to the Home Secretary in letters signed by 60 MPs, the Mayor of London, the BMA, six Royal Colleges that represent doctors and midwives, and over 100 civil society organisations; and justifies the longstanding opposition to the policies that precede the present crisis.17,18,19,20 The government has yet to acknowledge the ineffectiveness of the exemption for Covid-19, and has expressed little interest in investigating any potential deficiencies in its policies or the impact they are having. In response to the concerns raised by parliamentarians, unions, and civil society, the government merely reiterated that Covid-19 was exempt and that, many weeks into the pandemic, they would eventually “be publishing information about the free treatment of coronavirus in around 40 different languages”.21 This delayed and inadequate response has undoubtedly contributed to the confusion and disinformation recorded in this report. For those that do come forward, there are a range of additional barriers that affect migrants’ ability to access healthcare. These barriers – from language and translation issues to digital exclusion – have been exacerbated by the health system’s response to the lockdown. They also cannot be separated from the Hostile Environment, which has introduced a culture within the NHS which accepts the existence of such barriers and provides a way to justify the denial of care to people racialised as migrants. This is not to say that there are not many NHS staff working to support people to access care and, where possible, to circumvent the barriers put in place by the Hostile Environment. However, these actions alone are not enough to mitigate the fear created by these policies, or to ensure the safety of people accessing services which systematically share data with immigration enforcement. Avoidance of healthcare, for fear of contracting Covid-19, is exacerbated by the disproportionate number of migrant and BAME deaths, and a fear that they, as migrants, will not receive good quality care. 27