PATIENTS NOT PASSPORTS: Migrants Access to Healthcare During the Coronavirus Crisis | June 2020 Our research shows that: • Migrants are not coming forward for healthcare because of the Government’s Hostile Environment. It has long been common for migrants to avoid seeking healthcare because of these policies, which include NHS charging and data sharing with the Home Office. Tragically, this remains the case during the pandemic. 57% of respondents in our research report that migrants have avoided seeking healthcare because of fears of being charged for NHS care, data sharing and other migration enforcement concerns. Due to the complex nature of the policies, and the lack of staff and patient knowledge about eligibility, even those entitled to free care under the current policy are deterred from seeking healthcare. • The coronavirus exemption from charging is not working While treatment for coronavirus and other communicable diseases is exempt from charging, few respondents (20%) agree that migrants are aware of this exemption. Most of those responding to the survey (56%) have not seen any information from public bodies raising awareness of migrants’ rights to healthcare during the coronavirus crisis. Fewer still (9%) think that information about charging exemptions is reaching all sections of their communities in an accessible format. Further, there are reported instances of people being required to prove their entitlement to care whilst in hospital with coronavirus symptoms. Even when this information gets through, a decade of Hostile Environment policies means that fear and mistrust prevail, and the deterrent effect persists. This is compounded by fears of data sharing and immigration enforcement, as the Department of Health and Social Care has made no assurances that patient data will not be shared with the Home Office. • Migrants face a wide range of additional barriers – including language and digital exclusions – to accessing care, including emergency services. For those that come forward despite the fear created by the Hostile Environment, the coronavirus crisis has created additional barriers to accessing care. As many services - including health services and migrant support services - shut and others move online, the crisis has also shed new light on existing barriers, which are exacerbated and compounded during the pandemic. Chief amongst the additional barriers to care are: the absence of translation and interpretation services; digital exclusions; housing and proximity to care services. Further, a fear of contracting coronavirus while accessing healthcare, leading to an avoidance of services, has been exacerbated by fears of discriminatory treatment and the disproportionate number of migrant and BAME coronavirus death. Our research shows that migrants face many barriers to accessing healthcare, and provides an important insight into the daily experiences of migrants living under the Hostile Environment. The health system overlooks the specific needs of migrants and the fear and deterrence they face. These delays in seeking care result in harrowing examples of harm and needless death. It is important to note that many migrants, especially those whose status is most precarious, often do not receive any support from migrant organisations. The results of this research, therefore, are likely to understate the scale and depth of the issues highlighted. 2