and marginalised sections of the population.315 It must be economically accessible, that is to say affordable for all, with “a special obligation to provide those who do not have sufficient means with the necessary health insurance and health care facilities”.316 It must also be of good quality.317 Emergency healthcare, essential primary healthcare and non-discrimination in the provision of healthcare are identified as core entitlements that States must meet.318 Several participants interviewed revealed a range of health issues including a bowel condition,319 mental health problems and epilepsy,320 mental health problems and alcohol/ drug dependency,321 a kidney condition,322 lymphatic cancer,323 Hepatitis B,324 Hepatitis C,325 and chronic asthma and dental problems.326 However, except for one case of denied access to (non critical) dental treatment327 no participants were refused access to healthcare or required to pay for treatment before receiving it. However, the research identified other evidence that stateless persons were not always able to access healthcare as a result of previous Regulations and Department of Health Guidance.328 The legality of this guidance was challenged in a case brought by a stateless Palestinian who had claimed asylum when he arrived in the UK.329 His asylum claim had failed, but he could not leave the UK. He required treatment for lymphatic cancer, which was deemed “urgent” but not “immediately necessary” secondary healthcare. The hospital required him to pay a charge before he would be treated, on the basis that he had been neither “ordinarily resident” nor had been “lawfully present” for 12 months. The Court of Appeal held that, although the hospital was correct in its application of the Regulation and the Guidance, it maintained a discretion to treat the applicant. The Court held that the Guidance ought to be reviewed to consider the “plight of those who cannot be returned” and those for whom there is no prospect of paying for the treatment. Since the Court of Appeal’s judgment, new Regulations and Guidance have been brought into force.330 As before, if the person in need of treatment is not “ordinarily resident” he or she may be charged for it. Specific sorts of treatment, such as accident and emergency services, family planning or treatment for specific diseases which is necessary to protect public health, cannot be charged for.331 Importantly, these now provide that charges should not be applied to failed asylum-seekers who are in receipt of section 4 support, on the premise that “[s]ection 4 support is given to those failed asylum-seekers taking reasonable efforts to leave the UK but for whom there are genuine recognised barriers to their return home”.332 The new Regulations and Guidance do not expressly cover the situation of the stateless because, first of all, not all stateless persons in the UK claim asylum and, secondly, evidence 315 In accordance with ICESCR Articles 2(2) and 3 in particular and other prohibitions on discrimination discussed in Chapter 5. 316 CESCR General Comment No. 14, para. 18. 317 Ibid., para. 12. 318 Ibid., para. 48. 319 Participant 3. 320 Participant 4. 321 Participant 1. 322 Participant 10. 323 Participant 19. 324 Participant 21. 325 Participant 36. 326 Participant 27. 327 Participant 27. 328 National Health Service (Charges to Overseas Visitors) Regulations 1989 (SI 1989 No. 306 as amended) and the guidance to the NHS Trust Hospitals in England given by the Secretary of State for Health. 329 R (YA) v Secretary of State for Health [2009] EWCA Civ 225. 330 See The National Health Services (Charges to Overseas Visitors) Regulations 2011 No 1556 and Guidance on Implementing the Overseas Visitors Hospitals Charging Regulations 2011. 331 See Guidance on Implementing the Overseas Visitors Hospitals Charging Regulations 2011, section 3.26. 332 Ibid., section 3.63. in the United Kingdom 103