PATIENTS NOT PASSPORTS: Migrants Access to Healthcare During the Coronavirus Crisis | June 2020 Cases of undocumented migrants exhibiting Covid-19 symptoms and avoiding care out of fear suggest another strategy for dealing with the current crisis is needed. One client lived in a care home where she does live-in care and she has been exposed to Corona but has stated that she will not seek treatment and would rather die there than be detained.” Furthermore, it is clear that excluding coronavirus from immigration checks is not, in fact, being applied, resulting in people still having to demonstrate entitlement to care, despite being in hospital for Covid-19. One respondent reported a case where a man receiving treatment for coronavirus was sent a letter to his home asking him to prove his immigration status and entitlement to care - despite him being a British citizen. He was still unable to talk, having only one day earlier been discharged from the ICU. The respondent commented that “it is absolutely shocking that someone who was still so sick to be sent a letter in this time ... The family were alarmed when they received correspondence from the hospital asking for proof at such a moment. They see it as racial profiling.” It is clear from our findings that the Hostile Environment has left many migrants feeling unable to navigate the coronavirus crisis safely. Many view the threat to their wellbeing, posed by NHS charging and data-sharing, as at least equal to the threat of COVID-19 - leaving those exposed or suffer symptoms with an impossible choice. 3. Migrants face a range of additional barriers In Covid, everything has been massively exacerbated. All the original problems exist, plus it’s really difficult to navigate how the health system works now.” For those who do come forward despite the Hostile Environment, there are a range of specific barriers to accessing care during the coronavirus crisis. Many of these existed before the pandemic, but most have been exacerbated by coronavirus and changes to the health system as a result of the lockdown. The widespread problems of language barriers and digital exclusion, coupled with the closure of services and fears of contracting the virus, mean that at-risk migrants are left with little to no healthcare options. These barriers act concomitantly to exclude migrants from accessing care. As one respondent described, she was contacted by a very unwell woman, who spoke “little English, couldn’t explain her problem over the phone to a GP without an interpreter and was too scared to go to a pharmacy for fear of contracting coronavirus”. Survey respondents indicated that in these scenarios, people are tending to remain unwell at home. Several of those we spoke to note that these issues cannot be separated from the Hostile Environment policies outlined in the section above. For some, the Hostile Environment has introduced a culture of discrimination into the NHS, and together with the current crisis, has provided a justification for the obstacles and deterrents faced by migrants. It’s almost like the crisis is another excuse to not deal with the patients that are considered more difficult to help.” 19