PATIENTS NOT PASSPORTS: Migrants Access to Healthcare During the Coronavirus Crisis | June 2020 For me that was just another example of the way that the Hostile Environment has become embedded in the health services. you know, ‘you shouldn’t be our problem’.” A brief discussion of these barriers follows. For a more detailed analysis of barriers, see Doctors of the World’s Rapid Needs Assessment of Excluded People in England during the COVID-19 pandemic.14 While they have been separated for clarity, respondents frequently described these barriers operating together to prevent access to care. 3.1 Closed or limited services The cancellation of many ‘non-essential’ appointments and operations, the closure of some inperson services (particularly dentistry and GP surgeries), and other services being stripped to a bare minimum, were all cited in our survey as reasons for migrants not being able to access care during the coronavirus crisis. One respondent describes a situation where: one of my clients went two weeks without a prescription. The GP practice had cancelled her appointment due to coronavirus, told her to collect her prescription from reception, then when she went there, told her to go to A&E (as far as she understood) but she didn’t go because she was frightened of Coronavirus.” Services specifically available for migrants have been significantly limiting their practices, or closing altogether. One respondent reports that: GP surgeries have interpreted the fact that a Local Enhanced Service for asylum seekers is suspended as ‘registration of asylum seekers is suspended’ and one surgery sent a pregnant woman to another surgery to register instead. It took a number of interventions from myself to get her registered at her local surgery. Just another detail - the surgery’s door was locked.” 3.2 Language and digital exclusion During the coronavirus crisis, many health services are being administered online or over the phone, including: all health information and guidance; GP registration and booking; and support to access services. Many migrants face digital exclusions and language barriers, which make accessing health services in this way extremely difficult. Language barriers were one of the most frequently cited barriers amongst respondents, particularly the lack of translated materials and scarcity of interpretation services. Several respondents reported that, in contravention of NHS England guidance, migrants are frequently asked to pay for or provide their own interpretation services.15 Migrants also face particular barriers to accessing the internet and telephones. Digital exclusion is particularly prevalent for migrants who are destitute, including many asylum seekers who are provided with only £37.50 a week from the government, and many more who receive no support and are prohibited from working. They have extremely limited funds to top up their phones or buy additional data. Moreover, community centres, libraries, and support organisations where internet services were previously available to use have been closed as a result of the lockdown. 20