PATIENTS NOT PASSPORTS: Migrants Access to Healthcare During the Coronavirus Crisis | June 2020 There was a case of a guy who Whatsapped one of my colleagues to tell him he had chest pain, and I was quite worried about him … I tried to contact his GP but couldn’t get through ... so I said the only way we can do this is for you to call 111. He recorded the 111 conversation, which was eye opening even for me. It eventually worked out, but because of the algorithms they ask you all of these questions first. He was trying to say ‘I need a Tamil interpreter, I have chest pain, fever and shortness of breath’ and it was asking him which tube station he lived near. Eventually you do get put through to an operator, but it took the operator a while to work out he needed an interpreter. He then got an interpreter, which was great, but the conversation then went from bad to worse, with the interpreter getting angry with the operator because they were so determined to go down the path of yes or no answers that had no appropriateness to this poor, distressed guy. The operator had to get him an ambulance, which all worked out. But it was an eye opener for me to see how difficult it is even to talk to 111.” In Margaret’s experience, the complex nature of health care entitlements means that very few people understand how the system works; the law is often misapplied and many are concerned about accessing care for fear of being charged. This is compounded by datasharing and letters asking patients to prove their entitlement to care. Nobody understands health care entitlement… Certainly receptionists, certainly GPs, certainly patients do not understand who’s entitled to what.” Margaret is concerned about whether people are aware of coronavirus charging exemptions. I don’t think [my clients] particularly even make that sort of distinction [between exemptions for different types of services]. I think it’s much more of a sort of ‘oh my God, I’m not entitled to health care’ or I am.” 3.2.3 Lack of support services The barriers posed by the moving online of many services is compounded by the closure, or partial closure, of many migrant organisations’ offices or centres. For example, some migrants are entitled to access the NHS Low Income Scheme (LIS), allowing them to receive full or partial support for prescriptions, dental work, eye care costs, and healthcare travel costs. This should improve access to healthcare for migrants who are destitute and/or on very low income, who might otherwise be priced out of receiving healthcare. Some migrants are entitled to support from the scheme - which is demonstrated by receiving a HC2 certificate automatically. Others must fill in a HC1 form which requires completing a hard copy of the form and providing considerable evidence of financial and other circumstances. In normal times, many do not know that they are entitled to this kind of support; forms to access the support can be very burdensome to complete, and there are frequent delays in receiving HC2 certificates proving free entitlement to care because of the bureaucracy involved in obtaining them. During the pandemic this has worsened. Migrant organisations are less able to help with 24