Home | Friday 11th July 2008 | Issue 639

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FOREIGN BODIES

AS SchNEWS INVESTIGATES DICTATED RACISM IN THE NHS

As the NHS sinks into a privatisied pay-as-you-go American style health system, SchNEWS has decided to take an overdue look at the state of NHS Plcs' treatment of foreigners who have the misfortune to get sick over here. They're having their right to health taken away from underneath them by a swathe of new laws being passed.

Despite free healthcare for all being enshrined in the NHS charter, overseas visitors’ access to treatment has been systematically attacked since 1989, when the Tories brought in the first charges for foreigners. Neo-labour has (as always) smoothly stepped in where they left off, further tightening the noose. The latest piece of legislation was passed in 2007.

Thanks to the efforts of successive tightfisted and racist regimes, overseas visitors (anyone who’s been resident in the UK for less than a year) will only be treated when it’s absolutely necessary. For any treatment deemed not immediately necessary they must cough up or go home (not exactly an enticing offer for someone whose fled from persecution and poverty back home).

Whether it’s an attempt to save money or (more likely) pandering to tabloid induced fear of ‘health tourists’ comin’ over ‘ere and swamping ‘our’ NHS (not that foreigners would ever come over here to work in the NHS), the logic of the system simply doesn’t add up. If it’s ‘not immediately necessary’ to provide a patient with drugs to hold a heart condition at bay, before not too long it’ll be necessary to pay for open heart surgery to save his or her life, at a massively higher cost (about £10,000 for open heart surgery versus a few hundred quid for a GP visit and some drugs). It’s nice to know though that if a ‘chargeable’ foetus is delivered in a UK hospital, it is not charged, just its mother.

The latest Neo-Labour wheeze to squeeze the poor and the brown out of their fundamental rights is the new post of NHS Private and Overseas Patients Co-ordinator’. These staff are the attack dogs of this latest approach to maltreatment. They function as NHS debt collectors, who’s job it is to go bed to bed hunting down foreigners and making them pay or turfing them out of the country. These jobs are being advertised around the country- government diktat is that every NHS trust must have one.

Things are a little better in GP’s surgeries, where doctors can operate with a greater degree of freedom than within the over-bureaucratised NHS. Luckily as GPs are self employed it’s at their discretion to accept any person, including overseas visitors, to be fully registered as an NHS patient or as a temporary resident. Because nurses at a GP’s Practice are employed by them and not the NHS Trust, they’re exempt from the laws as well. Unfortunately not many of them seem to know this. However, GPs should know that any random generosity on their part will extend no further than their surgery. For example if the GP wanted to send them for an x-ray, the patient would have to pay up.

In a bizarre twist of government logic, the 65 page document detailing who is and isn’t eligible for free treatment is big on avoiding discrimination. The most important principle (according to the document) is all patients should treated as foreign until proven innocent, not just people who appear foreign (ie funny accents and dark skin). Theoretically, everyone who goes to hospital should be asked “Have you lived in the UK for the past 12 months?” and “Can you show you have the right to live here?” Anyone who has enough foresight to bring their proof they have lived legally in UK for 12 months before treatment should be OK. Of not expect a visit from the NHS debt chaser.

These new laws are compounding the lack of access to health of the poor, immigrant communities that are a micro third-world in large British cities, replete with developing country-style diseases such as tuberculosis and hepatitis. In Tower Hamlets (poor and multi-ethnic London borough) the rate of TB infection is eight times the national average.

Bucking the trend, the French-based NGO ‘Médecins du Monde’ set up a clinic, ‘Project London’ in Bethnal Green two years ago. MdM broke away from the more famous Medicine Sans Frontiers, and, like its larger parent organisation, is more used to working in slums and refugee camps than a scant few miles from one of the world’s financial centres.

Staffed entirely by volunteers, Project London aims to help the immigrant poor access medical services- assisting them to overcome language and cultural barriers. More than three quarters just needed help to register with a GP, and in 85% of cases they were able to get them registered. This suggests that if staff on the front desk aren't deliberately excluding people are too scared to seek help or no-one can actually work out who is and who isn’t entitled to care.

The Médecins du Monde style is the basic ethos of health workers- good old fashioned humanistic philosophy. Inside hospitals doctors and nurses are having to lie, cheat and break rules in order to protect the rights of patients, having to work against what amounts to an NHS anti-immigrant secret police.
As the UN Special Rappotuer Paul Hunt puts it: “The right to health applies to everyone, regardless of Immigration status...Governments are required to ‘refrain from denying or limiting equal access’ to health services for all persons including ‘illegal immigrants’.”

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