UK hospital fees left more than 900 migrants without treatment

A person walks past images of National Health Service (NHS) workers displayed on hoardings outside a temporary field hospital at St George's Hospital. (File/Reuters)
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Updated 20 August 2023
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UK hospital fees left more than 900 migrants without treatment

  • NHS trusts in England have required upfront payment before treating certain migrants with elective care

LONDON: Over 900 migrants in the UK have declined medical treatment after being required to pay upfront fees over the last two years, The Guardian reported on Sunday.

According to data obtained under the Freedom of Information Act, 3,545 patients across 68 hospital trusts in England have been told they must pay upfront costs totaling £7.1 million ($9 million) since January 2021. Of those, 905 patients did not proceed with treatment.

Since October 2017, NHS trusts in England have required upfront payment before treating certain migrants with elective care. This applies to foreign visitors and migrants who have been determined ineligible for free healthcare, such as unsuccessful asylum applicants and those who have overstayed their visas. 

In 2018, The Guardian reported the case of 71-year-old cancer patient Elfreda Spencer, who died after being denied chemotherapy for a year. 

Before having a stroke, personal trainer Simba Mujakachi was rejected treatment for a blood-clotting disease in 2019 due to the upfront fee policy. 

“The hospital told me I had to pay thousands of pounds before I came in for surgery and that having a debt could affect my asylum application, so I didn’t go, even though I knew I needed it,” he told The Guardian. 

Mujakachi continued: “I didn’t have that kind of money and I was not allowed to work. And then, just before I turned 30, I had a brain hemorrhage and a stroke that left me disabled.

“The inhumane treatment I have been subject to under the hostile environment over the past 10 years was the cause of my life-changing stroke. I think about what would have happened if I had been able to get the treatment I needed like everyone else.”

Oke, who moved to the UK from Nigeria in 2007, was diagnosed with Fabry disease in 2020 after suffering a stroke, kidney failure, and infection with COVID-19. He needed enzyme replacement therapy to help avoid future organ damage and strokes, but it was not available unless he could either legalize his immigration status or pay.

Oke involved the medical group Doctors of the World, his MP Afzal Khan, and the parliamentary and health service Ombudsman in his case during three years of increasing pain. A week later, the hospital trust agreed to provide ERT. 

“I felt like I was being treated like an animal, not a human being,” said Oke. 

“It’s been awful, because apart from the physical pain there’s also the mental pain, not knowing what’s going on, what could happen next. It’s been a nightmare,” he added.

Although the policy is not supposed to cover urgent or “immediately necessary” treatment, The Guardian reported several cases of people wrongly denied treatment. 

“Access to healthcare to all living in the UK, including secondary care, where we often see the most pressing health issues, should and can be equal, based on need and never dependent on someone’s financial or immigration status,” Amardeep Kamboz, head of services at Doctors of the World UK, told The Guardian.

A Department of Health and Social Care spokesperson told The Guardian: “The NHS is a residency-based healthcare system, and entitlement to free hospital care is based on being lawfully and properly settled in the UK. 

“People who are not ordinarily resident here must contribute to the cost of their care unless exempt from charge, such as refugees.

“Payment is only required upfront in non-urgent cases when the care can safely occur after the patient’s departure from the UK. 

“Immediately necessary or urgent care must never be withheld or delayed pending payment, as charges for this care can be recovered afterwards by installments or written off as unrecoverable if the patient cannot pay.”
 


Trump says Iran ‘want to negotiate’ after reports of hundreds killed in protests

Updated 57 min 24 sec ago
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Trump says Iran ‘want to negotiate’ after reports of hundreds killed in protests

  • US President Donald Trump said Sunday that Iran’s leadership had called him seeking “to negotiate” after he repeatedly threatened to intervene militarily if Tehran killed protesters

WASHINGTON: US President Donald Trump said Sunday that Iran’s leadership had called him seeking “to negotiate” after he repeatedly threatened to intervene militarily if Tehran killed protesters.
For two weeks, Iran has been rocked by a protest movement that has swelled in spite of a crackdown rights groups warn has become a “massacre.”
Initially sparked by anger over the rising cost of living, the demonstrations have evolved into a serious challenge of the theocratic system in place since the 1979 revolution.
Information has continued to trickle out of Iran despite a days-long Internet shutdown, with videos filtering out of capital Tehran and other cities over the past three nights showing large demonstrations.
As reports emerge of a growing protest death toll, and images show bodies piled outside a morgue, Trump said Tehran indicated its willingness to talk.
“The leaders of Iran called” yesterday, Trump told reporters aboard Air Force One, adding that “a meeting is being set up... They want to negotiate.”
He added, however, that “we may have to act before a meeting.”
The US-based Center for Human Rights in Iran (CHRI) said it had received “eyewitness accounts and credible reports indicating that hundreds of protesters have been killed across Iran during the current Internet shutdown.”
“A massacre is unfolding,” it said.
The Norway-based NGO Iran Human Rights (IHR) said it confirmed the killing of at least 192 protesters but that the actual toll could be much higher.
“Unverified reports indicate that at least several hundreds, and according to some sources, more than 2,000 people may have been killed,” said IHR.
More than 2,600 protesters have been arrested, IHR estimates.
A video circulating on Sunday showed dozens of bodies accumulating outside a morgue south of Tehran.
The footage, geolocated by AFP to Kahrizak, showed bodies wrapped in black bags, with what appeared to be grieving relatives searching for loved ones.
Near paralysis
In Tehran, an AFP journalist described a city in a state of near paralysis.
The price of meat has nearly doubled since the start of the protests, and many shops are closed. Those that do open must close at around 4:00 or 5:00 pm, when security forces deploy en masse.
There were fewer videos showing protests on social media Sunday, but it was not clear to what extent that was due to the Internet shutdown.
One widely shared video showed protesters again gathering in the Pounak district of Tehran shouting slogans in favor of the ousted monarchy.
The protests have become one of the biggest challenges to the rule of supreme leader Ayatollah Ali Khamenei, 86, coming in the wake of Israel’s 12-day war against the Islamic republic in June, which was backed by the United States.
State TV has aired images of burning buildings, including a mosque, as well as funeral processions for security personnel.
But after three days of mass actions, state outlets were at pains to present a picture of calm returning, broadcasting images of smooth-flowing traffic on Sunday. Tehran Governor Mohammad-Sadegh Motamedian insisted in televised comments that “the number of protests is decreasing.”
The Iranian government on Sunday declared three days of national mourning for “martyrs” including members of the security forces killed.
President Masoud Pezeshkian also urged Iranians to join a “national resistance march” Monday to denounce the violence.
In response to Trump’s repeated threats to intervene, Iran’s parliament speaker Mohammad Bagher Ghalibaf said Iran would hit back, calling US military and shipping “legitimate targets” in comments broadcast by state TV.
‘Stand with the people’
Reza Pahlavi, the US-based son of Iran’s ousted shah, who has emerged as an anti-government figurehead, said he was prepared to return to the country and lead a democratic transition.
“I’m already planning on that,” he told Fox News on Sunday.
He later urged Iran’s security forces and government workers to join the demonstrators.
“Employees of state institutions, as well as members of the armed and security forces, have a choice: stand with the people and become allies of the nation, or choose complicity with the murderers of the people,” he said in a social media post.
He also urged protesters to replace the flags outside of Iranian embassies.
“The time has come for them to be adorned with Iran’s national flag,” he said.
The ceremonial, pre-revolution flag has become an emblem of the global rallies that have mushroomed in support of Iran’s demonstrators.
In London, protesters managed over the weekend to swap out the Iranian embassy flag, hoisting in its place the tri-colored banner used under the last shah.