Page last updated at 23:02 GMT, Friday, 1 August 2008 00:02 UK

NHS 'confusion' over asylum rules

Failed asylum seekers are entitled to emergency care

Confusion over the rules on NHS care for failed asylum seekers means people are being turned away from hospitals and GP practices, a report says.

Trusts are currently told to decide if people should be treated on a case by case basis.

But an online article for the British Medical Journal reports trusts are making "appalling" decisions and denying people free care.

The Department of Health says the situation is under review.

Some managers are interpreting the rules too restrictively and are saying unless someone is at death's door you shouldn't treat them unless they pay
Adam Hundt

At the moment, people seeking asylum are fully entitled to free care, and everyone gets emergency care.

But once their bid has been rejected NHS trusts are asked to decide on eligibility on a case by case basis.

In April, a High Court judge ruled in the case of a Palestinian who claimed denying care for his chronic liver disease breached his human rights, saying banning failed asylum seekers from receiving free NHS treatment was unlawful.

However, the Department of Health was given permission to appeal, and the case is due to be heard in November.


Adam Hundt, the lawyer who represented the Palestinian man, said he had been contacted by many doctors who were confused about what they should do.

He told the BMJ: "They are telling me they'd been led to believe they didn't have any choice about who they can treat.

"Some managers are interpreting the rules too restrictively and are saying unless someone is at death's door you shouldn't treat them unless they pay.

"This is wrong."

He said he has learnt of some "appalling decisions", such as expectant mothers being wrongly told they would not be cared for if they turned up to hospital in labour.

He added: "Three of my clients - including a child - have died after treatment was refused."

Mr Hundt said he was not directly linking the deaths with the decisions, but added: "We'll never know whether they would have died anyway or not, but they weren't given the chance to survive."

The government began a consultation in 2004 on whether failed asylum seekers should be eligible for free GP care, but never published its responses.

Now Medsin, a student health group, has used the Freedom of Information Act to track down half of those who provided submissions, and found three quarters of healthcare providers were concerned denying care would put them in breach of their professional responsibilities.

And two thirds felt not treating people could put the general public's health in danger through a potential risk from infectious diseases.

Just over a quarter of respondents worried that denying care to those who needed it would violate the patients' human rights.

Medsin is calling on the government to release all the submissions it received to inform public debate.

A spokesman for the Department of Health said a review was under way, but there was no date set for publication.


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