Destitute asylum seekers in Scotland are not getting proper healthcare because the UK government denies them recourse to public funds, according to a new report.

The Equality and Human Rights Commission said that tuberculosis (TB) patients have been affected while disabled and pregnant asylum seekers also face severe barriers to healthcare.

People with mental health problems are also suffering while others, the report claims, have been too frightened to seek medical help due to rumours that the NHS passes information on patients to the Home Office.


Charities supporting refugees have welcomed the commission’s report. One organisation said it highlighted “the grim reality” facing many destitute asylum seekers in the UK.

But the Home Office has defended its treatment of people, saying that it “takes the well-being of asylum seekers very seriously”.

The commission examined issues experienced by people seeking or refused asylum when they try to use health services in Britain.

Representatives of 31 health and social care providers in England, Scotland and Wales contributed to the study. It is called “The lived experiences of access to healthcare for people seeking and refused asylum”.

The report said that asylum seekers who need healthcare have been left in “considerable fear” because of the UK government’s “hostile environment” policies.

People have gone without medical help since ministers forced the NHS in England to impose upfront charges to access care last year, the authors wrote.

This policy change has had a “chilling effect” on the readiness of asylum seekers in Scotland and Wales to seek the NHS’s help, even though neither country imposes charges, the report said.

A voluntary organisation – not named in the report – said that people were increasingly afraid to seek treatment because of rumours the NHS was passing information to the Home Office.

The organisation said: “I think something we’re seeing particularly at the moment is where rumour in the community is meaning people are afraid to come forward for care, or are considering other options, rather than accessing care.

“For example, people seeking asylum in Glasgow have heard that the NHS in England are either giving info to the Home Office or charging them for care. Even though it’s not the case in Scotland, they’ve heard the rumour. That can have a chilling impact. People don’t attend care because they’re worried about this.’

We have had increasing numbers of individuals who are destitute. We see increasing numbers with complexity of social situations - more who are destitute, no recourse to public funds. Nurse quoted in report

An unnamed nurse is quoted in the report expressing concern over people who have been ill with TB in Scotland. She said: “We have had increasing numbers of individuals who are destitute. We see increasing numbers with complexity of social situations – more who are destitute, no recourse to public funds.

She added: “And we have no way of helping these individuals. We have been fighting to get a policy in place for those with active TB and no recourse to public funds, so the government will give them a roof over their head for the duration of their treatment.”

The report also cited the case of woman called Sarah who said she had problems getting care for her disabled daughter in Scotland. The commission said that NHS charging regulations in England and data sharing with the Home Office are major issues for people.

“People’s experiences indicate considerable fear and misunderstanding about how personal and patient information and data might be used in relation to their immigration status,” the report added.

“The actual policy on charging for healthcare services, as well as people’s perception of it, emerged as a particular issue for pregnant women. Fear of the possible cost meant people sometimes did not get antenatal and other maternity care early or often enough.”

The study was welcomed by charities who support asylum seekers.

Esther Muchena, asylum services manager at Scottish Refugee Council, said it provides “an insight into the grim reality suffered by those refused refugee protection in the UK”.

She added: “This is one of the most marginalised and often traumatised groups in the country condemned to live in severe poverty or destitution and so vulnerable to physical and mental health and exploitation.

“The asylum ‘support’ system traps women, men and children into discriminatory and the most severe poverty in the UK. Not surprisingly it hurts people, physically and mentally, exerting serious health deterioration and triggering trauma.

“These conditions are the antithesis of the human right to health and they are, as the report pinpointed, rendered worse by other ‘hostile environment’ measures such as health charging regimes or unaccountable data-sharing agreements.

“Despite these measures not yet applying in Scotland they can, as the report found, exert a chill effect. It is important that Scotland makes clear it has free access to healthcare including for those refused refugee protection.”

Scotland’s ‘invisible epidemic’ of refugee destitution

Refugee Survival Trust (RST) also welcomed the report and said it was “aware of the barriers to accessing healthcare and other services, faced by people refused asylum in Scotland, mainly Glasgow”.

RST said that many healthcare professionals “do everything in their powers to help”. But the charity added there is a lack of “clear guidance for practitioners and confusion around how NRPF (No Recourse to Public Funds) conditions impact on someone’s entitlement to assessments and support services”.

“We recommend that healthcare practitioners along with other public service providers have clear guidance and training in working with people seeking asylum who are destitute to ensure that those who need services are able to access them,” RST said.

Robina Qureshi, of Positive Action in Housing, said: “It’s absolutely true that people who are seeking refugee protection at varying stages of the legal process are frightened from accessing all public services, this includes NHS and child care and schooling and education.

“From our work I believe this is leading to the creation of a “class zero” – people who are invisible from public services, have no rights to housing, work or health or education – and most vulnerable to exploitation of every kind.”

The Unity Centre Glasgow – an organisation that supports asylum seekers in Scotland – said it was currently supporting a man in England called Nasar Ullah Khan who urgently needs a heart operation.

According to a petition on change.org doctors in Birmingham have said they cannot treat Khan because of his immigration status. “The doctor’s report also states that his prognosis is very poor and there is a high likelihood that he will die without this advanced treatment,” the petition says.

“The hospital intends to discharge Mr Khan. This should not be allowed to happen without his treatment. The refusal to give him treatment due to his immigration status is inhumane.”

In response to the commission’s report, a Home Office spokesperson said: “We take the well-being of asylum seekers very seriously, and they have full and free access to the NHS. Those in receipt of asylum support because they would otherwise be destitute do not have to pay for prescriptions.

“Supported asylum seekers have the costs of travel to hospital appointments paid for by the NHS and we are absolutely clear that having a serious medical condition has no bearing on the outcome of an asylum claim.”

A spokeswoman for NHS Greater Glasgow and Clyde said: “We do not routinely provide the Home Office with patient information, be they UK nationals or asylum seekers.

“Any requests from the Home Office would be treated the same way for everyone, whatever their status. The Home Office would be required to submit paper work specifying what information they were seeking and why, and what legislation this was based on.

“We would review this and would only release information if we were satisfied that we were not in breach of the Data Protection Act. Additionally, any request for clinical information would also be reviewed by the appropriate health professional.”


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