We've written to the government's scientific advisors, urging them to look at how Home Office policies are putting lives in danger in this pandemic.

In the letter we call for changes to ensure:

• A vaccination programme that works for everyone, regardless of immigration status. That means we need a firewall between the NHS and the Home Office, and an end to NHS charging for migrant patients.
• Access to the social safety net so we can say no to dangerous working conditions. That means suspending the 'No Recourse to Public Funds' visa condition.
• Public health comes first. That means suspending detention and deportations, and end the hostile environment for migrants. We need fundamental rights so we can access healthcare, secure housing and safe work.

At JCWI we have been campaigning for fairer immigration rules and justice for migrants in the UK since 1967.

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Image credit: NHS Solent Trust

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Read the letter as a pdf

14 January 2021

Dear Sir Patrick Vallance,

RE: Impact of the Hostile Environment on the UK’s vaccination programme

I am writing on behalf of the Joint Council for the Welfare of Immigrants (JCWI). JCWI is a longstanding migrants’ rights charity which supports vulnerable individuals and their families with reliable, high-quality legal advice. We also call for immigration law and policies which are based on sound evidence, promote the rule of law and are underpinned by respect for human rights and human dignity. 

We are writing to you at what we believe is a critical moment in the UK’s response to the COVID-19 pandemic. Throughout the pandemic, migrants have been acutely impacted by policies which fall under the Hostile Environment, making it more difficult to access vital services, effectively self-isolate and access healthcare when needed. We have been dismayed at the failure of the government to take measures to ensure that migrant communities are protected from the spread of the virus alongside the rest of the population. This failure to prioritise public health over immigration enforcement has contributed to a measurably heavier impact on both the physical and mental health of migrant communities, has contributed to higher death rates among ethnic minority communities, and in industries where migrants are strongly represented. It is clear that the UK Governments ability to ensure a successful and speedy recovery from the pandemic if these communities continue to be left behind. We share with the experts that form SAGE, the utmost concern for ensuring the protection of public health and an effective and rapid a rapid, widespread vaccination programme in order to return to safe, unrestricted interactions in our communities.  

The BMJ, UNHCR and IOM are calling for the inclusion of migrants in global immunisation drives in order to ensure a full, UK-wide COVID-19 recovery with sufficiently widespread immunisation, any vaccination programme must include migrant communities and asylum seekers, including those who are excluded and disincentivised from accessing health care in ‘normal’ times. We wish to establish what consideration SAGE is giving to the impact of migration policies on its vaccination and recovery plans.

We would be interested to hear what consideration SAGE is giving to the impacts of the immigration policies below, and whether any assessment has been made of the impact of these policies on the UK’s ability to distribute the vaccine. 

1. Data-sharing between the Home Office and NHS
2. NHS charging regime for temporary or undocumented migrants

There is significant evidence that both NHS charging and data-sharing between the Home Office and the Department of Health and Social Care stops migrants from accessing healthcare, even in the case where exemptions exist for infectious diseases. For example, there is clear evidence the Hostile Environment deters individuals with tuberculosis from accessing care and that migrants are deterred from accessing healthcare advice for fear that they will be charged for treatment, or that interaction with the NHS could lead to them being targeted by immigration enforcement. Whilst the government has introduced an exemption for COVID-19 diagnostic tests and treatment, the charging system still acts as a deterrent for migrants that will be charged for other tests and treatment for any comorbidities that are not exempt. The threat of charging is not the only deterrent and neither the Home Office nor the DHSC will give assurances that patient data will not be shared for immigration enforcement purposes. Healthcare practitioners including the Faculty of Public Health have long raised concerns about under diagnosis and undertreatment of infectious diseases arising from charging policy. At a time when COVID-19 presents an increased risk to public health, it is vital that all those who need treatment are able to access healthcare without fear and without incurring charges. Simply adding COVID-19 to the list of exempt conditions is not enough, to be effective this must be accompanied by commitments to end data-sharing and a public information campaign designed to reassure people that accessing care is safe.

This also poses a risk for vaccine delivery, particularly as misinformation about the charging regime creates complexity in GP registrations. Many migrants report that they do not know they have the right to GP registration, are fearful that GP registration will lead to data-sharing with the Home Office and subsequent immigration enforcement or have been turned away by GPs who do not understand that primary care is not tied to immigration status.

For this reason, we have recommended that the government, at a minimum, suspend the charging regime and introduce a comprehensive firewall between healthcare and immigration enforcement for the duration of the pandemic. More broadly, we support a repeal in the charging regime in its entirety.

Further concerns regarding public health protections for migrant communities include the following:

1. The majority of migrants in the UK have ‘No Recourse to Public Funds’ meaning they are not entitled to access mainstream benefits including Universal Credit Long before the pandemic, NRPF restrictions have been pushing working families into abject poverty, forcing them into unsustainable debt and into homelessness or unsafe, overcrowded, insecure housing. Since the Covid-19 outbreak, this situation has considerably worsened Without support, people are forced to work in unsafe conditions, cannot remove themselves from unsafe housing, and are unable to both effectively self-isolate and feed their
2. Migrants are subject to ‘Right to Rent’ immigration checks carried out by their landlords, with the result that non-UK nationals and minority ethnic British Citizens spend longer trying to find adequate rental properties. ‘Right to Rent’ checks have been proven to directly cause racial discrimination, a factor which contributes to housing and poorer health outcomes, making it less likely they will have space to adequately self-isolate, greater need to commute long distances into work, and a lack of outdoor space for exercise during lock downs.
3. Migrants who are subject to immigration removals or deportations, and asylum seekers are routinely detained or accommodated in poor quality shared accommodation where it is impossible to self-isolate, and to maintain adequate hygiene standards in order to remain safe from infection.
4. Migrants have, throughout the pandemic, been required to continue to attend in-person interviews and regular registrations with the Home Office, even where all other unnecessary contact was banned across the country.

These policy decisions have consistently placed migrants in positions where it is difficult or impossible to abide by public health guidance in order to protect themselves and their communities from the spread of infection. This is, particularly egregious given how many migrant key workers have been on the front line throughout the pandemic, staffing our health service, transport infrastructure and food production lines. It is vital that, at this stage in the pandemic, they are no longer excluded from the public health protections that will control the spread of the virus and keep the public safe.

We look forward to hearing from you regarding your plans on this topic and remain at your disposal for further data and advice on the particular needs of migrant communities.

Yours sincerely,

Satbir Singh, Chief Executive, Joint Council for the Welfare of Immigrants