Recent changes in U.K. health policy affecting asylum seekers who have been denied refugee status reflect a larger trend of decreased willingness by governments to provide healthcare to migrants. Is this vulnerable group being denied the right to health?
It depends on who you ask. UK’s National Health Service (NHS) states that its mission is “to make good healthcare available to all, regardless of wealth, as long as you are a resident of the UK.” Overturning last year’s decision, appeals judges ruled that rejected asylum seekers are no longer legally entitled to free secondary NHS care, although hospitals can treat them at their discretion if they are penniless. Lord Justice Ward argues in his decision that “failed asylum seekers ought not to be here. They should never have come here in the first place and after their claims have finally been dismissed they are only here until arrangements can be made to secure their return.” Last year, Matthew Elliot of the TaxPayers’ Alliance argued that rejected asylum seekers should not be paid for at the expense of law-abiding taxpayers, and that providing them with free care will only create a burden on the already overstretched system, especially with the flood of health migrants he believes will follow. These concerns are by no means unique to the UK, and are echoed in other countries trying to decide how and whether to provide care to migrants using public funding.
Yet others argue that it not only makes public health sense to provide healthcare to all migrants – it helps control infectious diseases and decreases expensive emergency care through earlier diagnosis – it is a matter of human rights. The UK is a state party (see 5.2) to the treaties that include the right to health (see 10), which obligates the UK to make health services accessible to all, without discrimination, and especially to the most vulnerable and marginalized sections of the population. Asylum seekers are one of the groups least able to pay for their healthcare, while most vulnerable to suffering; most take enormous risks in migrating from their country of origin, where they face war, poverty, or persecution. Complicating matters, many of those who are not accepted as refugees are unable to return to their country of origin due to continued conflict or a refusal by that country to readmit them. They are effectively stuck, and should not be denied care.
Even if a country chooses to restrict immigration, there should be a clear separation between immigration law and the provision of health services. As the number of migrants steadily rises worldwide, with anti-immigrant sentiment following not far behind, governments should carefully reconsider their discriminatory health policies toward migrants, and incorporate the right to health.
See also:
Report: Access to health care for migrants and asylum seekers – Hesperian
For an interesting debate, read Responses to Peter Hall’s editorial “Failed asylum seekers and health care” – BMJ, 2006
Editorial: Care for vulnerable migrants in the UK – Lancet, Apr 2009
Exclusion Proposals for Overseas Visitors – UNHCR, Aug 2004
UN Refugee Agency Statistics Reports – UNHCR
Reports on Asylum Seekers, Refugees, and IDPs – Refugee Council USA, upd. Apr 2009
US Immigration Detention Legislation – Human Rights First
US May Be Mishandling Asylum Seekers, Panel Says – NY Times, Feb 2007