The effects of immigration policy on NHS patients and staff demonstrate how the government is focusing on restrictions to immigration over public health.

The issue of immigration has been at the forefront of political discussions for a number of years, and the COVID-19 pandemic has done little to slow this process down. Instead, the government’s response to the pandemic has cast a spotlight on the issues posed to the NHS and to public health by an increasingly restrictive approach to immigration.

The ‘hostile environment’ immigration policy has worsened health inequalities among BAME communities, with an even more devastating impact in the context of COVID-19. NGOs like Doctors of the World have voiced concerns that policies like the NHS surcharge — which increased from £400 to £624 in October — and the requirement for NHS hospitals to carry out immigration status checks, are scaring many people away from seeking medical care due to fear of fees or of being reported to the Home Office.

Recent reports have also revealed that migrants in England are often denied NHS care for an average of 37 weeks, in an alarming contrast to the maximum of 18 weeks within which people in England should be treated. Some are turned away for not paying upfront, whilst others are denied help when immigration checks wrongfully identify them as ineligible for free care. The disproportionate impact of COVID-19 on BAME people makes the need to suspend these policies even more urgent, highlighting the need to ensure that BAME and migrant communities have safe and equal access to medical care.

Immigration policies have also had a detrimental impact on the 170,000 NHS staff in England who are non-British. There have been reports of healthcare workers being forced to return to their countries of origin, and others scrambling to renew their visas in the face of delays and excessive costs. Despite the Home Office’s promises earlier in the year that NHS and care workers would have their visas extended if they were due to expire, many have been left shut out of this scheme and risk deportation, despite there currently being 122,000 vacancies in England’s health and care sectors.

At the same time, the new points-based immigration system, which comes into force in 2021 and considers applications for work visas on the basis of skill, has labelled a number of healthcare roles — including nurses, paramedics, social care workers, and hospital porters — as “low-skilled”. The impact of this system, barring potential new workers from overseas, could have dangerous effects during a pandemic that has no immediate end in sight, especially given reports warning that the low salaries of some of these jobs could make it difficult to hire UK-born healthcare and social care workers.

The government’s failure to include migrants in their response to COVID-19 — by not reversing exclusionary hostile environment policies within the NHS, ensuring that migrant healthcare workers are able to continue working in the UK, or stopping policies that bar new workers from overseas — limits their ability to respond effectively to the pandemic, posing dangerous risks to public health.

Nonetheless, the Home Office continues to push forward a ‘crackdown’ on immigration as the UK exits the EU, despite warnings from MPs, charities and think tanks about the risks that this poses in the context of COVID-19. The health inequalities suffered by BAME and migrant communities have been magnified and exacerbated during the pandemic, increasing the marginalisation of an already underrepresented and undertreated demographic. The government’s increasingly hard-line immigration policy will only make this worse.

A number of groups have led urgent calls for the government to take steps to protect migrants during the pandemic, including by suspending hostile environment policies and guaranteeing indefinite leave to remain for healthcare workers. It is clear that such measures are critical if the UK is to properly tackle the second wave of COVID-19, as well as challenge the health inequalities suffered by BAME people.

JAN Trust recognises the barriers posed to BAME communities and migrants in a number of areas including healthcare, and advocates for an inclusive response to COVID-19 that centres the experiences of BAME people. You can find out more about our work here.