Ministers have suspended controversial arrangements under which the NHS shared patients’ details with the Home Office so it could trace people breaking immigration rules.
The government’s U-turn on a key element of its “hostile environment” approach to immigration came after MPs, doctors’ groups and health charities warned that the practice was scaring some patients from seeking NHS care for medical problems.
Margot James, a minister in the Department for Digital, Culture, Media and Sport, announced the rethink during a parliamentary debate on the data protection bill. She confirmed that the government had decided to suspend “with immediate effect” the memorandum of understanding (MOU) under which NHS Digital, the health service’s statistical arm, shared 3,000 NHS patients’ details with the Home Office last year so they could check those people’s immigration status. Patients had given their details when attending GP and hospital appointments.
In future, Home Office immigration staff would only be able to use the data-sharing mechanism to trace people who are being considered for deportation from Britain because they have committed a serious crime, James made clear to MPs.
James paved the way for the U-turn by accepting an amendment, tabled by Conservative MP Sarah Wollaston and Labour MP Paul Williams, which called for the MOU to be suspended.
Williams, who is also a GP, welcomed “this huge U-turn”, adding: “NHS information should only be shared in the event of a conviction or an investigation for a serious crime, not to create a hostile environment where people are afraid to go to their GPs for fear information might be reported to the Department for Work and Pensions for benefit sanctions.”
The government backtracked after MPs on the Commons health and social care select committee twice called in unusually strong terms, in January and April, for data-sharing to stop. During evidence on the MOU’s impact it heard how one pregnant woman did not seek any antenatal care because she was too frightened to attend appointments. NHS staff only found out that she was expecting when she turned up at hospital already in labour. Another woman, a migrant domestic worker, died after not seeking treatment for a persistent cough, the committee heard.
Doctors of the World, a London-based charity that provides free healthcare for refugees, asylum-seekers and other undocumented migrants, welcomed the move. “For too long the Home Office has undermined doctor-patient trust and caused unnecessary fear and harm to people most in need of help. Our volunteer doctors saw every day the damage this deal was doing to people in vulnerable situations, including victims of trafficking and pregnant women”, said Lucy Jones, its director of programmes.
Deborah Gold, chief executive of the National Aids Trust (NAT), said: “We are delighted that at last this shameful sharing of confidential patient information with the Home Office is to end.” However, the NAT and Liberty, the civil rights group, both voiced concern about the “vague” definition of serious crimes that the Home Office will use when still pursuing personal details.
Critics warned that passing patients’ details on to the Home Office risked turning NHS staff into de facto immigration officers, was ruining patients’ relationships with NHS personnel and deterring some people from accessing NHS care.
The select committee called for the MOU to be scrapped because it is unethical and damaged patients’ trust in the NHS. Williams, a member of the committee, had previously warned that people left afraid to access care because of data-sharing posed a risk to public health through conditions such as tuberculosis going untreated and children not receiving vital vaccinations.
The Home Office said: “After careful consideration of the concerns raised by the health and social care select committee, the circumstances in which the Home Office will request data from the NHS has changed with immediate effect.
“The changes mean that data will be requested to locate foreign national offenders we intend to deport who have been given a prison sentence of 12 months or more and others who present a risk to the public.
“We remain committed to tackling illegal immigration and will continue to trace immigration offenders using a range of different investigative measures.”
The U-turn comes amid growing concern that staff in some public services, including teachers, housing officials and NHS workers, are being turned into border guards because of new duties put on them to check the immigration status of people they encounter. For example, hospital trusts have been obliged since last October to check that patients are eligible to receive many, but not all, types of care for free and demand that those deemed ineligible pay for their treatment in advance.
In March, the Guardian revealed that the NHS’s Royal Marsden cancer hospital in London had told a Jamaican-born London man who had lived in the UK for 44 years to pay £54,000 upfront before he could undergo radiotherapy to treat his prostate cancer. Sylvester Marshall, who was previously known as Albert Thompson, is now due to receive his treatment free on the NHS.
The British Medical Association, which has also voiced deep unease about sharing of patients’ data, had also called for James to accept the Williams-sponsored clause. The MOU “falls short of the well-established ethical, professional and legal standards for confidentiality”, it said.
The Health and Social Care Act 2012 allowed for patients’ details, which they had provided confidentially to the NHS, to be used to help trace immigration offenders. It led to the signing of the MOU between NHS Digital, the Home Office and the Department of Health. Last year it led to more than 3,000 patients having their details passed to the Home Office for its immigration purposes. Of those, 195 requests for data led to the Home Office finding out new information about people.
Meanwhile, Jeremy Hunt, the health and social care secretary, has come close to backing calls from leading doctors and Labour for NHS staff to be exempted from the monthly cap on the number of skilled workers from overseas who are allowed to come to the UK.
Having a separate system of visas for doctors and nurses, he said, was “a really interesting idea” that he will discuss with Sajid Javid, the home secretary. The cap has led to 400 doctors being denied permission to join the NHS since December, despite having job offers from hospitals, because the cap had been reached.
“It’s invidious when the NHS gets traded off against other sectors in the economy,” Hunt told the Health Service Journal.