A/HRC/14/30/Add.3
F.
Access to health care, regardless of immigration status
67.
The Special Rapporteur welcomes the adoption of interim guidance in April 2009 by
the Department of Health to clarify the scope of emergency treatment for refused asylumseekers and migrants in irregular situations, who, according to the law, do not benefit from
free health-care services except in case of emergency. He notes with appreciation that this
guidance indicates that immediately necessary treatment, including maternity care, must
never be withheld; urgent treatment for conditions such as cancer, which would deteriorate
significantly if untreated, should not be withheld or delayed if the person cannot pay and is
unable to return to his/her country; primary health-care trusts should not pursue charges
beyond what is reasonable and have the option to write off debts where it would be
impossible or futile to pursue them. Nevertheless, the Special Rapporteur is concerned by
the element of the guidance which states that “non-urgent treatment, which can wait until
the person returns home, should not be started until payment has been made”. In the Special
Rapporteur’s view, this guidance regrettably does not address the fundamental issue, which
is not to make health care conditional on a person’s immigration status.
68.
Information received suggests that the great majority of separated asylum-seeking
children are registered with a general practitioner. However, an overwhelming concern
among nearly all stakeholders was the issue of interpreters and how the lack thereof and the
reluctance of health services to use them affected children’s access and ability to
understand and continue with treatment. This seems to be the case across a range of
different services including general practitioners, hospitals and counselling and specialist
mental health services. In view of the above, the Special Rapporteur welcomes the findings
from a joint review carried out by the Department of Health and the Home Office on access
to the National Health Service by foreign nationals in July 2009, which recommends, inter
alia, that refused asylum-seekers or unaccompanied asylum-seeking children should not be
charged for access to secondary health care. 51
G.
Other concerns
69.
The Special Rapporteur acknowledges the threat posed by international terrorism
and is aware of the long-term strategy for countering international terrorism (CONTEST)
established in 2003. He welcomes the strategy’s revisions undertaken in 200652 and 2009,53
by virtue of which the observance of international law and human rights standards and the
promotion of good governance were included as guiding principles in all counter-terrorism
efforts. However, he remains concerned about the human rights implications of the use of
the grounds of “national security” and the “terrorism threat” to deprive non-nationals
legally married to British nationals of the right to stay in the territory of the United
Kingdom. In this connection, concern is expressed about section 56 of the Immigration,
Asylum and Nationality Act 2006, in force as of 16 June 2006, which lowers the threshold
for withdrawal of British citizenship by recognizing a new power of the Secretary of State
who may order that a person be deprived of a citizenship status if the Secretary of State is
satisfied that deprivation is “conducive to the public good”.
51
52
53
GE.10-12095
See Joint Department of Health and Home Office review, “Access to NHS Services for foreign
nationals”, July 2009.
HM Government, “Countering International Terrorism: The United Kingdom’s Strategy”, July 2006,
p. 9.
HM Government, “Pursue, Prevent, Protect, Prepare – Countering the terrorist threat. The UK
Government’s strategy”, 2009.
17