Ex-boss of England’s NHS blasts NHS migrant policy as a “national scandal”

As activists took to the streets at the weekend to protest Jeremy Hunt’s introduction of NHS passport checks and upfront charges, David Nicholson said the policy was “based on fake evidence” and “the thin end of a very big wedge”.

Ayse Ansell
4 October 2017
seacole docsnotcops.jpg

Image: Protestors in front of St Thomas hospital on Saturday. Rights: Docs Not Cops.

This weekend, Docs Not Cops held nationwide protests against immigration checks and upfront charges in the UK, amidst concern about the introduction of xenophobic new NHS policies. Our Twitter notifications exploded, our 2 minute #PatientsNotPassports video went viral.

We were delighted to have the support of groups as diverse as Liberty, Sisters Uncut, Medact, Doctors of the World, Global Justice UK and many more.

But one message of support came from an unexpected quarter - the former chief executive of NHS England, David Nicholson.

Nicholson shared our video with emphatic support, adding the comment: ‘This is nothing short of a national scandal based on fake evidence it is the thin end of a very big wedge #PatientsNotPassports.”

Nicholson’s intervention – as former head of the NHS - is remarkable. But his intervention is indicative of a deep and growing mood of disgust amongst NHS staff, at the policies now being imposed on patients in the name of xenophobia, not patients.

In February this year Jeremy Hunt announced the introduction of passport checks for all patients accessing NHS services and upfront charging for people who don't qualify for free care. These changes are already being piloted in over 20 hospitals and will come into full effect on the 23rd October.

On Saturday 30th Docs Not Cops marched to St Thomas’ hospital - where a pilot has been taken place. The final gathering at the Mary Seacole statue was moving and beautiful. Hundreds of protestors, many organisations, migration activists, healthcare activists, feminists, and LGBTQI+ activists came together with doctors and nurses to protest cruel policies that will do more harm than good.

The broad and growing coalition of people opposed to these policies was clear. 

The Government is trying to blame migrants for the NHS funding crisis, but the numbers show a different story. At most, so called ‘health tourism’ only accounts for 0.3% of the NHS budget. But Hunt’s policies are destroying patient’s relationships with NHS workers and creating a climate of fear that stops people accessing the care they need.

Already there are stories of patients being racially profiled when accessing care and being singled out for immigration checks – including an eight day old baby born to two English parents, who received a letter demanding her proof of eligibility for care.

At the demonstration, people read out heart-breaking testimonies that had been sent to Docs Not Cops.

One read:

 “I’m almost six months pregnant – but I haven’t had any antenatal care at all. I’ve missed several scans and midwife appointments in the past few weeks. I feel trapped… I need to go to the hospital but I can't because I feel my information might not be confidential. I have no idea if my baby is healthy - I think the bump might be too small for 6 months and I don’t know which vitamins or supplements to take. But I’m too afraid to get the care that I need, even though I’ve been told I’m entitled to it, legally. Carrying a child, the last thing you want to worry about is being separated from that child. I am scared that my hospital will share my address with the Home Office, who will then find and deport me, even though my partner is a British citizen.”

This fear is sadly rational. As home secretary, Theresa May talked of her desire to create a  “hostile environment” for migrants. This year a Memorandum of Understanding between the Home Office and NHS Digital formally set out a practice that has been going on for years: patient details may be passed on to the Home Office.

Nicholson is not the only significant public figure to express discomfort with the direction of government policy, with its the scapegoating of the vulnerable. Conservative MP for Totnes Sarah Wollaston has commented “If you meet a migrant in the NHS, they are more likely to be treating you than ahead of the queue”. Migrant workers are the backbone of the NHS, making up a greater proportion of the workforce than any other health service in Europe (28% of doctors, 13% of nurses).

The Conservatives, of course, have a long history of stoking anti-migrant or outright racist sentiment to “discredit socialised medicine” - as NHS founder Nye Bevan noted. Those moderate Tory MPs who have challenged recent scapegoating need to speak up about current policies – or they will be complicit in them. 

The Green Party has spoken out vocally. Jean Lambert MEP described her visit to a Doctors of the World clinic in an article in the New Statesman, in which she raised concerns that this policy would affect some of the most marginalised people in the UK. In Lambert’s words, “It’s now reached the point where victims of trafficking and exploitation are deterred from registering with a GP, as they fear detention and deportation. Women, such as sex workers, are denied access to contraception, safe abortions, and maternal care. Meanwhile, their children may never see a GP or a dentist, putting their own health at risk.”  


The current policies aren’t born of a genuine desire for a fairer NHS, but rather are punitive attempts to penalise those who aren’t born here, those who aren’t fortunate enough to have the seal of approval of a burgundy passport.


Discontent amongst healthcare workers is growing. The head of the Royal College of Midwives, Cathy Warwick, said in 2015, “We have real concerns that the aggressive pursuit of charging migrant women for medical care may deter them from accessing maternity care. I fear that these women could fall through the cracks and only find their way into the health system when it is too late – if at all...midwives should not act as gatekeepers to the maternity services. They owe a duty of care to all pregnant women who seek care from them and, they should provide care to all pregnant women irrespective of the woman’s ability to pay.”

Hunt’s policies can be seen for what they are by those working on the frontline, those working day-in, day-out alongside their migrant colleagues to provide us with a safe and caring NHS. 

Whether from vulnerable patients, midwives, politicians or from ex-NHS chief executive David Nicholson, the expressions of disgust towards the Department of Health’s regressive, xenophobic migration policy are growing to a cacophony.

It’s time for all those in high places, all those who know the facts, figures and inner workings of the NHS, to join the dissent.

I hope this will include Nicholson’s successor - current NHS chief executive Simon Stevens. Stevens has highlighted the underfunding of the NHS – will he now stand with us and oppose the government’s attempts to blame the NHS funding crisis on migrants?

People with platforms need use them to talk about healthcare as a right, not a privilege. These people have the power to challenge the discourse around migrants and the NHS.

But whoever you are reading this we need you too. Our resistance needs to be a unified front. If you are a doctor, nurse or other healthcare worker, don’t comply with checking. If you are a current patient or just interested in defending the principles of the NHS, join the next Docs Not Cops action on October 23rd when the policy is formally introduced. It is time for all of us including those in power to put their necks on the line. Healthcare is a right not a privilege and we must fight for each other’s rights.  

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