Dear Home Secretary, 

RE: Protecting migrants from COVID-19

We are concerned that adequate steps have not been taken to protect migrant populations at risk of COVID-19. Inaction from the government on this issue will worsen a health crisis that requires a truly public health-led response, not a tiered system which serves some and shuts out others. 

We believe the Home Office should urgently work with other government departments and take steps to:

Immediately suspend all NHS Charging and data-sharing with the Home Office for the purposes of immigration enforcement and mount a public information campaign reassuring people that it will be safe for them to access care during this global public health emergency.

There is significant evidence that both NHS charging and data-sharing between the Home Office and the Department of Health and Social Care stops migrants from accessing healthcare, even in the case where exemptions exist for infectious diseases. There is clear evidence the Hostile Environment deters individuals with tuberculosis from accessing care and that migrants are deterred from accessing healthcare advice for fear that they will be charged for treatment, or that interaction with the NHS could lead to them being targeted by immigration enforcement. 

Whilst the government has introduced an exemption for COVID-19 diagnostic tests and treatment, the charging system still acts as a deterrent for migrants that will be charged for other tests and treatment for any comorbidities that are not exempt. The threat of charging is not the only deterrent and neither the Home Office nor the DHSC will give assurances that patient data will not be shared for immigration enforcement purposes. 

Healthcare practitioners including the Faculty of Public Health have long raised concerns about underdiagnosis and undertreatment of infectious diseases arising from charging policy. At a time when COVID-19 presents an increased risk to public health, it is vital that all those who need treatment are able to access healthcare without fear and without incurring charges. Simply adding COVID-19 to the list of exempt conditions is not enough, to be effective this must be accompanied by commitments to end data-sharing and a public information campaign designed to reassure people that accessing care is safe. 

Immediately suspend ‘no recourse to public funds’ conditions to ensure that everyone can access the support they need to stay safe and where necessary cease working in order to self-isolate.

We welcome steps taken by the Department for Work and Pensions to ensure that extra support will be in place for workers and benefit claimants affected by self-isolation. However, most migrants have no recourse to public funds, leaving them unable to access support should they either contract COVID-19 or need to self-isolate. It is vital that NRPF conditions are lifted so that migrants are equally able to take the necessary time off to stay at home if they are suffering from COVID-19 or to prevent its spread

Make assurances that migrants unable to attend reporting appointments, court dates, or interviews whilst self-isolating will not be penalised.

Similar assurances must be made to migrants who may be forced to miss regular reporting to the Home Office, court hearings, interview appointments or are unable to submit documentation during this time. Similarly, if legal representatives cannot attend court hearings then the Home Office presenting officer or legal counsel should agree any extension that is required.  Migrants should not be forced to decide between accessing healthcare or risking their immigration status.

Make provision to extend or modify visas where necessary to prevent people being forced to ‘overstay’ their visa due to being self-isolated or unable to return to a country that is not safe to travel to.    

In addition, anybody who needs to self-isolate must be granted an automatic visa extension in cases where their visa may expire during their isolation period, irrespective of their nationality. Without this provision, people will fall out of status and become vulnerable to the Hostile Environment. This must also apply in all cases where migrants reaching the end of their visa period would need to return to areas with a high risk of infection, where the government has advised British citizens against all but essential travel. Although there is a policy providing for a limited automatic extension of visas, it only applies to Chinese nationals. This is no longer tenable in light of the global nature of the pandemic. The policy should apply to all migrants who are affected. The policy should also be updated urgently to extend beyond 31 March 2020.

Release everyone detained under immigration powers to reduce the risk of COVID-19 entering the detention estate and causing avoidable harm.

There is also a very serious risk that the virus could spread quickly throughout all immigration removal centres. COVID-19 is highly infectious and such diseases tend to spread more quickly in prisons and other sites of incarceration. Immigration detainees are also frequently moved between different immigration removal centres and so the infection is likely to spread rapidly across the entire detention estate. In order to prevent the disease spreading rapidly among detainees, custody officers, healthcare staff and all others in Immigration Removal Centres, the government should immediately release all immigration detainees. In doing so the government should also ensure there is adequate provision for healthcare in place for those people being released who have been receiving care in detention. Any scheduled deportation or removal flights should be cancelled as a matter of urgency.

Provide specialist support for those housed in shared Asylum Accommodation to enable safe access to medical services, testing, and where necessary, re-housing for particularly vulnerable people.

Asylum seekers housed in shared accommodation are similarly at risk from often overcrowded and unhygienic conditions. Independent health assessments of all asylum accommodation and relocation of persons at heightened risk from the virus must be urgently implemented alongside increased specialist healthcare provision for people in accommodation, including mobile clinic services. 

The above measures must be accompanied by a wide-ranging public information campaign to ensure that migrants are able to safely access the healthcare they need during a public health crisis. 

Yours sincerely, 

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