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Vaccines For All campaign to mark the anniversary of the pandemic

Thursday, March 11, 2021

Vaccines for All - Campaign Briefing

This briefing document sets out the background for the campaign calling on the Department of Health and Social Care (DHSC) to take action to ensure access to the Covid-19 vaccine for everyone in the UK, regardless of immigration status, proof of address or ID.

The campaign calls on the DHSC to:

  1. Guarantee a firewall that prevents any patient information gathered by the NHS or Test and Trace being used for the purposes of immigration enforcement.
  2. End all Hostile Environment measures in the NHS, including charging for migrants, to combat the fear and mistrust these policies have created.
  3. Provide specific support to all GP surgeries to register everyone, including undocumented and underdocumented migrants and those without secure accommodation, and ensure that all other routes to vaccination are accessible to everyone.
  4. Fund a public information campaign to ensure that communities impacted by the Hostile Environment are aware of their right to access the vaccine and the steps taken above.

Introduction

Over 340 organisations have signed the call to the DHSC, including Oxford, Haringey and Bristol Councils, health institutions such as the Royal College of Midwives and the Faculty of Public Health, migrant and homelessness charities, GP surgeries and primary care networks, and trade unions including the Trades Union Congress. You can view the full list of signatories at www.VaccineForAll.co.uk

The call responds to the Government announcement on Monday 8th February that the coronavirus vaccine will be available free of charge to all adults in the UK regardless of immigration status, and that immigration status will not be checked when registering for the vaccine. In this document, we evidence why the current policy does not go far enough to guarantee that everybody living in the UK will be able to access the vaccine.

Background

The current policy - as laid out in the NHS Entitlements Guide - is that access to coronavirus testing and treatment (including the vaccine) is free for everyone, regardless of immigration status. NHS providers have been instructed not to check patients’ eligibility for free NHS care or share patient data with the Home Office when someone is undergoing treatment for coronavirus. The Government has also advised that access to GP services remains available and free to everyone regardless of immigration status, and that lack of proof of address or ID should not prevent someone from registering with the GP.

Nonetheless, many people are still likely to be excluded from accessing the vaccine. This includes those without immigration status (undocumented migrants), those with precarious immigration status, migrants housed by authorities, people experiencing homelessness, people not registered with a GP, and people who do not have ID or proof of address.

The policies designed to ensure testing and treatment for coronavirus is available to everyone do not mitigate the wider deterrent of wider Hostile Environment immigration policies in the NHS, including charging, data sharing, and ID checks. Nor will they go far enough to challenge practices promoted by these policies that lead to migrant and BME patients regularly being challenged about their entitlement to care, or facing delays and outright denial of access, often in contravention of national policies.

Evidence

The Joint Committee on Vaccination and Immunisation (JCVI) have raised concerns about existing health inequalities are likely to exacerbate poor access to the vaccine for certain groups, including undocumented migrants, and that “to reduce health inequalities, targeted action focussed on some population groups is required.” Public Health England’s report “Beyond the Data” has also highlighted the negative impact of the Hostile Environment on BME communities. They note that the policies deter and delay migrants and BME communities from seeking care, and create mistrust between these communities and the NHS.

In a recent survey of migrants’ experiences trying to access the NHS, the Joint Council for the Welfare of Immigrants (JCWI) found that 43% of migrants were fearful of seeking healthcare for fear of having their status tested, or being charged. Of those with refugee status, 56% were wary of accessing healthcare because of fears about data-sharing between the NHS and Home Office, rising to 81% for those with no official status.

Research from Medact, Migrants Organise, and the New Economics Foundation that found 57% of migrant support organisations surveyed reported that migrants have avoided seeking healthcare, both before and during the pandemic, because of fears of being charged for NHS care, data sharing and other migration enforcement concerns. This was the case even when they had been told by trusted support workers that treatment and testing for coronavirus was exempt. These findings are supported by research from the Equality and Human Rights Commission that shows fear of data sharing prevented asylum seekers and refugees accessing care despite being exempt from charging, and are denied care.

Doctors of the World research has also shown that, even when supported by an NGO, around 1 in 5 migrants are wrongly refused GP registration, highlighting the frequent deviation of GP registration policies from NHS England guidelines and GP contract obligations. In 2019, Haringey Welcome also conducted local research which found that approximately two-thirds of the GP practices surveyed in Haringey refused to register a patient who either had no UK residency status, no formal ID or no recognised proof of address. Only one practice agreed to register such patients with no prior conditions.

Why Are We Making This Call?

In light of the evidence above, it is vital that the Government act now to address the fear, deterrence, and exclusion created by Hostile Environment immigration policies in the NHS, even for primary care services that are not included in these policies, and despite exemptions for coronavirus. The call to the DHSC sets out clear recommendations to tackle these problems and promote access to the vaccine for everyone, regardless of immigration status.

Ending NHS charging and data-sharing is the first step to ensuring people can access the NHS safely and without fear, accompanied by a public information campaign that aims to directly address the fear and mistrust created by these policies and begin to restore confidence in the NHS for the communities that have been excluded from care.

GP registration remains the primary route to access the vaccine for most people. The Government must support GP surgeries to register patients and ensure that people are not being denied registration in contravention of national guidance. Simultaneously, the Government must also provide resources, support and guidance for all organisations involved in the vaccine rollout to ensure that undocumented migrants and other excluded groups are not prevented from accessing the vaccine through exclusionary policy and/or practices (such as asking people to bring ID when it is not needed). This must include non-GP vaccine delivery sites and centres that allow people to self-register for the vaccine when these centres become operational.

For this to be effective, the Government must take the lead from and work with local and community organisations delivering the vaccine, including the Public Health Teams and community leaders already involved in vital vaccine outreach and hesitancy work. This is why we are encouraging local organisations across the country to sign on to the call, particularly those involved in the vaccine roll out.

We invite you to join the campaign and sign the call to the DHSC. You can see the full list of signatories at www.VaccineForAll.co.uk. For more information and to sign, please contact Aliya Yule (aliya@migrantsorganise.org) and James Skinner (jamesskinner@medact.org).