Creating a ‘hostile environment for migrants’: the British government’s use of health service data to restrict immigration is a very bad idea

AbstractIn January 2017, the UK Government made public a Memorandum of Understanding (MoU) between the Department of Health, National Health Service (NHS) Digital and the Home Office. This Memorandum allows for the more expedited sharing of a patient’s non-clinical data, specifically from the NHS England to the Home Office. The Government justified the MoU as in the ‘public interest to support effective immigration enforcement’. In this review, we seek to unpack this justification by providing, first, a background to the MoU, placing it in the context of creating a ‘hostile environment’ for migrants – a project initially sought by Theresa May in her time as Home Secretary. We then explore the potential impact of data sharing on individual health, public health and on health professionals. We conclude that the MoU could threaten both individual and public health, while placing health professionals in an unworkable position both practically and in terms of their duties to patients around confidentiality. As such, we agree with colleagues’ position that it should be suspended, at least until a full consultation and health impact assessment can be carried out.

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Invited commentary on The mental health of prisoners

Advances in Psychiatric Treatment ◽

10.1192/apt.9.3.200 ◽

2003 ◽

Vol 9 (3) ◽

pp. 200-201

Author(s):

Tony Maden

Keyword(s):

Mental Health ◽

Mental Illness ◽

National Health Service ◽

Health Service ◽

Task Force ◽

Mentally Disordered Offenders ◽

Home Office ◽

Mentally Disordered ◽

Department Of Health ◽

The Government

Psychiatrists have always been concerned about the mental health of prisoners. If they did not devote much energy to their treatment, it was only because they had more-pressing problems, including how to squeeze ten patients into nine beds. In any case, it was someone else's job to look after prisoners. Luke Birmingham's article (Birmingham, 2003, this issue) could not be more timely, as this situation has now changed. With the publication of The Future Organisation of Prison Healthcare (Prison Service & NHS Executive Working Group, 1999), and the creation of a joint Department of Health and Home Office task force, the Government has made it clear that the problem of mentally disordered offenders belongs to the National Health Service (NHS). There is a plan, there is a partnership and there are targets. Can those of us who have been worrying about prisoners with mental illness sit back and relax, as the solution unfolds?

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The negative health effects of hostile environment policies on migrants: A cross-sectional service evaluation of humanitarian healthcare provision in the UK

Wellcome Open Research ◽

10.12688/wellcomeopenres.15358.1 ◽

2019 ◽

Vol 4 ◽

pp. 109 ◽

Cited By ~ 2

Author(s):

Sophie J. Weller ◽

Liam J. Crosby ◽

Eleanor R. Turnbull ◽

Rachel Burns ◽

Anna Miller ◽

...

Keyword(s):

Service Evaluation ◽

Population Characteristics ◽

Vulnerable Groups ◽

Undocumented Migrants ◽

Hostile Environment ◽

Healthcare Provision ◽

Home Office ◽

Cross Sectional ◽

The Government ◽

The Uk

Background: Recent UK ‘hostile environment’ immigration policies, including obligatory charging and sharing of confidential data between NHS Digital and the Home Office, have created an atmosphere of fear and exposed already highly marginalised and vulnerable groups to significant health risks by increasing barriers to accessing NHS care. Methods: This is a cross-sectional observational study of patients accessing healthcare at Doctors of the World (DOTW) in the UK. DOTW is a humanitarian organisation, providing care to those excluded from NHS healthcare. We aimed to describe population characteristics of individuals using DOTW services and identify groups at greatest risk of facing ‘hostile environment’-related barriers to NHS care, specifically being denied healthcare or fear of arrest. Results: A total of 1474 adults were seen in 2016. Nearly all were non-EU/EEA nationals (97.8%; 1441/1474), living in poverty (68.6%; 1011/1474). DOTW saw a large number of undocumented migrants (57.1%; 841/1474) and asylum seekers (18.2%; 268/1474). 10.2% (151/1474) of adults seen had been denied NHS healthcare and 7.7% (114/1474) were afraid to access NHS services. Asylum seeker status was associated with the highest risk (adjusted odds ratio (OR): 2.48; 95% confidence interval (CI): 1.48-4.14) of being denied NHS healthcare and being undocumented was associated with the highest risk of fearing arrest (adjusted OR: 3.03; 95% CI: 1.70-5.40). Conclusions: Our findings make visible the multiple and intersecting vulnerabilities of individuals forced to seek care outside of the NHS, underlining the public health imperative for the government to urgently withdraw its ‘hostile environment’ policies and address their negative health impacts.

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Men's perception and understanding of male-factor infertility in the UK

British Journal of Nursing ◽

10.12968/bjon.2021.30.9.s8 ◽

2021 ◽

Vol 30 (9) ◽

pp. S8-S16

Author(s):

Eleanor L Stevenson ◽

Cheng Ching-Yu ◽

Chang Chia-Hao ◽

Kevin R McEleny

Keyword(s):

Public Health ◽

Emotional Support ◽

Health Professionals ◽

Male Fertility ◽

Public Knowledge ◽

Evidence Based ◽

Male Factor Infertility ◽

Male Factor ◽

The Public ◽

The Uk

Male-factor infertility is a common but stigmatised issue, and men often do not receive the emotional support and the information they need. This study sought to understand awareness of male fertility issues compared to female fertility among the UK general male public, and also what were perceived as being the optimum methods for providing support for affected men, emotionally and through information. Men feel that male infertility is not discussed by the public as much as female infertility. Lifestyle issues that affect male fertility are not well understood, and men affected by infertility desire more support, including online, from health professionals and through peer support. Health professionals, including those in public health, could offer evidence-based programmes to reduce stigma and increase public knowledge about infertility, as well as offer emotional support to men with infertility problems.

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An exploration of migrant women’s perceptions of public health messages to reduce stillbirth in the UK: a qualitative study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03879-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tomasina Stacey ◽

Melanie Haith-Cooper ◽

Nisa Almas ◽

Charlotte Kenyon

Keyword(s):

Public Health ◽

Perinatal Mortality ◽

Health Professionals ◽

Health Messages ◽

Migrant Women ◽

Global Public Health ◽

Wide Range ◽

Public Health Messages ◽

Associated Risk Factors ◽

The Uk

Abstract Background Stillbirth is a global public health priority. Within the United Kingdom, perinatal mortality disproportionately impacts Black, Asian and minority ethnic women, and in particular migrant women. Although the explanation for this remains unclear, it is thought to be multidimensional. Improving perinatal mortality is reliant upon raising awareness of stillbirth and its associated risk factors, as well as improving maternity services. The aim of this study was to explore migrant women’s awareness of health messages to reduce stillbirth risk, and how key public health messages can be made more accessible. Method Two semi-structured focus groups and 13 one to one interviews were completed with a purposive sample of 30 migrant women from 18 countries and across 4 NHS Trusts. Results Participants provided an account of their general awareness of stillbirth and recollection of the advice they had been given to reduce the risk of stillbirth both before and during pregnancy. They also suggested approaches to how key messages might be more effectively communicated to migrant women. Conclusions Our study highlights the complexity of discussing stillbirth during pregnancy. The women in this study were found to receive a wide range of advice from family and friends as well as health professionals about how to keep their baby safe in pregnancy, they recommended the development of a range of resources to provide clear and consistent messages. Health professionals, in particular midwives who have developed a trusting relationship with the women will be key to ensuring that public health messages relating to stillbirth reduction are accessible to culturally and linguistically diverse communities.

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Public health impact of low-dose aspirin on colorectal cancer, cardiovascular disease and safety in the UK – Results from micro-simulation model

IJC Heart & Vasculature ◽

10.1016/j.ijcha.2021.100851 ◽

2021 ◽

Vol 36 ◽

pp. 100851

Author(s):

Jorne Biccler ◽

Kaatje Bollaerts ◽

Pareen Vora ◽

Elodie Sole ◽

Luis Alberto Garcia Rodriguez ◽

...

Keyword(s):

Public Health ◽

Colorectal Cancer ◽

Cardiovascular Disease ◽

Simulation Model ◽

Low Dose ◽

Health Impact ◽

Dose Aspirin ◽

Low Dose Aspirin ◽

Micro Simulation ◽

The Uk

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Cuba and the Covid-19 pandemic

Theory & Struggle ◽

10.3828/ts.2021.12 ◽

2021 ◽

Vol 122 (1) ◽

pp. 118-131

Author(s):

Bob Oram

Keyword(s):

Public Health ◽

United States ◽

Health System ◽

Health Professionals ◽

The United States ◽

The Past ◽

The Uk ◽

Universal Health

For the UK struggling to deal with the Covid-19 pandemic, the experience of Cuba’s Ministry of Public Health over the past six decades provides the clearest case for a single, universal health system constituting an underlying national grid dedicated to prevention and care; an abundance of health professionals, accessible everywhere; a world-renowned science and biotech capability; and an educated public schooled in public health. All this was achieved despite being under a vicious blockade by the United States for all of that time.

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Understanding vaccine hesitancy: the evidence

Practice Nursing ◽

10.12968/pnur.2021.32.7.282 ◽

2021 ◽

Vol 32 (7) ◽

pp. 282-287

Author(s):

Alison While

Keyword(s):

Public Health ◽

Health Professionals ◽

Herd Immunity ◽

Public Health Intervention ◽

Health Intervention ◽

Vaccine Hesitancy ◽

Important Public Health ◽

Positive Attitudes ◽

The Uk

Vaccine hesitancy is a concern both globally and within the UK. Alison While reviews the evidence relating to vaccine hesitancy, its underlying factors and the sociodemographic variations Vaccination is an important public health intervention, but its effectiveness depends upon the uptake of vaccination reaching sufficient levels to yield ‘herd’ immunity. While the majority of the UK hold positive attitudes about vaccination, some people, including health professionals, decline vaccinations. This article reviews the evidence relating to vaccine hesitancy, its underlying factors and the sociodemographic variations.

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