Hostile environment causes death of three pregnant women

black pregnant woman
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Three pregnant women have died as a result of fear of migrant charging, a Government report released the day after the election has revealed.

The publication of the independent report, Saving Lives, Improving Mothers’ Care was originally due to be published on 14 November but this was delayed during the election campaign by NHS England. It is the first report of its kind demonstrating that migrant charging was a contributing factor in the deaths of pregnant women. The report also showed BAME women are five times more likely to die than white women in the UK.

Fear and delays

Authors of the study found delays in seeking treatment by the women had caused their deaths, and the delays were due to concerns over being charged for care and potential impact on their immigration status. This was despite the women all being eligible for free maternity care.

The report read:

“There was a suggestion that this woman and two others whose deaths are considered in this chapter may have been reluctant to access care because of concerns over the costs of care and the impact of their immigration status. Within England, free NHS hospital treatment is provided on the basis of someone being ordinarily resident (Department of Health and Social Care 2018). Although no woman will be refused emergency treatment, this may not be commonly known. The importance of maternity care is recognised and is the only service explicitly classed as being ‘immediately necessary’ in the regulations, meaning it cannot be withheld even if a woman has no means to pay. However, women may believe they will be asked to pay in advance for planned treatment and this may act as a disincentive to seeking care”

Migrant charging and the hostile environment

Migrant charging was introduced as part of the Conservative-LibDem coalition government’s attempt to reduce ‘health tourism’ spending, despite it costing just 0.3% of the NHS annual budget. Despite maternity care being defined as ‘immediately necessary’, meaning it can’t be withheld if women are unable to pay, a Freedom of Information act request earlier this year by Save Lewisham Hospital campaign showed women were facing charges of up to £9,000 in one hospital trust. Failure to pay could also result in the woman’s details being passed onto the Home Office, the investigation found.

The Conservative Party revealed plans to hike the £400 annual Immigration Health Surcharge £625 per person every year during the election campaign on 17 November. This was just three days after the report Saving Lives, Improving Mothers’ Care had originally been due to be published.

The increase was announced alongside measures to “take back control of our borders” and represents a tripling of the charge since it was introduced in 2015 by the Conservative-LibDem coalition government. This Government policy has rendered 600k people, including 120,000 children, ineligible for free NHS care.

Earlier this year the Royal College of Midwives and charity Maternity Action published a report on the impact migrant charging had on midwives. It highlighted concerns women were seeking maternity care late in their pregnancy, missing important tests and treatments, or avoiding antenatal care altogether for fear of charges and Home Office sanctions. They and many other health care professional groups and bodies are calling for the scrapping of migrant charging within the NHS.


Keep Our NHS Public has been campaigning against migrant charging and other forms of insidious privatisation of our NHS. Find out more on our campaigns page and please donate to our Crowd Funder to help us continue our work.





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