Results of patient identity checking pilot suppressed

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The Department of Health and Social Care has failed to provide the results of an identity checking pilot, that aimed to deny free NHS care to some patients.

Campaigners’ Freedom of Information Act requests for results from the 2017 pilot, made repeatedly since December 2018, have been declined or delayed. The final deadline for complying with the latest request on 9 June was not met.

Local Keep Our NHS Public campaigners from North East London initially submitted a request to the DHSC in December 2018, regarding the results of the identity checking pilot that took place at two sites within Barts NHS Trust, as well as at 19 other NHS trusts. This request for information was refused in January 2019, with the DHSC citing an exemption that can be used if the information is being used for the development of Government policy.

With this in mind, Keep Our NHS Public resubmitted the request in March this year, expecting the exemption to have expired. The Department requested two extensions to consider “the public interest in release under Section 35 of the FOI Act” since then, the maximum it can take.

The final deadline for providing this information was on 9 June. To date the department has confirmed it holds, but has not released this information.

Why we want this information

Identity checking was introduced in order to ascertain patients’ eligibility for free NHS care. The Conservative Government not only introduced annual charges for people who are not UK nationals to access NHS services (with plans to extend to all EU citizens from next year), but also treatment charges for those it deems ‘not ordinarily resident’.

Keep Our NHS Public campaigners in North East London behind the initial Barts NHS Trust investigation and Save Lewisham Hospital Campaign have revealed hundreds of pregnant women and their unborn children have already been denied free NHS care as they have been deemed ‘not ordinarily resident’.

Campaigner Rosamund Mykura said: 'This large scale pilot was introduced without announcement or consultation, and might have remained secret were it not for health campaigners repeatedly pressing Barts NHS Trust Board for details on the implementation of the NHS Hostile Environment in their local hospitals.

The 'identity checking' process was initially called a 'pilot',  and later was referred by Barts Trust as  'former DH ID checking pilots which had become business as usual . '  The hospital departments carrying out the 2017 'pilot' were not told to pause ID checking until 13th August 2018.'

Ms Mykura continued, 'later developments, which again were only revealed by health campaigners' questions, saw Barts NHS Trust Board admit that in one financial year (2018-2019) seven hundred and thirty-nine (739) patients were billed at the three Barts hospitals' maternity units for NHS maternity care.  Later it emerged that 290 of the 739 women had been wrongly invoiced.  This reckless withdrawal of free NHS maternity care has caused widespread fear, regardless of entitlement, since having a debt owed to the NHS and /or being reported to the Home Office can have life-changing future implications for local families."

Rosamund  Mykura added, "We do not know if Barts NHS Trust are still sending out these bills, which clearly  amount to a denial of free NHS maternity care.  At this time of public health emergency with the Covid-19 pandemic, the country needs an immediate end to legislation enforcing eligibility checks and charging in the NHS, including those related to residency status or national origin, allowing all patients to use the NHS without fear."

Of course the women were not really health tourists/overseas visitors, but instead women who had been deemed not ‘ordinarily resident’ in the UK due to Government policy changes made in 2015.

These changes mean that over 600,000 people including 120,000 children are now no longer eligible for free non-emergency NHS care. This means they will be invoiced for 150% of the standard tariff for all non-emergency care received, including maternity.

Outstanding NHS debts can be used as a reason to deport an individual. Keep Our NHS Public campaigners from Save Lewisham Hospital Campaign also found Greenwich and Lewisham Hospital Trust had partnered with credit checking agency Experian to screen patients for eligibility for free care and had shared patient information with the home office.

Blood money

Many healthcare professionals do not feel it is appropriate to act as gatekeepers to NHS services and believe charging will deter or delay patients from seeking help over fear of debts or having personal or incriminating information shared with authorities.

Denying free NHS care to patients has already been proven to be fatal. An independent report that had its publication suppressed until after the 2019 general election found three deaths of pregnant women its authors believed to be directly attributable to patient charging.

The Covid-19 pandemic has further shown how crucial it is for all members of our community to be free to seek medical care when appropriate without fear or debt or deportation. Half of women who have been hospitalised with Coronavirus have been BAME, a recent paper in the BMJ showed.

Concerns have been raised over the DHSC’s lack of transparency during the Covid-19 crisis with delays to information being released to the press.

Keep Our NHS Public is awaiting the outcome of a complaint to the Information Commissioner about the DHSC’s handling of its request for the information about the pilot.

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