Freedom from Torture - New NHS charging regulations risk health of torture survivors ​

New NHS charging regulations risk health of torture survivors ​

New NHS charging regulations introduced today (Monday 21 August) risks making vital hospital treatment inaccessible to vulnerable groups including torture survivors and other asylum seekers unless they are able to pay for it upfront.

The system will require people who do not qualify for free secondary healthcare in the UK to pay for this care before they receive it. Certain groups are exempt from these charges, however asylum seekers whose claims have been refused will be forced to pay for their hospital treatment upfront. Many refused asylum seekers who do not have access to asylum support are unable to return home, leaving them destitute and in limbo, and being forced to pay charges upfront will leave them denied vital medical care.

Many torture survivors are wrongly denied protection by asylum decision-makers. Research published by Freedom from Torture last year revealed how medical evidence relating to asylum claims by torture survivors is frequently mistreated by the Home Office, leading to people wrongly being refused asylum. In addition, Freedom from Torture regularly supports torture survivors whose legal representation has previously been poor and as a result, vital medical evidence of torture has not been submitted as part of their asylum claim or appeal. Many within this ‘appeal rights exhausted’ group will try to find a new lawyer to prepare a fresh claim, a process which may take many months, during which they are not entitled to free healthcare.

Charging does not apply to primary care services or to accident and emergency treatment. This means that existing health conditions will go untreated until an emergency hospital admission becomes inevitable. However once a patient is admitted, charging once again applies. It’s unclear whether, if a person is unable to pay, they will be discharged. If they are this could put the patient’s health at serious risk.

Torture survivors are considered highly vulnerable for various reasons including the complex, severe and multiple health difficulties they experience connected with their torture. The new charging system means that torture survivors will not be able to access vital rehabilitative treatment until they reach crisis point and require an emergency hospital or mental health admission. This compounds their vulnerability, prevents them recovering from their experiences, and places unnecessary strain on overstretched emergency health resources. Torture survivors are exempt from charging if they can demonstrate their condition is a direct result of their torture, but it is unclear how they would evidence this or indeed, that they are a torture survivor at all.

Susan Munroe, Chief Executive of Freedom from Torture said:

“The regulations being introduced today pose a serious risk to the health of torture survivors and are both unworkable and desperately unfair. Torture survivors come to the UK seeking safety but find it difficult to disclose what has happened to them. A complex and combative asylum system can leave them destitute and unprotected. To be unable to access healthcare in this situation puts lives at risk. Not to mention the cost to the public purse of leaving medical problems to worsen until a trip to A&E is the only option.

“These regulations make the system more and more complex, which is likely to increase the burden on already overstretched NHS staff. We urge the Department of Health to reconsider this draconian charging regime which besides putting an undue burden on the NHS only increase the hardships already experienced by very vulnerable people.”



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