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Barts Health slammed for charging vulnerable migrant women for treatment

Barts Health Trust charged 800 female patients for using its services in 2022-23. 581 male patients were charged in the same period, reports Josh Mellor, Local Democracy Reporter

Photo by Tugce Gungormezler on Unsplash

An East London NHS trust has been accused by a health campaigner of targeting vulnerable women migrants who have uncertain immigration statuses with treatment bills.

Under rules first introduced by the government in 2015, patients classed as “overseas visitors” are not entitled to free NHS care and must pay for their treatment unless their condition is urgent.

Those charged for care often have an uncertain visa status, with restrictions on their ability to work or access public services.

Rosamund Mykura, a campaigner at Newham Save Our NHS, has compiled figures showing that Barts Health NHS Trust has charged more women than men in the last four financial years.

Barts, which runs five hospital sites in East London (Whipps Cross, Newham, The Royal London, St Bartholomew’s and Mile End), charged 1,389 patients for their care in 2022-23 – 800 of those patients were women and 581 were men.

Rosamund said: “We know that many frightened women, including vulnerable residents who live in boroughs served by Barts three maternity units, may delay or not attend for their ante-natal or in-patient maternity care because they cannot afford to pay for it.

“Our residents fear NHS debt – this sad and dangerous plan to target our vulnerable women residents is the opposite of what our NHS was set up to do.

“Our NHS should be a safe place not a place of fear.”

It is unclear why Barts Health charges more women than men, but Rosamund suggested that the government’s “hostile environment” policies towards immigrants requires hospital trusts to “over-interrogate and under-protect” vulnerable pregnant women.


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The East London trust’s overseas patients team, which attempts to recover thousands of pounds of debt from patients, has also been singled out by charity Maternity Action as “slow to resolve” cases of vulnerable maternity patients who faced large healthcare bills.

Rosamund Mykura from Newham Save Our NHS. Credit: LDRS

Last month at a Newham Council scrutiny meeting, the charity’s director Ros Bragg said a woman was charged £10,000 for her miscarriage treatment, which was later reduced to £1,500.

She added: “I should emphasise, these are women who have been trafficked, have claimed asylum, and are domestic abuse victims – many are in very vulnerable circumstances.”

Maternity Action said that, unlike other NHS trusts, Barts Health does not refer maternity patients it attempts to charge to the charity’s service.

According to Barts Health’s 2022-23 annual report, those “overseas patients” were charged £11million in total, amounting to about £8,380 per patient.

However, about half of this income was written off and only £1.1m has been paid. The board report notes that recovery of debt from these patients is “challenging”.

A spokesperson for Barts Health NHS Trust told the Local Democracy Reporting Service: “Like all NHS trusts we have a legal duty to recover costs from patients who are not eligible for NHS treatment.

“We recognise that payment is a sensitive issue, strive to be fair and transparent with patients, and are committed to continually improving our processes to handle all cases with compassion.” 

The spokesperson said the trust has now had discussions with internal and external groups, and will review its online maternity booking form to identify, support and reassure patients who may be charged.


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