We have been involved in the National Campaign Patients Not Passports since 2019. This campaign has been developed by Medact , Docs Not Cops and Migrants Organise and seeks to directly challenge the Hostile Environment in the NHS.

This is an excerpt from the Patients Not Passports website, which gives a good overview of what the campaign is all about:

The Immigration Act 2014, which came into force in 2015, saw the expansion of pre-existing charging regulations for ‘overseas visitors’ using the NHS. This included broadening the group of people who are chargeable, introducing an ‘immigration health surcharge’ for those seeking visas to enter the UK, and up to 150% charge for treatment in secondary care at the discretion of NHS Trusts.

In October 2017, these regulations were once again expanded. Now, charging has been introduced into some community services, NHS Trusts have a duty to check the eligibility of all patients before providing treatment in secondary care, and, for certain treatments, patients may be asked to pay upfront or risk being turned away.


The expansion of these fees and the duty to check eligibility is having a direct and devastating impact on people in the UK every day. Despite asylum seekers and refugees being exempt from charging, it is often the case that NHS workers and clinicians, feeling the pressure from Management, CCGs and the Government, are lumping them in with those who are eligible to pay. This results in misinformation, letters of demands for payment being sent in error and, perhaps most worringly, people avoiding attending appointments out of fear of being charged.

Access to healthcare is a human right enshrined in the UN Universal Declaration of Human Rights.

We don’t believe anyone should be charged for health care, and we don’t believe clinicians should be turned into Border Guards, expected to check the Nationality and background of their patients. Clinicians should be allowed to perform their jobs as intended – to provide care and support to their patients.

Healthcare workers aren’t border guards and healthcare shouldn’t be a hostile environment


In Hastings we have recently published a report on access to interpreting services in the local NHS – one aspect of the Hostile Environment at play in clinical settings.

In 2020 we will be moving forward with the Patients Not Passports campaign more broadly, engaging clinicians from across the healthcare sector. If you would like to be involved please email rossana@therefugeebuddyproject.org.

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