Are refugee and asylum seeking children entitled to free health care?
Refugees and those with limited leave to remain
All refugees and people with limited leave to remain (DL/HP) are entitled to free health care in the UK. [1] This means they can register with a GP and receive hospital treatment free of charge.
Unaccompanied Asylum Seeking Children (UASC) with limited leave will remain entitled to free health care while their leave remains 'current' (but see exceptions below) - that is until the expiry of their limited leave or where they have applied 'in time' for an extension of that leave, until a decision is made on the extension application and where the application is refused until the time limit for appealing has expired or where an appeal is brought, until the appeal is finally determined.
Asylum seekers and failed asylum seekers
Asylum seekers are also entitled to free health care. However once their application has been finally rejected (and they then become failed asylum seekers, or in the case of former UASC granted limited leave, when their leave finally expires and they become 'unlawfully present') the entitlement to NHS hospital treatment, with some exceptions (see below), ends [2].
However, in April 2008 a UK High Court ruled that asylum seekers who have been refused refugee status but legally remain in the UK because they have no safe route home should be granted free health care under the National Health Service (NHS). The Department of Health has leave to appeal, but for now all asylum seekers will be entitled to hospital treatment until the case has been finally resolved.[3]
Furthermore, whilst there is still no provision in the Scottish regulations for saying what happens when someone is refused asylum and remains in the UK, guidance issued by the Scottish government basically states that "failed asylum seekers who have previously been resident in Scotland and remain in Scotland will remain in the care of the NHS in Scotland until arrangements for their return home can be made". The evidence that may also be asked of anyone has been extended and would not identify them as being refused.[4]
Exceptions
Certain treatments are always free of charge notwithstanding the immigration status of the patient [5].
- Treatments of certain communicable diseases (i.e. those listed in schedule 1 of the National Health Service (Charges to overseas visitors) Regulations 1989) such as malaria and TB.
- Treatment received at a special clinic for a sexually transmitted disease. Treatment for AIDS/HIV however is not free, only the initial test and counselling is.
- Emergency treatment which is provided in a hospital emergency department or walk in centre. This does not extend to services provided once the patient has been admitted as an in-patient.
If an asylum seeker is undergoing hospital treatment when his claim is finally rejected (or in the case of a former UASC granted limited leave, when their leave finally expires and they become 'unlawfully present' ) this treatment will continue free of charge until completed [6].
Furthermore, GPs have discretion to accept people as registered NHS patients and treat them free of charge (see Entitlement to NHS treatment table from the Department of Health).
Registration with a GP
It is not necessary to have an NHS number before registering as this will be provided once the person has registered. Where a patient has difficulties registering with a GP s/he should contact the local Primary Care Trust (PCT) who has the power to allocate a doctor.
Documentation
Guidance from the DoH states that where the patient is asked for documentation proving entitlement to free health care a letter from the Home Office confirming the asylum application or grant of limited leave or an ARC card is sufficient.
(NB There is no obligation for GPs to check the immigration status of patients.)
Revised 24/06/08
Notes
[1] Regulation 4 (1)(c) National Health Service (Charges to overseas visitors) Regulations 1989
[2] Regulation 4 (1)(c) National Health Service (Charges to overseas visitors) Regulations 1989, as amended by the National Health Service (Charges to overseas visitors) Amendment regulations 2004, 4 (e), which inserted in paragraph (c) after the words "United Kingdom" where they occur for the second time "which has not yet been determined" - i.e. if you are refused you will be liable for charging.
[3] See Department of Health guidance on 'Failed asylum seekers and ordinary residence'
[4] See Scottish Government 'Overseas Visitors Shortened Guidance, February 2008', paras 29 and 30.
[5] Regulation 3 National Health Service (Charges to overseas visitors) Regulations 1989
[6] Regulation 4 (3) National Health Service (Charges to overseas visitors) Regulations 1989
