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Migrants and pregnancy

02 August 2019
Volume 27 · Issue 8


Although maternity care can never be refused on account of inability to pay, evidence shows charging migrants for NHS care has serious consequences. George F Winter debates whether this is ethical

In 2017 there was a global population of 244 million international migrants, including 22 million refugees. With the inevitable implications for healthcare as a result of mass population movements, Abubakar and Zumla (2018:1) are clear that ‘national governments and international bodies have a responsibility to ensure that, in keeping with their pledged obligations to the United Nations' Sustainable Development Goals, no migrant or refugee is “left behind.”’

When Cross-Sudworth and Williams (2015: 734) investigated the high rate of adverse outcomes in pregnancies of migrant mothers in the West Midlands, they found that many had ‘medical and social risks that are currently not recognised or acted on, which can result in perinatal deaths that are potentially avoidable.’

It is significant that in the same year that Cross-Sudworth and Williams (2015) reported their findings, the immigration health surcharge was introduced in the UK. Feldman (2018: 4) wrote in a report for the charity Maternity Action that, ‘[o]verseas visitors are charged 150% of the normal tariff and Clinical Commissioning Groups and hospitals have a duty to report to the Home Office any patients who owe £500 or more for two months […] Holders of visitor visas and undocumented migrants are the main chargeable groups under current rules.’ This means that, according to the overseas patient upfront price list 2019/2020, a prenatal package can cost £1475–2212, a birth £3024–4536; and a postnatal package £415–623 (NHS Improvement, 2019).

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