Pregnant women without legal status ‘too afraid to seek NHS care’. 2017. (accessed 11 May 2018)

Pregnant women frightened away from healthcare in the UK. 2017. (accessed 11 May 2018)

Saving Lives, Improving Mothers' Care: Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2013–15. In: Knight M, Nair M, Tuffnell D (eds). Oxford: National Perinatal Epidemiology Unit, University of Oxford; 2017

Upfront Charging Operational Framework: Operational framework to support identification and charging of Overseas Visitors.: DHSC; 2017

Dear Secretary of State

02 June 2018
Volume 26 · Issue 6


In an open letter to Jeremy Hunt, Secretary of State for Health and Social Care, Sophie Windsor argues why the NHS cost recovery scheme is dangerous for women accessing maternity care

I write in my capacity as a consultant midwife regarding my serious concerns about the impact of the ‘cost recovery’ programme on upfront charging on community midwifery for overseas visitors (Department of Health and Social Care, 2017).

The new regulations, which came into force in October 2017, introduce not only upfront charging, at a tariff of 150% (Harvey, 2017), but, also require the compliance of the health professional in determining immigration status (Department of Health and Social Care, 2017)—a gross distraction from our clinical priorities.

What I find more concerning, however, is that, in clinical practice, undocumented migrants who cannot afford to pay are simply not attending or engaging with antenatal care (Gentleman, 2017).

The whole purpose of antenatal care is one of preventative medicine. I can only assume that this regulation was either imposed to save the NHS money or create a hostile environment to pregnant migrant women from accessing care (Harvey, 2017).

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month