Dear Secretary of State

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).