Denial of HIV treatment to failed asylum seekers `a human rights violation`, says BMJ

The British government is violating the right of failed asylum seekers to healthcare, according to an editorial in this week's British Medical Journal.

Destitute failed asylum seekers are being refused hospital treatment and being hounded by debt collectors if they have received emergency treatment, according to a recent report by the Refugee Council.

In restricting their access to free secondary healthcare, writes Peter Hall, chair of Doctors for Human Rights, the British government is violating the right of failed asylum seekers to the highest attainable standard of health, guaranteed by the International Covenant on Economic, Social and Cultural Rights.

In 2002, the Committee on Economic, Social and Cultural Rights, which monitors states' compliance with the covenant, asked the UK to ensure that its obligations under the covenant were taken into account in national legislation and policy on health and education.

Yet within two years the government had blocked access to free NHS hospital healthcare for most failed asylum seekers and expressed an intention to deny them access to free NHS primary care.

At a recent symposium organised in London by NAM, HIV experts and community organisations talked about the effect of these regulations on people with HIV.

They described how people with HIV with failed asylum claims had been pursued back to their country of origin for debts to NHS trusts by a debt collection agency.

An African community spokesperson, Winnie Sseruma, said that resistance to HIV testing in the African community was being increased by rumours of the ways in which failed asylum seekers were treated, with charging for treatment a particular cause of concern.

The National AIDS Trust and Terrence Higgins Trust say that they are receiving frequent reports of charging for treatment.

“They include pregnant mothers deterred from maternity care, people co-infected with HIV and TB who discontinue their TB treatment for fear of their HIV-related bills, and people either without legal residency status or whose status is unclear being billed for many thousands of pounds.”

Denial of access to healthcare by one of the richest countries on earth is inhumane because it jeopardises their health and illegal because it violates international law, says the author of the editorial.

But where do these regulations leave doctors, he asks? Conforming with legislation that denies access to health care goes against the instincts of many doctors, affronts common decency, and infringes international and domestic ethical codes.

In its 2002 report, the Committee on Economic, Social and Cultural Rights urged the UK government to ensure that health professionals be educated in economic, social, and cultural rights and the public be informed of the requirements of the covenant, but neither recommendation has been followed.

The government needs to observe its obligations under the covenant, the editorial states. In the meantime, health professionals who have cooperated in limiting access should understand they have knowingly been made complicit in the abuse of a fundamental human right, he concludes.

Speaking at the recent NAM symposium, Professor Jane Anderson of Homerton University Hospital in London said: "Doctors need to be aware that they may potentially become involved in a future human rights case."