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Charging undocumented migrant children for NHS healthcare: implications for child health
  1. Neal James Russell1,2,
  2. Lisa Murphy3,
  3. Laura Nellums4,
  4. Jonathan Broad5,
  5. Sarah Boutros6,
  6. Nando Sigona7,
  7. Delan Devakumar8
  1. 1 Paediatric Infectious Diseases Research Group, St George’s University, University of London, London, UK
  2. 2 Paediatric Registrar, London, UK
  3. 3 Public Health England, London, UK
  4. 4 Institute of Infection & Immunity, St George’s University, University of London, London, UK
  5. 5 Paediatric ST2 and Academic Clinical Fellow, London, UK
  6. 6 Paediatric Registrar, London, UK
  7. 7 Department of Social Policy, Sociology and Criminology, University of Birmingham, Birmingham, UK
  8. 8 Institute for Global Health, UCL, London, UK
  1. Correspondence to Dr Neal James Russell, Paediatric Infectious Diseases Research Group, St George’s University, University of London, London WC1E 7HU, UK; nrussell{at}

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Recent changes to NHS charging regulations undermine child health and represent an unprecedented departure from the founding principles of the NHS. Justified by the narrative of ‘health tourism’,1 NHS ‘overseas visitors’ charging regulations now restrict access to NHS care for undocumented migrants living in the UK. This includes an estimated 600 000 people, including 120 000 children, of whom 65 000 were born in the UK.2 Regulations include a charge of 150% of the NHS tariff for those unable to prove a regular status and sharing of personal data with the Home Office if debts are unpaid, effectively discouraging healthcare seeking with the threat of immigration enforcement. As such, the UK has abandoned universal health coverage, in conflict with the Sustainable Development Goals.3 We write this editorial in the context of growing concerns in the health community about the effects of these policies on child and public health, demonstrated most recently by a joint statement by the Royal College of Paediatrics and Child Health (RCPCH) and other medical colleges calling for suspension of this charging regime,4 as well as increasing recognition that ‘migration and global health are defining issues of our time’.5

Definition of undocumented migrant children

‘Undocumented’ (or ‘irregular’) refers to children lacking documentation proving a regular immigration status which, unless they are unaccompanied, is usually dependent on the status of, or applications made by, their parents.2 A child born in the UK to undocumented migrant parents may be considered an undocumented migrant, even without having ever left the UK. ‘Undocumented’ also includes unrecognised victims of trafficking and modern slavery, or children who have fled their countries of origin but are yet to seek—or have been refused—asylum.

Recent policies reducing healthcare access for children

Recent changes to healthcare access have been implemented as part of the government’s ‘hostile environment’ policy for undocumented migrants living in the UK. The …

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