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COVID-19: children on the front line
  1. John W Puntis
  1. -, Leeds, UK
  1. Correspondence to Dr John W Puntis, –, Leeds, UK; john.puntis{at}

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Charging those with uncertain immigration status for NHS services was introduced as part of Theresa May’s ‘hostile environment’. Non-payment of bills can result in being reported to the Home Office and used as a reason for not being granted settled status. This system remains in place during the COVID-19 pandemic, actively discouraging healthcare seeking through the threat of immigration enforcement. Of around 618 000 people living in the UK but without the documentation to prove a regular immigration status, it is estimated that 144 000 are children,1 half having been born here. The legislation over charging introduced by the government under the spurious pretext of targeting ‘health tourism’ represented an unprecedented departure from the founding principles of the NHS and, among other adverse effects, has a negative impact on child health.2

On a global scale, the numbers of people forcibly displaced from their homes because of conflict, persecution, natural disasters and famine reached 68.5 million by the end for 2017 and continues to rise. Children make up over half the world’s refugees and, like other asylum seekers and undocumented migrants, they are exposed to multiple risk factors for poor physical and mental health throughout their migration experience.3 NHS charging regulations undermine the government’s stated commitments to child health, as well as obligations to children under the United Nations Convention on the Rights of the Child (Article 24). This states that …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests JWP is cochair of ‘Keep Our NHS Public’.

  • Provenance and peer review Not commissioned; externally peer reviewed.