No surveillance in healthcare: NSUN’s response to proposed data sharing between NHSE & the Home Office

Photograph showing a nurse holding a tablet
By Kieran Lewis, NSUN’s Rights and Migration Policy Officer

Recent reports that the Home Office is attempting to access migrants’ personal data from the NHS should come as no surprise – turning medical professionals into border guards has long been a goal of the UK’s ‘hostile environment’. The proposal in question, as reported by the Guardian, would see a Home Office reference number added to the medical records of migrants by NHS England (NHSE). This would allow immigration enforcement to access the information contained in these records, expanding the already extensive system of surveillance to which many non-British citizens are subjected. 

The constant monitoring and calculated criminalisation of migration has well-documented consequences for the physical and mental health of migrants, particularly in cases where people are fleeing persecution.

A legal challenge brought against the Home Office by Migrants Rights Network and Liberty in 2018 ended a pre-existing agreement by which non-clinical data from NHS Digital and the Department of Health could be accessed for the purpose of immigration enforcement. The discontinued agreement clearly violated patients’ right to privacy under the Human Rights Act, and this new agreement is no different. 

Much like previous attempts to break down ‘firewalls’ between the Home Office and statutory services, the proposed change would undoubtedly deter migrants from accessing the basic and often lifesaving care to which everyone in the UK is theoretically entitled, regardless of immigration status, due to the fear of being deported as a result. The prevalence of barriers to mental health care access for minoritised communities is already a critical issue, and is all the more concerning given that 61% of sanctuary seekers in the UK experience serious mental distress. 

The Guardian’s report suggests that the Home Office may seek to allay fears about the proposed reference numbers by claiming that they would only be used to charge non-British citizens for secondary care. However, we must also remember that the NHS charging system is, itself, a tool of the hostile environment. Relentlessly pursuing individuals – who have often been made destitute by the immigration system – for vast amounts of money for having accessed lifesaving care is not a question of justice or cost effectiveness. It further stigmatises and disadvantages those in the most precarious situations and deters others from seeking help.

Migrants in the UK are already caught in the complex web of regulations and practices that make up the hostile environment, which seeks to prevent them from accessing information and services that might give them a chance of living a dignified life. This includes services to which they are entitled. Sanctuary seekers face years of limbo while their applications are processed, many visas automatically exclude their holders from accessing public funds and other non-citizens are subjected to GPS surveillance by private corporations at the Home Office’s behest. 

Any proposal to facilitate information sharing between the NHS and the Home Office is designed to ensure the border remains present in the everyday lives of migrants, even during a visit to the doctor. 

The proposed introduction of tracking numbers on migrant patients’ medical records cannot be understood in isolation. It is part of a growing trend towards surveillance which threatens the rights of citizens and non-citizens alike. From recent calls to increase the use of facial recognition technology in UK policing to the troubling rise of video surveillance technology in inpatient mental health facilities, these changes target the most marginalised. 

We must recognise these developments as different parts of the same state strategy that scapegoats marginalised groups and keeps them precarious, fearful, and unable to access services they are entitled to.