Illegal immigrants are "too frightened" to access healthcare because of a data-sharing agreement between the NHS and the Home Office to track, MPs have heard.
One domestic worker died because she was too afraid to see a doctor out of fear that her immigration status would be shared with the Home Office, evidence presented to the Health Committee stated.
Immigrants are being “driven underground” by the legislation, MPs heard at a session which explored the impact of a Memorandum of Understanding (MoU) published last January, setting out how patient data may be provided to the Home Office by the NHS.
The coordinator for charity Voices of Domestic Worker, Marissa Begonia, told the committee most of the women she works with choose not to access the NHS when they have medical problems.
She told of one case in which a domestic worker died as a result after contracting pneumonia.
“I’m very worried at the current situation and what is being proposed at the moment, because encouraging the domestic workers I support to get healthcare is really very difficult, even for those who already have very serious diseases like cancer," she said.
“We have cases of death. We have one member who died because she had pneumonia but never sought any hospital or GP help because she was too frightened. She came from abusive employment, where her employer poured hot water on her.
“She never reported this because she was too frightened to come forward to authorities. So she survived all that, but what killed her was her fear of accessing healthcare.”
The MoU, published last January, gives the Home Office access to confidential patient information to aid immigration enforcement. It caused some anger after it was published without consultation with NHS staff, medical organisations or the public.
The Department of Health reported that the Home Office made 8,127 requests for data in the first 11 months of 2016, which led to 5,854 people being traced by immigration enforcement teams.
But figures show that less than 3 per cent of these led to a change of action by the Home Office.
Campaign groups have argued the data-sharing arrangement violates patient's’ right to privacy under the Human Rights Act and that it cannot pass the considerable public interest test required to breach the doctor-patient relationship.
The Home Office is currently facing a legal challenge led by human rights group Liberty about that very issue.
Doctors of the World, which runs clinics for undocumented migrants, victims of trafficking and asylum seekers, has also publicly condemned the data-sharing legislation, urging that it requires them to act as “border guards” for the Home Office’s immigration enforcement.
Giving evidence to the Health Committee, Dr Lucinda Hiam, one of its general practitioners, said: “In our clinic we often see people in exploitative situation where the GP is only place they might be able to go to speak with someone safely and securely. It’s turning that GP practice into a place that can also appear very dangerous for that person.”
She said an Eritrean woman who had been kept as a slave and subjected to sexual violence for seven years in the UK had not felt able to go to her GP.
Citing evidence reported by The Independent last year which showed that a third of vulnerable migrants requiring medical treatment, such as those who are pregnant or seriously ill, had been deterred from seeking timely healthcare over concerns their information would be shared with the Home Office, she added that the MoU was “damaging public trust” in the NHS.
"Confidentially is the cornerstone of the doctor/patient relationship," she said. "With that broken, I don’t think you can continue to have such a good relationship. I don’t think it has considered enough the damages to public trust it has done.”
Yusef Azad, director of strategy at National AIDS Trust, told the Committee the data-sharing requirement put GPs in a” very difficult position”.
He said: “Patients believe doctors will look after their data and keep it confidential. Few people would argue that in cases of rape murder of manslaughter it wouldn’t be right to pass the information on, but as soon as you apply it to immigration offences you get different points of view and you lose the trust in the NHS – it’s a very dangerous direction of travel."
He added: “If you want to look at practical immigration enforcement, I would say this isn’t great."
Dr Joanne Bailey, member of the advisory panel for the National Data Guardian, said: “It’s vital that patients feel they can trust and that the information held by doctors is held in confidence and only shared with a high threshold. Traditionally, the threshold has been high. The key concern is the implications of this policy for public trust are far reaching. There are obvious consequences for undocumented migrants and also for the wider health of this country."
She added: “All the public guidance makes it clear that all data held by doctors and the health service is held with duty of confidence and that informs public expectations. It’s longstanding that it is confidential data. The weighting is not being balanced correctly between the immigration control and trust in the public health service.”
When the evidence was put to Lord O’Shaughnessy, Parliamentary Under Secretary of State for Health (Lords), Department of Health, he said: “What we have established are a set of processes in governance – and don’t forget this information has been shared for decades – it just now has proper governance.
“The role of the Department is to make sure the health system is operating in a way that is legal and proportionate […] We are a receiver of a request as the health system, and we have to comply with the law.”
Lord O’Shaughnessy said a review was being carried out into the impact of data-sharing on patients, saying: “We do want to get to the bottom of what impact – if any – data sharing has on health seeking behaviours.
“NHS England is currently carrying this out. We don’t currently have statistics evidence on this. We have to work on a strong evidence base.”
Hugh Ind, director general of Immigration Enforcement for the Home Office, told the Committee obtaining people’s addresses was “very valuable” to the Department for assisting them with “locating someone and re-establishing contact”.
He added: “We do not wish to deter anyone seeking healthcare where necessary but we also have a public duty to know where as many people are as possible."