This article was taken from: https://www.theguardian.com/society/2019/sep/09/end-nhs-maternity-charges-for-vulnerable-migrants-say-midwives
By Patrick Greenfield
Destitute women and their babies are ‘put at risk of avoidable harm’ by high fees
Midwives have called on the government to scrap NHS charges that can amount to tens of thousands of pounds for pregnant women who are refugees, migrants or visiting from overseas, amid concerns that “hostile environment” policies are making it hard for health workers to do their jobs.
The safety of vulnerable mothers and newborn babies is being put at risk by NHS fees that deter undocumented migrant women from accessing care, a new report from Maternity Action backed by the Royal College of Midwives (RCM) has warned.
NHS packages for overseas pregnant women start at £7,000 for antenatal, pregnancy and postnatal care, but can rise to thousands of pounds if the mother or child experience complications. Midwives said some women delay accessing help or fail to have scans over fears that they will be charged or detained.
In the first study to investigate the impact on midwives of the policy of charging overseas visitors for NHS care, one midwife said she felt as if she was “working for the Home Office” while another said her job was “becoming about charging”.
The fees particularly harm undocumented migrant women, who already have a heightened risk of maternal death and adverse pregnancy outcomes, according to the report.
“I am not here to enforce immigration rules, I am not here to enforce people’s entitlement, I have a duty of care as a midwife and I need to fulfil that duty of care,” one of a group of 15 midwives interviewed for the study said.
“Part of my duty of care as a midwife is to gain the trust of people who are giving me medical history, who are entrusting me to guide them through the booking process which is the first step they are taking in pregnancy care. I need them to trust me and to trust the service.”
Maternity Action and the RCM have called on the government to immediately suspend charges for NHS maternity care and also to stop debt built up from such services from affecting immigration applications.
Rosalind Bragg, the director of Maternity Action, told the Guardian: “NHS midwives provide brilliant care to the destitute women they see, but the policies of charging for maternity care make it hard for them to do effectively. The charges put them at risk of avoidable harm.
“Antenatal care is intended to identify the conditions that arise in pregnancy, so women can receive appropriate care. If they don’t receive proper care, they can encounter problems from high blood pressure to HIV to infections, which can result in premature births.”
Gill Walton, the chief executive of the RCM, said her organisation “is committed to supporting our members to deliver safe high-quality care, and cost recovery is a barrier to this.
“We believe that maternity care should be exempt from NHS charging altogether to protect and promote maternal and newborn health.
“The recommendations from this report, if implemented, will absolutely improve the situation for vulnerable migrant women and the midwives who care for them, and begin to right the wrongs of cost recovery.”
A Department of Health and Social Care spokesman said: “We take the provision of maternity services very seriously – and we will never refuse maternity care, regardless of whether someone can pay.
“Every taxpayer supports the health service and so it is only right that overseas visitors contribute towards their treatment costs, but exemptions are in place to protect vulnerable people who receive care free of charge.
“We want clinicians to be able to concentrate on delivering the best healthcare and midwives and doctors are not responsible for checking if a patient is eligible for free care or for recovering those costs.”