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Refused Asylum Seekers and NHS Debt

Asylum seekers who have travelled to the UK have often spent many months without access to decent food, medicine, and healthcare. Often, female asylum seekers are pregnant and/or nursing young children.

Healthcare availability to asylum seekers is not widely discussed. And what about those who have had their application for asylum rejected? If the NHS treats them, a debt incurs, which can affect their ability to seek out another immigration route to remain in the country.

People who have fled their home country seeking asylum in the UK are often not fluent in English and have little knowledge of the culture and healthcare structure. For example, who do you call if you feel unwell? Do you need to be registered with a GP, and if so, how can you register if you are waiting for your asylum application (which can take months, sometimes years) to be decided upon?

Last year it was revealed that the NHS was using private debt collecting firms to chase treatment costs from overseas patients and refused asylum seekers.

One doctor of the World patient was a refused asylum seeker from Guinea who couldn’t be deported as Guinean authorities refused to accept him.

A month later a bailiff turned up at the friend’s house he was staying at, demanding £3,900 relating to the treatment he had had a year earlier at London’s Royal Free hospital.

He told Doctors of the World at the time:

“I have explained over and over again that I am an asylum seeker, not working, with no income and no support from the state. I just live on handouts from friends, living from day today.

“This unexpected visit at the address to collect the money makes me feel very uncomfortable. Not only I do not have the money but also I cannot cope with the unbearable stress of being chased up at the house.”

Some of the most distressing cases of refused asylum seekers being hounded for debt involve vulnerable pregnant women. Some women have been harassed by phone calls from debt firms for the costs of maternity care. The charity Maternity Action told The Guardian.

Carla Montemayor, its spokeswoman, said:

“We’re talking here about women who’ve just given birth, or in one case just had a miscarriage, so they were already traumatised, and then they received these phone calls making threats.

“It’s repeated phone calls pressuring them to pay. And for those whose immigration status is insecure; it brings up the possibility of deportation … Because it’s the policy of NHS trusts that any debts coming above £500, unpaid within two months, will be reported to the Home Office.”

This is undoubtedly a frightening situation for an asylum seeker or refused asylum seeker. Although anyone in England, regardless of nationality or immigration status is entitled to register with a GP and to receive NHS services provided by the GP free of charge, only the following types of care are free of charge to refused asylum seekers:

  • Accident and emergency (A&E) services up until the point that you are admitted as an inpatient (outpatient services are chargeable).
  • Family planning services (except pregnancy terminations)
  • Diagnosis and treatment of certain contagious diseases e.g. TB or HIV
  • Diagnosis and treatment of sexually transmitted infections
  • Treatment of any physical or mental condition caused by torture, female genital mutilation (FGM), domestic violence or sexual violence (as long as you did not travel to the UK for the purpose of seeking that treatment).

Maternity care is available at no cost to asylum seekers or refused asylum seekers in some circumstances, including, but not limited to those who:

  • have claimed asylum, humanitarian protection or temporary protection or article 3 protection and are waiting for a decision on your claim or appeal,
  • have been refused asylum or article 3 protection and have made an in-time appeal and are awaiting the outcome.
  • are receiving asylum support under Section 95 of the Immigration and Asylum Act 1999,
  • have been granted refugee status, or humanitarian protection or article 3 protection or temporary protection,
  • are being held at an immigration detention facility

If you are refused asylum and your appeal/judicial review is unsuccessful, you will need to pay for maternity care and/or all other types of healthcare not listed as free of charge above.

Can I be refused leave to remain if I have an outstanding NHS debt?

Paragraph 320 (22) of Part 9 of the Immigration Rules says that an application for entry clearance should normally be refused:

“where one or more relevant NHS body has notified the Secretary of State that the person seeking entry or leave to enter has failed to pay a charge or charges with a total value of at least £500 in accordance with the relevant NHS regulations on charges to overseas visitors”.

The use of the wording “normally” means that the Home Office has the discretion to grant leave to remain where “there are compelling or compassionate circumstances or human rights considerations that would make refusal inappropriate because discretion should be exercised in the person’s favour.”

What should I do if I am a refused asylum seeker and have an NHS debt?

The most crucial step to take if you wish to apply for leave to remain is to talk to experienced immigration lawyers. There are many factors they will consider when examining the best route to take to secure leave to remain for you, despite your NHS debt. These include (but are not limited to):

  • The date of the treatment you received.
  • The nature of the treatment.
  • The total amount of debt.
  • Whether any human rights factors should be considered by the Home Office.

Even if the NHS debt has been paid, you may be refused leave to remain. The policy document states:

“You must consider whether the applicant has sufficient funds to support themselves in the UK, given that they previously had an outstanding healthcare debt. You must also consider whether they intend to access further NHS treatment without paying, unless such access is permitted on the route under which they are applying.”

Such a decision, if challenged, has a high chance of success. However, it is vital to instruct experienced immigration solicitors to ensure you have the best advice and representation possible.

Related Articles:

Temporary changes to Asylum and Immigration process

Illegal Immigrant becoming legal in the UK

Some of our Happy Clients

Reiss Edwards Awards

ACQ5 Awards Award
Lexis Nexis
Three Best Rated
Department For International Development
University Of Cambridge
ACQ5 Awards Award ACQ5 Awards Award
Lexis Nexis Lexis Nexis
Three Best Rated Three Best Rated
Department For International Development Department For International Development
University Of Cambridge University Of Cambridge

O.L

Andy Tieu is absolutely amazing.

As a lawyer myself I can categorically say that he knows his stuff, gentle, responsive, cares about you and not just about the money, very professional.
I mean I can go on and on!

Andy and the entire team at Reiss Edwards are amazing!

Thanks again Andy.

Kiran Sardar


I found Joe very helpful and tremendous patience which is a must in this professional as there are lots of emotions always involved in each and every case.

The way they dealt with my case during COVID19 Situation is highly appreciable. I would definitely recommend Joe D. and Anna F. Anna is an amazing lady, her patience is beyond my words.

Her hard work and professionalism have no boundaries. She is the right person for all type of cases.

Thanks to Anna and Joe for all your support and guidance which helped me fulfill my dream.

I would say Reiss Edwards is lucky to have Joe D. and Anna F. Great job Reiss Edwards.

thanks once again. Anna you’re a Gem and a Star.

Cheyam Shaked

"Anna Foley was the lawyer helping my partner obtain an EEA EFM visa. She was outstanding. Handling the case with constant correspondence over a lengthy, lockdown delayed 7-month application process. Her expert advice guided us successfully through some difficult times as a result of COVID-19. Some of the best service I have received for any service ever! Often replying to emails late at night, offering to send additional correspondence to the home office and going above and beyond in handling our case! Well done and thank you Reiss Edwards and thank you Anna!!".

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"Reiss Edwards did a great job, and so much work, for their reasonable fixed fee. I would heartily recommend them to anyone looking to secure a Visa and /or Visa renewal. I will use them again when mine needs to renew. Great value".

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"The help, the professionalism, the kindness from this team is phenomenal. A massive thank you to Anna Foley.

I have had a really tough time with getting my husband’s visa. My last immigration lawyer made many mistakes that caused stress, disappointments and sadness.

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What I received was: constant emails and calls updating me and asking if anything else is needed. If I called and they missed my phone call I would get a call back within 10 minutes. All of my documents were carefully checked and I would get a reply the next day if anything was missing or not correct. There were times that I was impatient and asked to just send the visa off, but was reminded that everything had to be perfect and correct before submitting the application. I was told about every option I had and discussed what the best would be. I was always spoke in a nice, calm, polite manner.

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"The team of lawyers at Reiss Edwards are very professional and friendly people. Their experience in and around UK immigration law is quite extensive; be sure that you application is in safe and competent hands. My immigration matter was an indefinite leave to remain application based on Tier 1 on a self-employment basis. The immigration lawyers at Reiss Edwards made sure that the application was perfect and ready to be accepted. I got a positive decision and I recommend them highly for anyone who needs a UK immigration help".

Reiss Edwards Reviews

O.L

"Andy Tieu is absolutely amazing, as a lawyer myself I can categorically say tha...

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"Anna Foley was the lawyer helping my partner obtain an EEA EFM visa. She was ou...

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"Professional service. I was very impressed with the fact that my ILR applicatio...

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"Reiss Edwards did a great job, and so much work, for their reasonable fixed fee...

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"Investing over 2 million pounds is defintely not a routine decision. We had to ...

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