Seeking medical justice

With reference to Heath,¹ existing secondary care restrictions have already contributed to avoidable deaths among failed asylum seekers.^{1 2} There is no evidence that they have saved money, except perhaps by deterring people who are still entitled to care from seeking it. Removing the right of general practitioners to register failed asylum seekers will extend the damage to individual and public health and the ethos of our profession. These steps will not produce economies or make these patients “go home,” even though government openly intends to use denial of care to coerce their involuntary departure. They will require doctors to act as immigration police.

If the state forbids us to investigate, treat, and refer certain patients on public funds, we can still examine, document, and advise about their medical conditions. We can also inform ministers and the public of the consequences of these policies. That is the commitment made by over 600 doctors who have signed a petition, Medical Justice for Undocumented Migrants.³ The petition is still open to signatures, and a form letter to document and publicise the consequence of denial of care⁴ is available online.

Our actions are completely lawful but are unlikely to find favour with our masters. They may also lead to retribution (see competing interests). Many of us believe that the BMA (and the General Medical Council and royal colleges) have an obligation to offer practical guidance and protection to doctors who put their duties to patients ahead of government blandishments, and that these bodies have not yet fulfilled it. It would also help if the BMJ could—as a service to evidence based policy making—accept, collate, and publish analyses of the consequences of these immodest and thoughtless policies.