Eligibility of non-residents for NHS treatment

Editor—We share the concerns expressed by Williams about the eligibility of failed asylum seekers to full NHS treatment.¹ In 2002, only 10% of 25 000 children who applied for asylum in the United Kingdom were granted the right to stay.² In our experience, these children often have unmet medical and social needs that may not necessarily be immediately life threatening but have profound long term implications.

We reviewed the children from asylum seeking families referred to a community pediatrician in the central area of Liverpool over a year.³ Children were referred with health problems including cerebral palsy (four), autism (three), behavioural difficulties (two), spina bifida, epilepsy, developmental delay, Down's syndrome, and growth failure. These medical problems had been previously undiagnosed in six children. Most needed further investigations and referrals. A further nine children were referred with social concerns, of whom two were moved to a place of safety and one was placed on the child protection register.

This cohort gives a flavour of the healthcare needs of these children. Continuing care is difficult due to rehousing, deportation, and communication failures. It would be unethical to deny basic medical care to these children irrespective of their asylum status. The UN Convention on the Rights of the Child reminds us that the actions or inactions of governments affect children more strongly than any other group in society.⁴ The amendments to the NHS (charges to overseas visitors) regulation would be detrimental to the long term health of these already vulnerable children.⁵