Covid-19 Inquiry Module 4 Update

'The British Government ignored public health warnings and undermined the pandemic response'

Our witness Anna Miller from Doctors of the world testified this month that the Govt ignored advice to defend Public Health instead prioritising anti-migrant policies. NHS charges remained for non-residents and a failure to firewall data-sharing with the Home Office deepened the hostile environment for access to vaccines and life-saving treatment. 

https://twitter.com/DOTW_UK/status/1882808299289985487

For Module 4 of the Covid-19 Public Inquiry, PILC are representing a collective of migrant rights groups organising under the ‘Migrant Primary Care Access Group’ (MPAG). MPAG is made up of the Joint Council for the Welfare of Immigrants (JCWI), Kanlungan Filipino Consortium, Medact and Doctors of the World (DOTUK).

Throughout the pandemic, MPAG member organisations provided essential provisions to migrant communities in Britain. With their combined expertise, they have shown how Government policies and actions intentionally and disproportionately affected migrant communities in accessing the Covid-19 vaccine and other life-saving treatment during the pandemic. The Government ignored expert advice and warnings, and undermined Public Health as a whole. 

Sonali Naik KC, in her opening submissions, stated that the Government’s ‘failure to address extant and persistent barriers that exclude certain segments of society based on their migration status not only exacerbates inequalities but also undermines the health and safety of the entire population.’ 

Migrant communities, who are more likely to die from infectious disease, and have a lower general vaccine uptake compared with the wider community, are also considered an ‘Inclusion Health Group’ which is characterised by multiple risk factors. The evidence submitted to the Inquiry shows the Government failed to address, design, and deliver effective strategies to ensure equitable access to vaccines for migrants.  

Home Office and Department of Health and Social Care (DHSC) policies, alongside the Government’s ongoing Hostile Environment agenda all contributed to deterring and preventing migrant communities' access to healthcare – including life-saving health care – throughout the pandemic.  

One of the most significant barriers to access was the NHS charging regime that imposes charges or refuses treatment to non-residents. This policy remained fully operational throughout the pandemic and while introduced by the Home Office in 2014, is under the remit of the DHSC. Public health advice warned that the NHS migrant charging regime increased the risk of influenza and SARs-like virus spreading was repeatedly ignored by ministers. 

Moreover, regulations included that the NHS undertake immigration checks and debt-collection mechanisms with the Home Office which fostered a deep mistrust among some migrant communities in accessing care. As such, there is overwhelming evidence that shows data-sharing between the Home Office and NHS actively contributed to migrants’ fears in accessing health care.  

While some assurances were made that the vaccine would not result in immigration checks, they came too late and did not provide the official safeguard that data would not be shared. At any rate, this could not be guaranteed as the regulations were not revoked and the Government failed to acknowledge or address this as a key reason for low uptake of vaccines among some migrant groups. 

"Healthcare is a basic human right…it is absolutely disgusting that people were forced to play Russian roulette with their health due to the government's hostile environment policy. People died because of these brutal policies, and those responsible must be held to account."  

Yasmin Halima, Executive Director of JCWI

When Professor Sir Chris Whitty gave his evidence, Melissa Kizito one of the PILC legal team at the Inquiry gave the following overview:  

The Inquiry’s counsel, Hugo Keith KC, questioned Professor Sir Chris Whitty about the barriers to uptake of the vaccine during the pandemic.  

Professor Sir Chris Whitty responded acknowledging that the Government in fact “didn’t do well as they should and could have, accepting that those who are cautious about the vaccines is for a variety of reasons and if they were going to listen to the Chief Medical Offer, they would have already.” Against the backdrop of unjust immigration policies, notably the hostile environment policy disproportionately affecting migrant communities, this has undoubtedly tainted the channels of communications between disadvantaged communities and the Government. Thus, making it increasingly difficult for migrants and willingly take up the vaccine without fear of disparate consequences out of their control.  

Fortunately, Professor Sir Chris Whitty accepts that the Government could have put in greater effort to communicate with lower uptake groups but also that the Government needs to accept that “they’re seen as authority by some groups”, therefore, to break down barriers and to understand the concerns of migrant communities, would be to simply acknowledge, address and abolish the existing barriers to accessing the vaccine. 

Furthermore, Professor Sir Chris Whitty posed a pertinent question that, “when there is an emergency [the Government] come to us, but in between [the Government] don’t talk to us, so why should we trust [the Government] now?” This illustrates the lack of sufficient dialogue and communication between the Government and disadvantaged communities, and to avoid this, there ought to be “continuous communication in both directions, learning in both directions, hearing what people are concerned about, and addressing it, or learning from it, which makes this work”.    

Agreeably, he stated that for “future recommendations there ought to be better identification of lower uptake groups, engaging much earlier and repeatedly with local leaders, recognising that lower uptake can be due to deprivation and distrust rather than ethnicity”. 

We will be updating more as the Inquiry Continues - the closing submissions of Module 4 are today.

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MPAG is represented by PILC and Garden Court Chambers.  

Solicitor Ellen Fotheringham and Paralegals Melissa Kizito and Holly Ahom have been working on this Module.