The Home Office told the NHS to retrospectively issue an incorrect bill for medical treatment, and then refused a woman a visa to the UK for failing to pay an invoice that she never received, her lawyer has said.
John Vassiliou, an immigration specialist with McGill & Co, based in Edinburgh, told BuzzFeed News that his client, a Turkish woman with a British spouse, had her spouse entry clearance visa application refused after Home Office Counter Fraud Services asked the NHS to issue a bill for treatment that she was entitled to receive for free.
The woman, who wishes to remain anonymous, had given birth to her second child while visiting the UK. The couple's two children are both British citizens.
Vassiliou had been helping the couple with the application and received a call from his client, who was overseas at the time, saying that her application had been refused.
His client sent him a scan of the letter they had received, which said that an NHS Lothian bill of almost £8,000 was outstanding for the treatment she received while giving birth to their son.
"Confirmation with the relevant authorities show that £7838.00 remains outstanding with the NHS Lothian," the letter said. "I am therefore satisfied that you have failed to pay charges in accordance with the relevant NHS regulations on charges to overseas visitors and your application is refused."
Vassiliou, describing the situation on the Free Movement blog, said that his client had never received a bill and was never offered the option of paying the charges, and that the NHS invoice was issued a day after the refusal letter was sent.
Under immigration rules, a visa can be refused "if one or more relevant NHS bodies has notified the Secretary of State that the applicant has failed to pay charges."
However, Vassiliou said that he had seen a letter from NHS Lothian which said that they had been contacted by Home Office Counter Fraud Services, who had asked NHS Lothian to issue the bill after the woman declared legitimate medical treatment that she had received in Scotland two years previously on her visa application.
While his client would have been liable to pay for her treatment in England and Wales, Vassiliou said, the NHS had been correct in not issuing a bill in the first place, as under Scottish rules the spouse or child of a person who has resided in the UK for at least one year prior to treatment is not liable for any charge.
The Home Office later backed down and granted the visa after her spouse proved his residency, but only after the couple had been forced to spend a considerable amount of money on legal and tribunal fees.
"It’s hard to say what aspect of the decision-making was most shocking," Vassiliou told BuzzFeed News. "The fact that they raised the bill after the application had been made without giving the applicant the opportunity to answer that or to pay –they went straight to refusing it.
"The bill was quite rightly never raised by the NHS at the time my client gave birth to her British child, but the Home Office official thought that they knew better than the NHS administrator that made the decision not to raise the bill in the first place.
"The bill was raised one day after the decision was made to refuse the case, which was also very frustrating because the language used by the decision-maker suggested that my client had failed to pay a bill that had been outstanding for some time.
"Our only remedy was lodging written grounds of appeal to the immigration tribunal, which came to quite a considerable cost to my clients, above and beyond their visa application fees. They had to pay me for my time, and they had to pay the tribunal fee, just to remedy a fundamentally unjust decision.
"This combination of procedural unfairness and an unlawfully raised bill, culminating in refusal of an application that had been awaiting a decision for around half a year, was infuriating for both myself and my clients."
A Home Office spokesperson said: "We do not routinely comment on individual cases.”
They would not confirm whether it is standard practice for the Home Office to ask the NHS to issue retrospective bills once visa applications have been submitted.
CORRECTION
Vassiliou said he had seen a letter from NHS Lothian which said they had been contacted by Home Office Counter Fraud Services (HO CFS). A previous version of this post said he claimed to have seen a letter sent by HO CFS to NHS Lothian.