A British woman who received a letter stating that she'd failed to provide proof of UK residency at a routine hospital appointment believes she was singled out because of her Polish surname.
Emma Szewczak-Harris, who was born and raised in the UK, was told in a letter from Cambridge University Hospital Trust last week that she had failed to provide the necessary identification when attending a recent antenatal appointment at Addenbrooke's hospital.
Patients who are not from the UK are required to pay for certain NHS treatments, and hospitals will ask patients to declare their immigration status in order to determine eligibility for free care.
A policy of asking maternity patients for two forms of ID has been piloted in several NHS trusts, including Cambridge University Hospital Trust, since August.
But there is concern among doctors and campaigners that these checks are not being carried out for every patient, leading to some people being profiled on the basis of their presumed ethnicity.
The NHS sent me a threatening letter questioning my residency. Polish surname? I'm 8 months pregnant… https://t.co/GnFHDgzmGP
The letter asked Szewczak-Harris to provide proof of identity from a list of documents including a passport or residence permit by 30 October.
She told BuzzFeed News she found the letter "terrifying" as she has never previously been asked to provide ID when using the NHS, including during the first eight months of her pregnancy.
"I’m very accident-prone," she said. "I’ve been to A&E loads over the last couple of years, and I’ve been having more appointments recently because I’m pregnant, and I was never asked anything. This came out of the blue, and it feels like it’s because of my surname."
Szewczak-Harris said she began using her Polish husband's surname alongside her own around a year ago. She believes it is only after hospital staff saw her surname following the appointment that the letter was issued.
"I find it interesting that nothing was ever asked of me in person," Szewczak-Harris said. "I am very obviously British – I look it, I sound it, and so does my husband."
A spokesperson for Cambridge University Hospital Trust said Addenbrooke's had issued the letter as part of a Department of Health pilot scheme to better monitor and collect payment from overseas patients who are not eligible for free NHS treatment.
“From 01 August 2017, all non-emergency patients in maternity and urology have been asked in their appointment letters to provide two forms of identification when they attend – one to prove identity and one as proof of residence," the spokesperson said. "Once you have provided this information you will not be asked again."
They added: "The letters are sent to all non-emergency patients in maternity and urology. There is no discrimination at all."
Szewczak-Harris said that during her pregnancy she has never received any letters requesting proof of residency, nor did any of her appointment letters ask that she provide ID.
While Szewczak-Harris is able to prove that she is entitled to free NHS care, she said she found the letter distressing, and worried about the wider impact ID checks might have.
"Personally, because I was born in Britain and I live here, I know I have a right to that treatment, but it’s still very frightening because I’m giving birth in the next month," she said. "What if I don’t have my passport, are they going to turn me away?"
Non-emergency maternity care has been the focus of a pilot scheme for checking ID at several hospital trusts, but urgent maternity care is among the Department of Health's list of exemptions for overseas patient charges, meaning that a woman in labour would be admitted to hospital regardless of her immigration status.
"The whole point of focusing on maternity is that it provides plenty of opportunities for patient contact and therefore for the patient to provide the required information prior to the birth," the Cambridge University Hospitals Trust spokesperson said.
But doctors and campaigners worry that many will not be clear on the details of the policy.
Demo at St Thomas' hospital protesting new NHS charges for non-Brit citizens and passport checks in hospitals… https://t.co/ZozMMPpBLI
"I just can’t even imagine what women who maybe weren’t born in Britain are feeling right now," Szewczak-Harris added. "Maybe this will deter women who don’t have residency status, which is very frightening."
The spokesperson for Cambridge University Hospitals Trust sought to reassure patients who are not eligible for free NHS care and would need to be charged for treatment.
"We will not turn away any non-eligible patients or delay their treatment, but we will clearly communicate the Department of Health regulations and agree plans for payment,” they said.
From 23 October, all hospitals will be legally obliged to recover costs for non-urgent treatment for patients who are not eligible for free NHS care prior to it being administered.
Doctors will be required to withhold care "if it’s deemed by the trust’s clinical staff that this routine aspect of their care can wait until they return to their home country," according to guidelines, while urgent care will be administered and charged for later.
"If they are not entitled to free NHS care they will be charged and expected to pay for that treatment. This applies to all aspects of the maternity care pathway, including ante-natal appointments, the birth itself and any post-natal care," the spokesperson added.
Sarah, an NHS midwife who preferred not to give her last name, is a member of the group Docs Not Cops, which campaigns against ID checks in the NHS. She told BuzzFeed News she believed that only certain patients were being singled out to prove their eligibility for care.
"The introduction of immigration checks has made racial profiling an NHS policy and already we are seeing an alarming number of people singled out and threatened by the institutions that are supposed to be caring for them," she said.
Sarah said the policy meant vulnerable people were already being deterred from accessing maternity services.
She added: "Healthcare should be provided on a basis of need, not on ability to pay or to provide identity documents, and it's devastating that NHS trusts don't have the courage to stand up for their patients and say no to the introduction of immigration checks and upfront charging."
The Department of Health declined to comment and referred BuzzFeed News to the statement from Cambridge University Hospital Trust.