The public discourse on migrant access to healthcare in the UK has significantly hardened over the last four years, with questions about the ethics and economics of NHS delivery to migrant communities becoming more high profile.  This debate has resulted in a number of significant proposals to curb their access to free healthcare, to strengthen charging mechanisms and to enforce more robustly existing schemes to recoup costs.

This Doctors of the World report ‘Do no Harm – Ensuring fair use of the NHS efficiently and effectively’, researched and written by Demos, aims to establish an evidence-based pragmatic set of arguments and interventions that enable politicians, policy-makers and campaigners from across the political spectrum to make the case for access to healthcare.  It does not attack the ethical impulse to promote a contributory view of health services. Instead, it seeks to set these arguments within the frame of public health and pragmatism – asking what can be done to improve charging that will be practical, not threaten public health and genuinely save taxpayers money.

The research looks to tie the question of access to healthcare for migrants into the wider frame of problems accessing healthcare as experienced by the population at large. In particular – the report asks if there are ways of reforming the wider primary and secondary care bureaucracy to make means-tested charging of visitors to Britain easier and less burdensome while also improving access for the resident population.