Healthcare arrangements for children on the move and migrants

In early 2019, we asked frontline professionals their views and experiences of NHS charging for children and pregnant women. The survey forms work we are undertaking to further understand the impacts of the charging regulations and wider migration policy changes in practice, and the results will contribute to evidence submitted by RCPCH to the Department of Health and Social Care, which will be presented at RCPCH Conference and exhibition.


In 2018 a coalition of UK Royal Colleges called for the suspension of NHS charges and associated regulations until a full independent impact assessment has been completed1 . An estimated 120,000 children are undocumented in the UK, with 60,000 of those born here, many of whom may have restricted access to secondary care under current regulations2 .

RCPCH has been alerted to several cases of children's care being affected and intends to collate comprehensive evidence on health workers' understanding and experiences of this to inform ongoing action in this area. This is informed by reports that the charging regulations have also affected groups of patients, who are currently eligible for NHS care, including refugees and asylum seekers (who are exempt from charging)3 4 5 .

Our aim

We are seeking to understand the impacts on the wider population, as well as those children and families deemed ineligible for healthcare under the new regulations. We are also collecting evidence on the impacts of wider immigration policies and services that influence the wider determinants of children's health6 .

We need evidence-based policies for a world with increasing numbers of children on the move7 . RCPCH hopes to follow other countries in Europe and beyond that have collected extensive evidence and testimony of the impact of charging and associated regulations, subsequently leading to policy change8 9 .

Results of our survey will be submitted to the Department of Health and Social Care as evidence. They will also be presented at RCPCH Conference and exhibition, during the Child Protection Special Interest Group and Child Protection Standing Committee Symposium on Monday 13 May 2019. Book your place at conference.

  • 1U.K.GOV., 2014. Immigration Act 2014.
  • 2Sigona, N., Hughes, V. 2012. No Way In, No Way Out: Irregular migrant children and families in the UK. P.a.S. Compas: Centre on Migration, Editor. University of Oxford.
  • 3Mahase, E. 2018. Quarter of migrant patients are wrongly refused GP access, study claims. Pulse Magazine.
  • 4Doctors of the World. 2017. Deterrence, delay and distress: the impact of charging in NHS hospitals on migrants in vulnerable circumstances.
  • 5Knight, M., Kurinczuk, JJ., Spark, P., et al. 2009. Inequalities in maternal health: national cohort study of ethnic variation in severe maternal morbidities. BMJ 2009; 338:b542.
  • 6Dexter, Z. Capron, L., Gregg, L. 2016. Making Life Impossible: How the needs of destitute migrant children are going unmet, The Children's Society, Editor.
  • 7International Organisation for Migration. 2015. Migration Trends Factsheet.
  • 8Hjern, A., Østergaard, L.S., Norredam, M., de Luna, C.M.M. & Goldfeld, S. 2017. Health policies for migrant children in Europe and Australia. The Lancet, 389(10066),249.
  • 9Legido-Quigley, H., Pajin, L., Fanjul, G., Urdaneta, E., Mckee, M. 2018. Spain shows that a humane response to migrant health is possible in Europe. The Lancet Public Health 2018, 3(8), p.358.