Interview

Covid-19 Interview Series: Minnie Rahman (JCWI)

NHS-Home Office data sharing has put migrants at risk.
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Interview

Covid-19 Interview Series: Minnie Rahman (JCWI)

NHS-Home Office data sharing has put migrants at risk.

Executive Summary

Covid-19 is an unprecedented public health emergency and economic crisis. To contribute to the public conversation, Common Wealth is running an interview series with leading academics, activist and campaigners to explore the coronavirus conjuncture: what it has exposed, its effects, and what might come next.

The Joint Council for the Welfare of Immigrants (JCWI) is a national charity that works on legal, political campaigning and grassroots organising around the rights of migrants in the UK. They offer legal advice and carry out large-scale legal challenges against discrimination and the hostile environment, a set of policies put forward by the Home Office aimed at creating unfavorable conditions for people without leave to remain in the UK. They’ve been working with migrants and the families of migrants to provide advice and support during the Covid-19 pandemic. Common Wealth spoke with Minnie Rahman, JCWI’s public affairs and campaigns manager, to discuss the group’s work and the implications that Covid-19 had for migrant organising.

Full Text

The Hostile Environment

[.green]Josh Gabert-Doyon:[.green] How has the hostile environment policy worsened the crisis for migrants living in the UK?

[.green]Minnie Rahman:[.green] I think it worsened the crisis in a number of ways. The purpose of the hostile environment is to deny people access to basic services if they don't have the right documentation. What that means is that there are already people in the country who don't have access to safe housing, are not allowed to work, don't have recourse to public funds and are also not eligible for free healthcare. What that means in a crisis is that you have numerous people who are already on the back foot in a crisis situation where they are extremely vulnerable and need to be able to rely on government support in order to survive. And they don't have those basic provisions in place.  

There are migrants who are forced to continue to work unsafely because they can't provide for their families. Or they're not coming forward to access healthcare when they really should be, or they're coming forward at a very late stage. We're also seeing a lot of migrants who are working, who are here on insecure contracts, who are also feeling like they have to go to work and make a choice between their income or their health, which is also bad for public health as a whole.

There are also numerous migrants in the country whose visa conditions are being affected by the crisis. Because either they've lost their jobs and their visas are no longer reliable and they will have to transfer to another visa, so their status has become insecure, or they have been forced to become undocumented because they can't leave the country. Many face general uncertainty about what their situation is. Of course, you have the additional problem with asylum seekers who are in government accommodation, which has been found numerous times to be unsafe, overcrowded, and bad for public health.  

There are quite a few different aspects to how migrants are experiencing Coronavirus, but the thing we're concerned about above all is not being able to access public services during a crisis.

Data Sharing

[.green]JGD:[.green] What sort of barriers do migrants face when it comes to accessing healthcare?

[.green]MR:[.green] It's slightly complicated and it isn't helped by the government purposefully conflating enforcement with healthcare. You have something called NHS charging, and then you have data sharing between the NHS and the home office. What that means is if you are not eligible for healthcare, it's secondary healthcare you're not eligible for. You can come forward to a GP, you can come forward to access healthcare. But if they determine you're eligible for charging – if you're treatment is not lifesaving and not urgent – then you can be charged up to 150% of the profit.  

On the one hand, you have migrants who are afraid to come forward to see a doctor and access healthcare for fear they'll be charged an extortionate fee. At the same time, you have data sharing with the Home Office, where the Home Office can access your medical records and use that as a reason to deny you status in the future. We've seen that many times. We've seen many cases of people who have come forward, for example for mental health care, and had their records seen by the Home Office, and things they've said in one-on-one interviews with psychiatrists or treatment being used against them as a means to deny them healthcare. That's the main principle of it. But what we've seen happen in previous cases with conditions like tuberculosis, which is also an infectious disease that affects the lungs, is that although the government makes an exemption and says "if you've got tuberculous that's free and you can access it", the very existence of the charging system is a deterrent enough to prevent people from coming forward that they're just so uncertain about what will happen to them. If you come forward with suspected Coronavirus and you're tested and you're found not to have Coronavirus but to have something else, that something else could be eligible for charging.  

Although the government has put this exemption in place and said people can access healthcare for Coronavirus, it isn't clear cut, there hasn't been a big public campaign to let the public know this happens, and they also haven't suspended data sharing. We're also suspecting that in a few months' time that anyone who has come forward, when enforcement starts again properly, they will have their data shared and the government might use that to track them, deny them status, and deport them.

[.green]JGD:[.green] Common Wealth has done some work on publicly-held data, and there's a lot that's been said about NHS data and how it could make healthcare systems more efficient, but there's this question of it becoming privatised and the question of who has control of it, and who has ownership of it. Beyond an end to data sharing between the NHS and the Home Office, what kind of policy would you want to see when it comes to NHS data and the rights of migrants?

[.green]MR:[.green] We believe there should absolutely be a firewall between the Home Office and the NHS. We do not think there should be any correlation between your immigration status and your access to healthcare. The ownership of data is something we've thought a lot about because data sharing exists between all the departments, not just the NHS and the Home Office. It happens a lot with policing. We've had examples of cases where people have reported a crime and been arrested themselves through data sharing, especially victims of domestic violence, as well as survivors of rape and sexual violence.  

For us, there's a bigger question about the digital system and the way it works. At the moment, the problem is that the Home Office has ownership of that data sharing. You have no control over how they access your data or who they share it with. There are forms that people sign with their NHS data, called medical consent forms, they usually sign them very early on after entering the UK. Those documents are not translated, lawyers aren't present, and they have no idea what they're signing away, and then at some point, it comes back to bite them.

Additionally, the memorandums of understanding between the NHS and the Home Office are very secretive and not particularly clear. In terms of a digital system and data sharing, we're not necessarily opposed to faster digitisation when it comes to processing people's cases quicker. What we are concerned about is how the Home Office uses that data, who has ownership of it, and how it's shared. At this point in time, looking at how the system is structured, we would absolutely ask for a firewall between NHS, police and Home Office for immigration status purposes.  

No Recourse to Public Funds

[.green]JGD:[.green] You mentioned another element which has complicated the pandemic response is the "No Recourse to Public Funds" (NRPF) policy, which stops migrants from accessing essential services. How has the government justified this policy during a public health crisis? How have they found the justification for this?

[.green]MR:[.green] It's a really difficult question to answer because for me it doesn't feel like there is a justification for denying people public funds. The government's response has been to make the system slightly easier: they've made the form easier, made tiny edits around the edges of how that process works, without engaging with the fact that you need a lawyer to do [getting recourse to public funds] that and there's no legal aid, and that switching from NRPF conditions to something else changes your route to settlement, essentially starting it again. What they tend to argue with hostile environment policies is that it is suitable to pursue their objectives of immigrant enforcement and their targets. We've seen this with other parts of the hostile environment, for example with the right to rent, which has been proven to cause racial discrimination. What the government argued when we took them to court, and what the Home Office argued when we took them to court, is that they should be legally allowed to cause racial discrimination in order to pursue their immigration objectives. What they would say is that we won't lift NRPF conditions because it would encourage to enter the country in a clandestine thing.

What we would argue is that we have people living in the country who have entered legally and who have entered by other means, who are very vulnerable, underground, at high risk of contracting Coronavirus, and the government has done nothing to support them. And that is actually really bad for public health, and not just for those people affected by the policy.

Enforcement

[.green]JGD:[.green] Has the way that immigration enforcement is carried out changed during the pandemic?

[.green]MR:[.green] We've seen very little evidence of what immigration enforcement is currently doing. We expect they've minimised it to protect immigration officers and to protect public health. There is no social distancing during enforcement. We think that they've minimised it. There's also legislation that was passed to give immigration enforcement powers to help the policing effort, we believe that it may have come about because police forces actually don't have enough capacity to manage Coronavirus alone, rather than them needing to give immigration officers more powers. But the two-year period suggests that they will at some point pass immigration officers back to normal duty. The way the hostile environment works in terms of landlords and employers is that they've tried to make checks digital and online – what they've done is asked landlords and employers to carry out checks online, which suggests they're recording that data and will come back to it at a time when they have capacity to manage it, which is another aspect of digitisation that we don't agree with. Enforcement is a lot lower as well because people are inside, less visible, and it’s harder to manage. We're wary they will pick it up again at full speed at some point.

The Decriminalisation of Work

[.green]JGD:[.green] JCWI has called for a New Deal for Migrants in the wake of Covid-19. I was wondering if you could lay out what that involves and how it would go about transferring wealth and power across our society?

[.green]MR:[.green] The New Deal is split into two main principles: The first is scrapping the hostile environment in all its forms to make sure everyone can have access to public services, in particular, because we believe Coronavirus has shown how the hostile environment makes society unsafe and makes people safe particularly during a health crisis. It is untenable to have numerous people in society who can't access healthcare and basic support. We've also seen them suspend the hostile environment and enforcement in a similar way during other crises. During Grenfell, for example, they had to suspend the hostile environment because they know that people wouldn't come forward because of data sharing and because they wouldn't be able to access services. If every time you have a crisis you need to suspend key policies, it should be apparent to the government that these policies do not work

The second part of the deal is workers’ rights and our valuation of work. We've seen a whole new narrative come forward on workers and who is high skilled and who is low skilled. As the government pursues its point-based system, we think they're going to have to totally reframe that and recognise the skills and contributions of people who are working in this country. And alongside that, we have to recognise who is working right now, and those people are low-payed, potentially undocumented cleaners, delivery drivers, and the very people we ignore the most of the time but are the people who are keeping the country going.

At the moment work is actually criminal if you are an undocumented migrant. It's not only illegal to work and it's illegal to employ someone who doesn't have the right documentation. For us, the decriminalisation of work must be a key part of any new economic recovery. You have 1 million people in the country who are estimated to be undocumented. Those people have no access to public services, no access to public funds so they will be working in some sort of informal economy. The only way to ensure they have rights as workers and are able to unionise and be able to be paid correctly is to decriminalise work.

[.green]JGD:[.green] I wanted to touch on a discussion that's been happening around migrant overrepresentation among key workers. Something that came up during the recent NEON panel you were on was the tension between this idea that migrants are working essential jobs and therefore deserving of rights, and the notion that migrants deserve rights regardless of their role as essential workers. I'm curious about what you think will be the implications of this rhetoric after the pandemic.

[.green]MR:[.green] What's happening at the moment is that we have very narrowly defined what a key worker is – in terms of what the government has defined in their public comms. We're looking at them make heroes out of NHS workers but only NHS workers who provide medical care. So not NHS workers who are cleaners, or people working in the cafes in the NHS, or even in admin. The government has been looking very narrowly at doctors and nurses and ambulance drivers. All of whom deserve more rights, particularly as the system will have often put them in difficult life circumstances, like paying the immigration health surcharge, which is one of the biggest barriers to people getting on a route to settlement, because it's so expensive.

We've seen people calling on things like citizenship for NHS workers, and whilst that's a really important thing, we have to recognise the root causes. First of all, these people may not want to become British citizens, they might want to retain their own citizenship, and they shouldn't have to be British citizens in order to be respected. Secondly, it is the system which has stopped many of them becoming citizens if they wanted it because of their experience with the home office, because of high visa fees, because of the way that jobs and skills work in your immigrant applications. We have to broaden that conversation out to talk about systemic injustice and how that works. And we have to broaden out who is a key worker, because we really don't want to play into this narrative that the government has already set about who is low skilled and who is high skilled. If you look at the points-based system, the people who are keeping us going would have absolutely no route of entry into the UK in two-years' time. We really need to stop that from happening, because we would not have survived with migrant work right now.

[.green]JGD:[.green] Has there been anything about Covid-19 that's changed your approach to organising around migrants’ issues?

[.green]MR:[.green] I wouldn't say it's changed our approach, but it's made it clearer where the failures are in the sector. What's become really clear in the global response is that migrant workers are much more visible in other countries because they do not have the hostile environment in the way we do. In Ireland, in Spain, in the US, there have been quite broad and bold campaign asks around Coronavirus. For example, Ireland suspended data-sharing. Spain has come up with a new route for people to be documented. In the US they're talking about migrant workers and key workers and how they should be treated after Coronavirus. The reason they've been able to do that is because their migrant communities who are undocumented are far more visible because the hostile environment hasn't criminalised them. It is ok to work and access social security in those countries, where it is not here. For me and probably for JCWI too, it's really highlighted a need to talk about decriminalisation in a tangible way, in a way that a lot of other groups and sectors have done previously on migrants’ rights. It's reached a point where we need to not only make their work more visible but talk about that specific piece of policy that is the key difference between us and other countries.

We're having a whole societal reframing of what work is and who those workers are. Because of the high impact on BAME communities and migrant communities, we're really seeing those people on the forefront of that conversation. Traditionally economic reforms and even climate responses have not necessarily included those people in a comprehensive way. I'm excited to see how those conversations can be pulled together, and for those people most impacted to be at the forefront of the conversation. I am wary that economic reform conversations often don't want to talk about things like decriminalisation, and there is a real risk that if something like austerity happens again the same groups of people will be targeted. There's a lot of work to be done to unite those groups, groups talking about universal basic income and a jobs guarantee, and how that can fit with the people who don't have access to those services but are providing and working primarily in the sectors that are needed during Coronavirus.

Footnotes