Asylum seeker billed £10,000 for NHS maternity care ‘could only afford penny a month'
A destitute asylum seeker who was billed more than £10,000 for having a baby could afford to pay just a penny a month, leading to calls for an urgent review of NHS maternity charging for migrants.
Kim, 34, whose name has been changed to protect her identity, was invoiced and then contacted by a debt collection agency after having an emergency caesarean section.
Asylum seekers, who receive around £7 a day per person for food, clothing, communication and toiletries, with small 'healthy food' top-ups for mothers of young children, are exempt from charges under the NHS cost recovery programme. The scheme was first introduced by a Conservative government 10 years ago this month, targeting overseas visitors and migrants.
However, many women entitled to free NHS maternity care are being wrongly charged, pregnancy charity Maternity Action said.
Kim's case was complicated by changes in her migration status. She first claimed asylum in the UK in 2017 after a crackdown on government critics in Zimbabwe, her country of birth, but was refused.
In 2021 she became pregnant and made a fresh asylum application, having struggled to do so earlier, she said, because of the pandemic.
After the birth of her daughter in March 2022, when she had an active asylum claim and should have been exempt, Kim was invoiced for maternity care by Leeds teaching hospitals NHS trust (LTHT) for £10,703.23.
The trust later told a debt collection agency that she owed an additional £3,450 relating to previous inpatient care for mobility problems that occurred after her first asylum application had been refused.
Kim, supported by the early parenthood charity National Childbirth Trust (NCT), wrote to LTHT saying: 'I am forbidden by law from working and do not have a bank account.
'I would like to propose repayment of £0.01p a month. I am embarrassed that I cannot offer greater contribution … even this will be a stretch. A requirement to pay more than this will put me under significant pressure to obtain money unlawfully.'
LTHT has now apologised to Kim 'for any distress caused', confirming they 'cancelled' the invoices once they received 'updated information demonstrating her eligibility'.
The trust's chief medical officer, Magnus Harrison, added: 'Where a patient has accrued charges for NHS treatment and their eligibility later changes, previous charges still apply. If a patient is deemed destitute or at risk of imminent destitution then the trust may choose not to pursue the debt for the time being.'
It is recommended in the UK that pregnant women have an initial antenatal appointment before 10 weeks, but fear of charges meant Kim did not seek antenatal care until four months, encouraged by NCT.
'The danger is that incorrect implementation of the rules deters women from seeking appropriate antenatal and postnatal care,' Judith Dennis, Maternity Action's head of policy, said. 'This has serious implications for maternity safety (and) the health of women and babies.'
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Anna Miller, Doctors of the World's head of policy, said charging migrants meant babies whose parents had been here for years were 'born into debt', with no evidence of the cost-effectiveness of a policy that led to 'people avoiding treatment' until crisis.
Describing the impact of being charged, Kim said: 'I really felt depressed … where am I going to get this money? I was still a new mum, breastfeeding as well … you're trying to heal from a caesarean and then there's a bill, there's a small child as well.'
Kim remains in asylum accommodation, where residents have complained of mould and cockroaches, awaiting a decision on her claim and attending college, hoping to study nursing.
The NCT is calling for the impact of maternity charging to be examined and for access to interpreters and 'secure housing' for pregnant women who are migrants.
The NCT head of programmes, Helen Lloyd, said: 'The threat of NHS charging creates a hostile environment for pregnant women with unclear immigration status.'
A Home Office spokesperson said: 'Asylum accommodation is required to meet strict standards, and regular inspections are conducted to ensure these are maintained.
'The NHS is a residency based system and it is only right that those who are not lawfully settled here, or exempt from charge, should contribute to the cost of their care.'
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South Wales Argus
25 minutes ago
- South Wales Argus
Streeting launches investigation into maternity services after families ‘gaslit'
Wes Streeting said that 'up and down' the country 'maternity units are failing, hospitals are failing, trusts are failing, regulators are failing' and there was 'too much passing the buck'. Mr Streeting, who has been meeting families who have lost babies to poor maternity care, told the Royal College of Obstetricians and Gynaecologists (RCOG) conference in London: 'Over the last year, I've been wrestling with how we tackle problems in maternity and neonatal units, and I've come to the realisation that while there is action we can take now, we have to acknowledge that this has become systemic. 'It's not just a few bad units. Up and down the country, maternity units are failing, hospitals are failing, trusts are failing, regulators are failing. 'There's too much obfuscation, too much passing the buck and giving lip service.' Mr Streeting apologised on behalf of the NHS, having met families in Nottingham and around the country whose children have died or been injured. Senior midwife Donna Ockenden is currently examining how hundreds of babies died or were injured in the care of Nottingham University Hospitals Trust. Mr Streeting said: 'All of them have had to fight for truth and justice, they describe being ignored, gaslit, lied to, manipulated and damaged further by the inability for a trust to simply be honest with them that something has gone wrong. 'I want to say publicly how sorry I am, sorry for what the NHS has put them through, sorry for the way they've been treated since by the state and sorry that we haven't put this right yet, because these families are owed more than an apology. They're owed change, they're owed accountability and they're owed the truth.' The Health Secretary said risk is 'considerably higher' than it should be for women and babies because of a 'crisis' in maternity and neo-natal services. He added: 'Within the past 15 years, we've seen appalling scandals that blew the lid on issues ranging from care, safety, culture and oversight: Shrewsbury, Telford, East Kent, Nottingham. 'The last government responded with initiatives like Better Births in 2016 and the maternity transformation programme. 'But, despite improvements on some metrics, inequalities in maternal and neo-natal outcomes have become more visible, not less. The rate of late maternal deaths has been consistently rising. 'Babies of black ethnicity are twice as likely to be stillborn than babies of white ethnicity, and black women are still two to three times more likely to die during pregnancy or shortly after birth than white women. 'Tragically, that gap is closing slightly, but partly because more white women are dying in childbirth.' Other high-profile scandals had deepened the public's mistrust in the state, Mr Streeting continued. 'From the Horizon Post Office scandal to the infected blood scandal, the degradation of responsibility and trust in our institutions is compounding a cynicism and malaise at the ability of British politics to deliver for people. 'This is a dangerous place for a country to be. 'If we do not admit the scale of the failure in maternity services, we're condemning ourselves to etching that mistrust deeper. 'If we cannot admit openly that we as institutions and as a state got this wrong, we'll never be able to fix it or rebuild that trust. 'Too many children have died because of state failure and I will not allow it to continue under my watch.' The new investigation will consist of two parts. The first will investigate trusts of greatest concern at the moment, including Leeds, Gloucester, Mid and South Essex and Sussex, 'to hold them to account for improvement', Mr Streeting said. He added: 'I'm currently discussing with Leeds families the best way to grip the challenges brought to light in that trust by their campaigning, reports in the media and the latest Care Quality Commission (CQC) report, and I'll be ordering an investigation into nine specific cases identified by families in Sussex …' The second part of the investigation will be a 'system-wide' look at maternity and neonatal care, uniting lessons from past maternity inquiries to create one 'clear set of actions' designed to improve national NHS care. A National Maternity and Neonatal Taskforce, chaired by Mr Streeting, has also been set up, made up of experts and bereaved families. The investigation will begin this summer and report back by December. A new digital system will be rolled out to all maternity services by November to flag potential safety concerns in trusts, while an anti-discrimination programme to tackle inequalities is being launched. Asked about the cost of the review, Mr Streeting said: 'I suspect it will be somewhat less than the enormous costs we pay in clinical negligence claims. 'Probably the most shocking statistic in this area is that we are paying out more in clinical negligence for maternity failures than we are spending on maternity services. That's how bad things are. 'So, putting together a review team, undertaking the level of analytical work required to produce a really good, high-quality evidence-based report is a drop in the ocean compared to the price of failure.' Sir Jim Mackey, chief executive of NHS England, said: 'Despite the hard work of staff, too many women are experiencing unacceptable maternity care and families continue to be let down by the NHS when they need us most. 'This rapid national investigation must mark a line in the sand for maternity care – setting out one set of clear actions for NHS leaders to ensure high quality care for all. 'Transparency will be key to understanding variation and fixing poor care – by shining a spotlight on the areas of greatest failure we can hold failing trusts to account. 'Each year, over half a million babies are born under our care and maternity safety rightly impacts public trust in the NHS – so we must act immediately to improve outcomes for the benefit of mothers, babies, families and staff.' The Royal College of Midwives (RCM) said maternity services are 'at, or even beyond, breaking point'. RCM chief executive Gill Walton said: 'Every woman and family should leave maternity and neonatal services whole, happy and healthy. 'Yet we know that, for far too many, that isn't their experience. 'Systemic failings and a lack of attention to the warning signs have let those families down and let down the hardworking staff who are trying so hard to provide the care they deserve. 'Everyone involved in maternity services: the midwifery community, obstetricians, anaesthetists, sonographers and, of course, the women and families in their care; knows that maternity services are at, or even beyond, breaking point. 'This renewed focus and commitment by the Health Secretary to deliver change is welcome, and we will do everything we can to support him in doing so.' Professor Ranee Thakar, president of the RCOG, said: 'The maternity workforce is on its knees, with many now leaving the profession.' She said that 'for years, maternity units have had too few staff, too little time for training and lacked modern equipment and facilities, resulting in women and babies being harmed.' She urged the Government to 'not to lose sight of funding and workforce shortages within this'.
Leader Live
29 minutes ago
- Leader Live
Streeting launches investigation into maternity services after families ‘gaslit'
Wes Streeting said that 'up and down' the country 'maternity units are failing, hospitals are failing, trusts are failing, regulators are failing' and there was 'too much passing the buck'. Mr Streeting, who has been meeting families who have lost babies to poor maternity care, told the Royal College of Obstetricians and Gynaecologists (RCOG) conference in London: 'Over the last year, I've been wrestling with how we tackle problems in maternity and neonatal units, and I've come to the realisation that while there is action we can take now, we have to acknowledge that this has become systemic. 'It's not just a few bad units. Up and down the country, maternity units are failing, hospitals are failing, trusts are failing, regulators are failing. 'There's too much obfuscation, too much passing the buck and giving lip service.' Mr Streeting apologised on behalf of the NHS, having met families in Nottingham and around the country whose children have died or been injured. Senior midwife Donna Ockenden is currently examining how hundreds of babies died or were injured in the care of Nottingham University Hospitals Trust. Mr Streeting said: 'All of them have had to fight for truth and justice, they describe being ignored, gaslit, lied to, manipulated and damaged further by the inability for a trust to simply be honest with them that something has gone wrong. 'I want to say publicly how sorry I am, sorry for what the NHS has put them through, sorry for the way they've been treated since by the state and sorry that we haven't put this right yet, because these families are owed more than an apology. They're owed change, they're owed accountability and they're owed the truth.' The Health Secretary said risk is 'considerably higher' than it should be for women and babies because of a 'crisis' in maternity and neo-natal services. He added: 'Within the past 15 years, we've seen appalling scandals that blew the lid on issues ranging from care, safety, culture and oversight: Shrewsbury, Telford, East Kent, Nottingham. 'The last government responded with initiatives like Better Births in 2016 and the maternity transformation programme. 'But, despite improvements on some metrics, inequalities in maternal and neo-natal outcomes have become more visible, not less. The rate of late maternal deaths has been consistently rising. 'Babies of black ethnicity are twice as likely to be stillborn than babies of white ethnicity, and black women are still two to three times more likely to die during pregnancy or shortly after birth than white women. 'Tragically, that gap is closing slightly, but partly because more white women are dying in childbirth.' Other high-profile scandals had deepened the public's mistrust in the state, Mr Streeting continued. 'From the Horizon Post Office scandal to the infected blood scandal, the degradation of responsibility and trust in our institutions is compounding a cynicism and malaise at the ability of British politics to deliver for people. 'This is a dangerous place for a country to be. 'If we do not admit the scale of the failure in maternity services, we're condemning ourselves to etching that mistrust deeper. 'If we cannot admit openly that we as institutions and as a state got this wrong, we'll never be able to fix it or rebuild that trust. 'Too many children have died because of state failure and I will not allow it to continue under my watch.' The new investigation will consist of two parts. The first will investigate trusts of greatest concern at the moment, including Leeds, Gloucester, Mid and South Essex and Sussex, 'to hold them to account for improvement', Mr Streeting said. He added: 'I'm currently discussing with Leeds families the best way to grip the challenges brought to light in that trust by their campaigning, reports in the media and the latest Care Quality Commission (CQC) report, and I'll be ordering an investigation into nine specific cases identified by families in Sussex …' The second part of the investigation will be a 'system-wide' look at maternity and neonatal care, uniting lessons from past maternity inquiries to create one 'clear set of actions' designed to improve national NHS care. A National Maternity and Neonatal Taskforce, chaired by Mr Streeting, has also been set up, made up of experts and bereaved families. The investigation will begin this summer and report back by December. A new digital system will be rolled out to all maternity services by November to flag potential safety concerns in trusts, while an anti-discrimination programme to tackle inequalities is being launched. Asked about the cost of the review, Mr Streeting said: 'I suspect it will be somewhat less than the enormous costs we pay in clinical negligence claims. 'Probably the most shocking statistic in this area is that we are paying out more in clinical negligence for maternity failures than we are spending on maternity services. That's how bad things are. 'So, putting together a review team, undertaking the level of analytical work required to produce a really good, high-quality evidence-based report is a drop in the ocean compared to the price of failure.' Sir Jim Mackey, chief executive of NHS England, said: 'Despite the hard work of staff, too many women are experiencing unacceptable maternity care and families continue to be let down by the NHS when they need us most. 'This rapid national investigation must mark a line in the sand for maternity care – setting out one set of clear actions for NHS leaders to ensure high quality care for all. 'Transparency will be key to understanding variation and fixing poor care – by shining a spotlight on the areas of greatest failure we can hold failing trusts to account. 'Each year, over half a million babies are born under our care and maternity safety rightly impacts public trust in the NHS – so we must act immediately to improve outcomes for the benefit of mothers, babies, families and staff.' The Royal College of Midwives (RCM) said maternity services are 'at, or even beyond, breaking point'. RCM chief executive Gill Walton said: 'Every woman and family should leave maternity and neonatal services whole, happy and healthy. 'Yet we know that, for far too many, that isn't their experience. 'Systemic failings and a lack of attention to the warning signs have let those families down and let down the hardworking staff who are trying so hard to provide the care they deserve. 'Everyone involved in maternity services: the midwifery community, obstetricians, anaesthetists, sonographers and, of course, the women and families in their care; knows that maternity services are at, or even beyond, breaking point. 'This renewed focus and commitment by the Health Secretary to deliver change is welcome, and we will do everything we can to support him in doing so.' Professor Ranee Thakar, president of the RCOG, said: 'The maternity workforce is on its knees, with many now leaving the profession.' She said that 'for years, maternity units have had too few staff, too little time for training and lacked modern equipment and facilities, resulting in women and babies being harmed.' She urged the Government to 'not to lose sight of funding and workforce shortages within this'.
Leader Live
29 minutes ago
- Leader Live
Government launches national investigation into NHS maternity services
Health Secretary Wes Streeting said that 'up and down' the country 'maternity units are failing, hospitals are failing, trusts are failing, regulators are failing' and there was 'too much passing the buck'. Mr Streeting, who has been meeting families who have lost babies to poor maternity care, told the Royal College of Obstetricians and Gynaecologists (RCOG) conference in London: 'Over the last year, I've been wrestling with how we tackle problems in maternity and neonatal units, and I've come to the realisation that while there is action we can take now, we have to acknowledge that this has become systemic. 'It's not just a few bad units. Up and down the country, maternity units are failing, hospitals are failing, trusts are failing, regulators are failing. 'There's too much obfuscation, too much passing the buck and giving lip service.' Mr Streeting apologised on behalf of the NHS, having met families in Nottingham and around the country whose children have died or been injured. Senior midwife Donna Ockenden is currently examining how hundreds of babies died or were injured in the care of Nottingham University Hospitals Trust. Mr Streeting said: 'All of them have had to fight for truth and justice, they describe being ignored, gaslit, lied to, manipulated and damaged further by the inability for a trust to simply be honest with them that something has gone wrong. 'I want to say publicly how sorry I am, sorry for what the NHS has put them through, sorry for the way they've been treated since by the state and sorry that we haven't put this right yet, because these families are owed more than an apology. They're owed change, they're owed accountability and they're owed the truth.' The Health Secretary said risk is 'considerably higher' than it should be for women and babies because of a 'crisis' in maternity and neo-natal services. He said giving birth carries risk, but 'that risk is considerably higher than it should be because of the state of the crisis in our maternity and neonatal services.' He added: 'Within the past 15 years, we've seen appalling scandals that blew the lid on issues ranging from care, safety, culture and oversight – Shrewsbury, Telford, East Kent, Nottingham. 'The last government responded with initiatives like Better Births in 2016 and the maternity transformation programme. 'But, despite improvements on some metrics, inequalities in maternal and neo-natal outcomes have become more visible, not less. The rate of late maternal deaths has been consistently rising. 'Babies of black ethnicity are twice as likely to be stillborn than babies of white ethnicity, and black women are still two to three times more likely to die during pregnancy or shortly after birth than white women. 'Tragically, that gap is closing slightly, but partly because more white women are dying in childbirth.' Other high-profile scandals had deepened the public's mistrust in the state, Mr Streeting continued. He said: 'From the Horizon Post Office scandal to the infected blood scandal, the degradation of responsibility and trust in our institutions is compounding a cynicism and malaise at the ability of British politics to deliver for people. 'This is a dangerous place for a country to be. 'If we do not admit the scale of the failure in maternity services, we're condemning ourselves to etching that mistrust deeper. 'If we cannot admit openly that we as institutions and as a state got this wrong, we'll never be able to fix it or rebuild that trust. 'Too many children have died because of state failure and I will not allow it to continue under my watch.' The new investigation will consist of two parts. The first will investigate trusts of greatest concern at the moment, including Leeds, Gloucester, Mid and South Essex and Sussex, 'to hold them to account for improvement', Mr Streeting said. He added: 'I'm currently discussing with Leeds families the best way to grip the challenges brought to light in that trust by their campaigning, reports in the media and the latest Care Quality Commission (CQC) report, and I'll be ordering an investigation into nine specific cases identified by families in Sussex…' The second part of the investigation will be a 'system-wide' look at maternity and neonatal care, uniting lessons from past maternity inquiries to create one 'clear set of actions' designed to improve national NHS care. A National Maternity and Neonatal Taskforce, chaired by Mr Streeting, has also been set up, made up of experts and bereaved families. The investigation will begin this summer and report back by December. A new digital system will be rolled out to all maternity services by November to flag potential safety concerns in trusts. An anti-discrimination programme to tackle inequalities in care for black, Asian, and other communities is also being launched. Sir Jim Mackey, chief executive of NHS England, said: 'Despite the hard work of staff, too many women are experiencing unacceptable maternity care and families continue to be let down by the NHS when they need us most. 'This rapid national investigation must mark a line in the sand for maternity care – setting out one set of clear actions for NHS leaders to ensure high quality care for all. 'Transparency will be key to understanding variation and fixing poor care – by shining a spotlight on the areas of greatest failure we can hold failing trusts to account. 'Each year, over half a million babies are born under our care and maternity safety rightly impacts public trust in the NHS – so we must act immediately to improve outcomes for the benefit of mothers, babies, families and staff.' The Royal College of Midwives (RCM) said maternity services are 'at, or even beyond, breaking point'. RCM chief executive Gill Walton said: 'Every woman and family should leave maternity and neonatal services whole, happy and healthy. 'Yet we know that, for far too many, that isn't their experience. 'Systemic failings and a lack of attention to the warning signs have let those families down and let down the hardworking staff who are trying so hard to provide the care they deserve. 'Everyone involved in maternity services – the midwifery community, obstetricians, anaesthetists, sonographers and, of course, the women and families in their care – knows that maternity services are at, or even beyond, breaking point. 'This renewed focus and commitment by the Health Secretary to deliver change is welcome, and we will do everything we can to support him in doing so.' Professor Ranee Thakar, president of the RCOG, said: 'The maternity workforce is on its knees, with many now leaving the profession.' She said that 'for years, maternity units have had too few staff, too little time for training and lacked modern equipment and facilities, resulting in women and babies being harmed.' She urged the Government to 'not to lose sight of funding and workforce shortages within this.'
