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R (OK) v Royal Free London NHS Foundation Trust

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The Administrative Court (Ritchie J) will today hear the challenge in R (OK) v Royal Free London NHS Foundation Trust, which raises important questions regarding the scope of the Secretary of State’s NHS charging regime for migrants. The relevant regulations provide that bodies providing secondary health care services must charge a person who is an ‘overseas visitor’, defined as a person who does not have indefinite leave to remain in the UK. One exception to that obligation arises where securing payment in advance would prevent or delay the provision of an urgent service. The claimant suffers from chronic kidney disease. He was initially receiving scheduled haemodialysis but, upon the Trust becoming aware that he was chargeable under the relevant regulations, was informed that he would need to present himself at Accident & Emergency and would only be given dialysis treatment if doctors assessed that the treatment was urgent. The defendant Trust accepts that, had the claimant not been an overseas visitor, he would have continued to receive scheduled dialysis treatment. The claimant challenges the decision on the basis that the Trust’s doctors misunderstood the meaning of urgent treatment, which only requires clinicians to consider whether the treatment in question can wait until the overseas visitor can reasonably be expected to leave the UK. In this case, it is argued, the clinicians provided an inferior service on the simple basis that the claimant was an overseas visitor, and thus strayed into consideration of policy rather than clinical issues. Doctors of the World, an NGO that undertakes significant work supporting migrants who have been denied treatment under the charging regime, has been granted permission to intervene in the proceedings and is making submissions in support of the claimant’s case. Admas Habteslasie is acting for Doctors of the World, instructed by Janet Farrell of Bhatt Murphy.

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