NHS letter demands eight-day-old baby provide identity documents to prove right to free healthcare

An eight-day-old baby has been sent a letter from an NHS overseas department demanding identity documents to prove her right to free healthcare.

Violet Vipulananthan Horne, who was born in the UK and has two British parents, was told that NHS records indicated she may need to pay for treatment she had received at a London hospital, because she was not “ordinarily resident” in the UK.

A spokesperson for the hospital has since told The Independent the letter was sent "by mistake due to a clerical error".

The letter, addressed to “C/O Baby Vipulananthan” – which is the child's mother's maiden name – ordered that she show identity documents “as evidence of her status”, with a list of possible documents on the next page, including a passport, a marriage certificate of council tax bill.

It stated: “NHS records indicate that you may need to pay for the treatment that you received at London North West Healthcare NHS Trust.

“NHS care is not free. As a visitor to the United Kingdom, you may need to pay for your NHS treatment. A person who is not ‘ordinarily resident’ in the UK falls within the definition of an overseas visitor.”

It goes on to state that in order to avoid payment, Violet must “provide evidence that [they] are either ordinarily resident in the UK or are exempt from payment”, adding: “It is your responsibility to prove that you are entitled to free NHS care.”

Her father, 41-year-old Nik Horne, wrote a letter of complaint to the hospital, to which he received a reply stating that it had been sent in error – admitting that it was not the first time – and apologising for putting the family in an "awkward situation".

He told The Independent that he felt his daughter was being racially profiled on the basis of his wife's foreign-sounding maiden name – due to the fact that it was the only name included on the letter.

“My first thoughts were surprise and anger that we'd received it. I knew there was no question of us actually being liable to pay for my daughter, as my wife and I are both UK-born and resident,” he said.

“I wondered if it could be due to my wife's maiden name being conspicuously Sri Lankan Tamil. I must stress that I have no evidence that this was a case of racial profiling, but also nothing to confirm it wasn't.

“The fact that we gave our full details – names, addresses etc – on numerous occasions in the hospital makes the fact that the only name on the letter is ‘Baby Vipulananthan’ puzzling.”

In an apology letter sent to Mr Horne, an official at the Overseas department stated that it is not the only time such letters had been sent out in error to people who are eligible for free healthcare.

It read: “My department has so many patients to check every day and it is my job to deal with all the patients on my daily list. I try to visit as many patients as possible on the ward and those who I am not able to visit face to face, I send letters.

“Unfortunately some people who are eligible do receive letters and this may explain your case. I know it is an inconvenience for you to receive such a letter. Therefore I apologise for putting you in an awkward situation.”

Mr Horne said he sympathised with NHS staff, but criticised a system that presumes patients are not UK residents without any evidence.

“I appreciate the apology and the tone and sentiment of the email. While I have huge sympathy with NHS staff, who are overworked and undermanned, it seems wholly disproportionate that the outcome of this situation is a letter indicating that patients are non-UK residents when there is no supporting evidence for this supposition,” he said.

“I also sympathise with NHS trusts being pressured from the Government to save money by collecting payment for treatment of visitors to the UK, but I think when sending letters such as the one we received, they need to include details of their reasons for belief that a patient is a visitor to the UK and/or obliged to pay for NHS treatment.

“I also think it's incumbent on the Department of Health and Jeremy Hunt to provide guidance across all trusts on how these delicate situations should be handled.

"If it was a mistake on the hospital's part, it would be interesting to know how it happened and how many others were affected."

It comes after a memorandum of understanding was published in January stating that NHS digital was required to share patient information with the Home Office.

According to the Department of Health, the Home Office made 8,127 requests for data in the first 11 months of 2016. This led to 5,854 people being traced by immigration enforcement teams.

A pilot scheme to ask patients for identification has since been launched in a number of hospitals across the UK, including London North West Healthcare NHS Trust, but a spokesperson for the hospital and the Department of Health have said this erroneous letter was not sent as part of this pilot.

Erin Dexter, a member of campaign group Docs not Cops, accused the Government of creating a system in which racial profiling is "inevitable", and said they were concerned that such letters could scare and intimidate many people who are in fact eligible for free healthcare.

“We are not surprised that the Overseas Visitors Office is sending letters to eight-day-old babies with foreign-sounding surnames," she said.

“The Government has rushed through these measures with no consideration as to how they may be thoughtfully executed, because it cares more about persecuting migrants than creating a sustainable NHS.

“Racist profiling was always going to be an inevitability. We're very happy Nik was able to take them to task, but we worry for the patients that these letters will scare or intimidate - many of who will be perfectly eligible for NHS care.

“We believe no one should have to receive a letter like this eight days after the birth of their child. Healthcare should be provided on a basis of need, not on ability to pay or to provide identity documents.”

A spokesperson for London North West Healthcare NHS Trust said: “We reiterate our apologies to Mr Horne and his family for the letter they received - it was sent by mistake due to a clerical error.”