Public Health
There will be public health consequences to regulations that prevent a section of the community routinely accessing secondary care. If people are unable to have non-specific symptoms investigated in secondary care, diagnosis and treatment of infectious diseases will be delayed and the result will be increased incidence and spread of disease.
Exempting particular infectious diseases from charging will not make a substantial difference, as people with communicable diseases present with symptoms rather than diagnoses.
While exemptions to charges are made for other communicable diseases, it is notable that HIV treatment remains chargeable, though testing and related counseling are free.
Requiring payment for treatment extends to the provision of antiretroviral therapy to prevent pregnant women passing the virus to their child at birth, despite the obvious long term benefit of doing so both for the individual concerned and the health system in whatever country they later reside.
There is no proof that these groups come to the UK seeking treatment for HIV. On the contrary, diagnosis is more often the result of an opportunistic infection with a resulting late diagnosis. Earlier presentation during an asylum claim or while a work visa is valid would have ensured treatment was available.
For Further Information
• Gazzard B, Anderson J, Ainsworth J, Wood C. Treat with respect: HIV, public health and immigration. UK Coalition of People Living with HIV and AIDS, 2005
