Regimes of Care and Control: UK Borders and Immigration Policing in the National Health Service

This research examines the extension of UK borders and immigration policing into the
National Health Service (NHS). In a post-9/11 age of data-driven security, and in the
context of the 'hostile environment', recent years have seen the UK incorporate
immigration checks and bureaucratic acts of border policing into a range of banal
(typically institutional) spaces, including NHS hospitals and surgeries. This has
included the introduction of the Immigration Health Surcharge (IHS) (2015), upfront
charging for overseas visitors (2017) and various alterations to the Memorandum of
Understanding allowing the Home Office to trace immigration offenders using data held
by NHS Digital (2017; 2018). However, while several scholars have considered the
uneasy coupling of care and control and acknowledged the enrolment of hospitals and
surgeries in bordering, none have focused on the specific roles these institutions have
come to play in UK migration policy. In this context, the research examines how data
sharing, upfront charging and the IHS function as border controls and how the ethical
tensions of this are generating new political alliances and forms of civic action.
Employing a qualitative multi-method approach, it will draw on the experiences of
multiple groups on the frontline to understand how UK border policing is being
extended into regimes of healthcare. Conducted amidst precipitous policy changes and
a major post-Brexit shift in the healthcare entitlements of EU migrants, this research is
both novel and exceptionally timely, allowing it to contribute to NHS and public-policy
making and interdisciplinary research on borders, immigration and healthcare.