Hacker News Reader

>What was once a universal healthcare system is actually no longer: In England, General Practitioners are required to write to patients and remove them from the register if they do not confirm receipt of the letter. This means being homeless without an address means emergency-only care, at least according to policy. [3]

I think you are misinformed

per https://www.nhs.uk/NHSEngland/AboutNHSservices/doctors/Docum...

Message to the GP Practice

Thank you for helping to register this patient. We hope the patient was able to show you relevant documents. NHS Guidelines say ‘If a patient cannot produce any supportive documentation but states that they reside within the practice boundary then practices should accept the registration’.

Please be aware that a homeless patient cannot be refused registration on the basis of where they reside because they are not in settled accommodation. For safety reasons they may need to change the places where they sleep rough on a daily basis. There is no regulatory requirement to prove identity, address, immigration status or an NHS number in order to register as a patient and no contractual requirement for GPs to request this.

Those who are homeless, vulnerably housed or ‘of no fixed abode’, asylum seekers, refugees and overseas visitors, whether lawfully in the UK or not, are eligible to register with a GP practice even if they have to pay for NHS services outside of the GP practice. The patient MUST be registered on application unless the practice has reasonable grounds to decline. GP practices have limited grounds on which they can turn down an application and these are;

if The commissioner has agreed that they can close their list to new patients.

The patient lives outside the practice boundary.

> I think you are misinformed

It appears, according to that leaflet, that I was, and that central policy is that people should be able to register without fixed address.

It does seem that at least one homelessness charity[0] has taken up a campaign around this, so it may well be an implementation detail within individual GP practices that leads to accounts such as:

> "Early in our frontline delivery, staff reported difficulties in supporting people to register with a GP." [0]

[0] https://www.homeless.org.uk/connect/features/2017/oct/06/hom...

I do wonder how having a postal address is related to being a legal or illegal immigrant. After all - if your friend has a fixed address, they can share it with you, so you can receive mail, can they not?

Regardless if you are an illegal immigrant or not.

> I do wonder how having a postal address is related to being a legal or illegal immigrant. After all - if your friend has a fixed address, they can share it with you, so you can receive mail, can they not?

It's generally not so much about receiving mail as having an address which you are deemed resident at for official purposes. That's a little bit different to having somewhere to pick letters up. There's always Poste Restante for picking letters up, so if it was merely post that was the problem that would be the solution.

If you are going to provide an address for residency, you will be treated as providing accommodation. If you're on any kind of benefit, this will be used against you when your friend gets their first pay packet, because address is mandatory for payroll and is shared with the benefits agencies and immigration enforcement electronically. Good luck disputing the home office claim that the person you're providing accommodation to isn't a UK citizen.

In the UK there is a legal requirement on employers to check right to work of employees. This requires paperwork that the applicant is unlikely to have if homeless. Getting duplicates of the paperwork takes money and time.

You need either a passport or evidence of national insurance number from a previous job or benefits claim in addition to a birth certificate to prove eligibility to work if you are a UK citizen.

> Regardless if you are an illegal immigrant or not.

In creating a system hostile to illegal immigrants the past few UK governments have made a hostile environment for the bottom quartile of earners in the UK to gain work. These checks exist for no other reason. [0]

What we often see in newspaper articles is the first reason somebody can't get a job. It's very rare to see the full list of obstacles. It's like a compiler that fails at the first error when there are tens of other errors waiting after that first one is fixed.

[0] Even the guide to right-to-work documents is published by Immigration Enforcement and UK Visas and Immigration. See https://www.gov.uk/government/publications/acceptable-right-...

You'd think the homeless shelters would allow their occasional residents to use that as an address?