Barts accused over charging of vulnerable women

Barts NHS Trust promises to be ‘more transparent’ with patients as report finds body wrongly charges for care.

By Aidan White

Baby lying in cot with hospital tag on its  right foot.
Image ©Charles Eugene/Unsplash

A national charity has said that Barts NHS Trust, which includes Newham University Hospital, is failing to protect groups of vulnerable women and wrongly charging them for medical care.

The report into charging for NHS maternity care in some of East London’s most deprived areas examined the cases of 36 maternity patients over the past year including women who were living in extreme poverty, or were victims of domestic violence, or were asylum seekers.

As well as claims that many women were being wrongly charged for maternity care, the report by the charity Maternity Action said there was bureaucratic insensitivity in dealing with the women. In one case a destitute woman’s evidence of her economic situation was ignored and victims of domestic violence were not believed.

The startling conclusion is that Barts hospitals under-protect vulnerable women, says Newham health care campaigner Rosamund Mykura.

“There is a cruel pile-up of inequality in maternity care in East London,” she said. She blames the government and its “hostile environment” policy in dealing with migrants and asylum seekers for putting added pressure on NHS services. “The ‘hostile environment’ regulations and guidance requires NHS Trusts to over-interrogate and under-protect our vulnerable pregnant women in northeast London,” she said.

Mykura, the spokesperson for North-East London Save our NHS, added: “This is particularly dangerous in poor areas where infant deaths (under one year old) are double those in the richest areas. Since 2020 black and black British infant deaths, and Asian and Asian British infant deaths have risen, while deaths for white infants have stayed steady.

“Getting rid of NHS racist charging is an obvious move if the government seriously wants to improve our babies’ health outcomes in northeast London.”

The detailed evidence in the report is drawn from a sample of 36 maternity patients in the trust area, covering Barts, the Royal London, Whipps Cross and Newham Hospitals.

On 31 October Maternity Action director, Ros Bragg presented the report to Newham Council’s Health and Adult Social Care, Equalities and Air Quality Scrutiny Commission. At the meeting the Chief Executive of Newham Hospital Simon Ashton, speaking on behalf of Barts Trust, acknowledged the sensitivity of the issues and promised to discuss the problems after the meeting.

A spokesperson for Barts Health NHS Trust told Newham Voices: “Like all NHS trusts we have a legal duty to recover costs from patients who are not eligible for NHS treatment. We recognise that payment is a sensitive issue, strive to be fair and transparent with patients, and are committed to continually improving our processes to handle all cases with compassion.”

But in recognition of the issues raised, the Trust says there will be changes.

“After discussions with various groups, internally and externally, we will implement overseas training, and support the women’s experience midwives in developing an information sheet for patient packs.”

The Trust will also “review our online maternity booking form to identify what can be improved to best identify patients who may be charged, and have them referred to us more swiftly so they can be supported and reassured at the earliest opportunity in their pathway.”

Maternity Action has recommended that hospitals must not charge women for health care when they are exempt, for
example, if a patient has a current asylum claim, is destitute or has been a victim of domestic violence and they must also
stop pursuing debt collection during pregnancy. The group has also called on the Trust to adopt the charity’s access guidance as a standard reference in dealing with maternity care cases.