UK Resilience
Last updated: 28 October 2008
Depending on the nature of the emergency, the involvement of foreign nationals may not be readily apparent either during the response or recovery phases. But where possible, it is important that responders identify the nationality of those involved.
As is the case with everyone affected, foreign nationals may be among the fatalities, casualties or witnesses of the emergency. Whilst everyone caught up in an emergency will be treated equally, nationality will have an impact on certain aspects of the response and recovery phase.
For example, all foreign nationals who require consular assistance should be directed to the nearest diplomatic/consular post or representative (eg. Honorary Consul) of their national government (see list of contacts below). Although foreign nationals are under no obligation to make contact with such a representative, this should be encouraged and assistance in obtaining the details should be given (see list of contacts below). In addition, where a crime is suspected, and an individual is arrested, the Government is obliged to notify the appropriate diplomatic mission, whether in London or non-resident overseas, of the detention.
If foreign nationals should lose their documentation (passports, etc.) as a result of an incident, they should be directed to their relevant Foreign Embassy.
The handling of foreign nationals in a crisis may, in an extreme situation, affect international relations, and/or trade, and this possibility should be borne in mind by local responders. If there is any reason to believe that an emerging situation might create such overtones, the Foreign and Commonwealth Office (FCO) should be alerted.
Foreign Embassies and High Commissions in London will inevitably monitor any developing emergency situations within the UK, and may ask for information, whether or not they believe/suspect any of their nationals are involved.
Stranded foreign nationals would not normally be entitled to Benefits (including Social Fund). People who are subject to immigration control (ie. those whose leave to enter or remain in the UK is subject to a “no recourse to public funds” condition) are excluded. For European Economic Area (EEA) nationals and UK nationals from abroad, the habitual residence test would normally apply.
The support that could be made available would be:
This would require:
Regardless of residential status or nationality, emergency treatment given at Primary Care Practices (a GP) or in Accident and Emergency departments or a Walk-in Centre providing services similar to those of a hospital Accident and Emergency department is free of charge.
Primary Care: Entitlement to free NHS Primary Medical Services (GP Practices)
A person's entitlement to free NHS treatment is based on residence in the UK, not on nationality, the payment of UK taxes or National Insurance contributions.
Even though a person may have the right of abode in the UK, they are not necessarily entitled to free NHS Primary Medical Services at a GP practice if they are not in the UK on a lawful and settled basis.
Legislative Framework
Regulations 1 provide GP practices with wide discretion in accepting or declining applications to join their lists of NHS patients. GP practices are expected to exercise their discretion in a non-discriminatory way, with sensitivity and due regards to all the circumstances on a case-by-case basis.
Current guidance (HSC 1999/018) does, however, discourage practices from accepting applications from people who are not considered to be ”ordinarily resident” in the UK.
Secondary Care
In order for a person not ordinarily resident in the UK (i.e. an “overseas visitor”) to access NHS hospital treatment free of charge, they must meet the criteria for one of the exemptions from charge categories within the NHS (Charges to Overseas Visitors) Regulations 1989, as amended. These regulations place a legal duty on NHS trusts to establish “by means of such enquiries as it is satisfied are reasonable in all the circumstances” the eligibility of each patient to free secondary care.
One exemption category is for any overseas visitor who is taking up (or resuming) permanent residence in the UK. They must have the lawful right to reside in the UK and it must be their intention to live here for the time being. As detailed above for primary care, those evacuated would have to have, or to be given by the Home Office, the right to reside in the UK for this exemption category to take effect.
Evidence of a permanent move having been made is usually required for this exemption category (such as selling of overseas property, shipping of goods etc
Long-term health monitoring
For information on long-term health monitoring, see the Needs of people – health topic sheet.
If one or more foreign nationals are killed in a disaster involving mass fatalities, the police and the coroner will investigate the circumstances surrounding the death as they would for a British national. Every effort will be made to identify the deceased and contact the next of kin, as necessary, through contact with consular officials. The coroner will arrange for a post-mortem examination to be performed (in certain circumstances more than one may be necessary) and then once the body is no longer required, it may be released to the next of kin for funeral purposes. If the body is to be taken out of England and Wales, the coroner will issue an Out of England Order to indicate that he no longer needs the body.
No difference of approach. The FCO will keep the relevant DA informed, and vice versa, where incidents involving foreign nationals occur in devolved areas.
No difference in approach in Scotland.
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Under Section 47 of the NHS and Community Care Act 1990, local authority social services departments are responsible for assessing the needs of people who may need care services. The social services department must arrange any services.
Under the National Assistance Act (NAA) 1948, local authority social services departments are responsible for arranging social care for people who are eligible to receive services. Ordinarily, persons who are subject to immigration control are ineligible for support if their need for care and attention arose solely as a result of destitution. They would have to demonstrate they are suffering from destitution, plus additional causes of their need for care.
With the Diplomatic Protection Group (DPG) of the Metropolitan Police Service (MPS), FCO has successfully developed its responses and service to the Diplomatic Community in the form of “Project Hermes”. Project Hermes integrates information from the MPS and HM Government and transmits it, via a number of e-communications methods, direct to Diplomatic Missions in London. It is a joint MPS and FCO initiative to provide accurate and timely information to the diplomatic community following a Mass Casualty Incident. Under the initiative, the diplomatic community will be notified of such an incident within minutes, followed by regular updates about the incident as it unfolds.
It is not the role of the Casualty Bureau to answer enquiries. Its systems are not focussed towards this and outgoing casualty information is transmitted via the Family Liaison Officer Team and not the Casualty Bureau. Casualty information is not released until it is verified and its release authorised. That authority comes from the Senior Identification Manager, working with HM Coroner and, in the case of criminal enquiries, the Senior Investigating Officer. Under Project Hermes, the Met Police (DPG) working with FCO (Protocol Directorate) access and collate information at the earliest possible stage, following a mass casualty incident, and transmit it in 4 ways to previously identified points of contact in each Diplomatic Mission in London:
With these arrangements, we are able to transmit information to Diplomatic Missions as soon as we reliably can. Family Liaison Officers, whose contact with the Diplomatic Community will be facilitated by DPG, will deliver specific notifications about individuals.
The Welsh Assembly Government will act in the same way as the Government Offices in England and co-ordinate any regional response required in Wales.
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Other than any medical care which will be provided by the Department for Health, there is no long term funding to assist foreign nationals who are distressed because of an emergency situation, either in the UK, or for the purposes of repatriation. All costs remain their responsibility.
In the case of a terrorist attack or other crime, foreign nationals would be eligible to apply for compensation from the Criminal Injuries Compensation Authority (see the Financial support for individuals topic sheet for more information).
Health is a devolved function in Wales and medical care will be the responsibility of the relevant devolved administration.
Funding for NHS in Scotland comes from the Scottish Government and is distributed to Health Boards on a formula basis. There is no long term funding to assist foreign nationals. That will remain their own responsibility.
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The London Diplomatic List [External website] is an alphabetical list of the representatives of Foreign States and Commonwealth Countries in London with contact details for their Diplomatic Staff.
Foreign and Commonwealth Office switchboard number – 020 7008 1500
Para 17 of Schedule 6 to the NHS General Medical Services Contracts) Regulations 2004 – S.I. 291 & Para 16 of Schedule 5 to the NHS (Personal Medical Services Agreements) Regulations 2004 – S.I. 627
General enquiries: Cabinet Office, 22 Whitehall, London SW1A 2WH.
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