We were given medals by the UK Government for our role in the Ebola Epidemic.

We represented the UK and the NHS, and the right to health.

However, that principle has been abandoned by introducing the ‘Hostile Environment’ into the NHS, leading to denial of even life-saving healthcare to people who are unable to prove their immigration status.

The Government rewarded us for treating patients across borders, now borders are being created between us and our patients at home.

So we are giving our medals back.



We are a group of people who believe in the right to health and the founding principles of the NHS, and have been awarded honours for risking our lives for such values. 

We are therefore deeply disappointed that these values have been abandoned in service of creating a ‘hostile environment’ for undocumented migrants in the UK, which is now undermining access to even life-saving healthcare. The same immigration system that is proved to be flawed, by detaining and deporting it’s own citizens, is now legally determining a person’s access to healthcare – this is unacceptable to any healthcare worker. 

Recent regulations now oblige hospitals to enforce charging at 150% of true cost, even before treatment, for a range of NHS care for anybody unable to prove their immigration status. They were introduced despite opposition from 193 organisations (see letter to former Health Secretary), and represent an unprecedented attack on the principles of the NHS and the right to health, depriving vulnerable people of essential healthcare.

It is well recognised that these policies will not result in significant cost savings, and may lead to greater costs due to missed preventative care and worsening public health. 

We are shocked that even the Windrush scandal, and high profile cases such as those of Albert Thompson, have still not led to these charging regulations being withdrawn, despite being only the tip of an iceberg.

There are many people living in the UK, including pregnant women and even children who were born here, who are in vulnerable circumstances, and who will now be unable to access free secondary heath care and a range of community services. 

We know that these regulations go far beyond those of a civilised country, and that many other comparable countries provide a free and full package of health care to undocumented migrants. The NHS was always intended to do the same, and has been doing so for the majority of its existence. 

In returning our medals, we call upon the government to remove the ‘hostile environment’ from the NHS, and reinstate it’s founding principle, the right to health.

Arbitrary immigration policies should not decide whether a person lives or dies

We are asking the UK Government to:

Repeal the October 2017 regulations enforcing immigration checks and upfront charging before treatment

Remove charges for pregnant women, newborns and children as a matter of priority. 

Suspend NHS charging regulations, given their clear evidence of harm, until an independent public health impact assessment is carried out, particularly focusing on vulnerable groups. 



Letter to the Prime Minister


24th JULY 2018


Dear Prime Minister,


Thank you for accepting this letter explaining why we have decided to return our Ebola Medals to the UK Government.

You have previously expressed the intention for Britain to be a ‘beacon of hope’, and this is an aspiration we truly believed in when we represented this country and the NHS in our work in West Africa during the Ebola epidemic.

However, we are deeply concerned about the implementation of ‘hostile environment’ policies, and in particular, their introduction into the NHS in the form of a regressive charging system. These policies contradict the values that inspired us in our efforts for which we were awarded medals. Whilst we remain extremely proud of our work, we regrettably feel that we are unable to keep the medals given to us by the UK government.

We were disturbed to see patients of the Windrush generation being denied NHS care under new charging regulations (including those of October 2017) which now require proof of immigration and residency status before treatment. We are glad that their specific situation has finally been recognised and efforts are being made to address it. However we remain deeply concerned that many others are being denied and deterred from even life-saving care, with more devastating consequences. The obvious next step would be to abandon the regulations.

We understand that health tourism, and its perceived drain on healthcare resources, has been used as a justification for these policies. However the estimated cost of this is minute. Indeed it has not even been demonstrated that the charging system saves more than it costs, and there is much evidence to suggest that it may actually cost more, with patients presenting at much later stages of their illnesses at greater cost to the NHS.

Furthermore, far from targeting ‘health tourists’, in many cases the people being denied or deterred from care are vulnerable people living in the UK. It is particularly disheartening that the regulations even apply to pregnant women and children. Exemptions for some vulnerable groups such as refugees, asylum seekers, victims of trafficking and slavery are not working, and all these groups have been charged, denied, and deterred from care.

This was clearly predicted in a letter sent in October 2017 to the then Secretary of State for Health, which was signed by 193 organisations. Despite this widespread concern, the legislation went ahead.

An NHS which was designed to be free at the point of use, for everyone, now finds itself in its 70th year denying care to some of the most vulnerable people. Britain, having been a pioneer of Universal Health Care, now takes an approach which contradicts international human rights laws (CECSR, Article 12), including the rights of the child (UNCRC, Article 24) and is significantly more restrictive than comparable countries, many of whom explicitly provide full and free access to primary and secondary healthcare for undocumented migrants.

Far from the aspiration we had for this country, we are concerned that Britain now stands out as a beacon of hostility, due to a political agenda against migrants.

We are calling on the government to:

  1. Repeal the October 2017 regulations enforcing eligibility checks and upfront charging
  2. Remove charges for pregnant women and children as a matter of priority.
  3. Suspend NHS charging regulations, given their clear evidence of harm, while an independent public health impact assessment is carried out, particularly focusing on vulnerable groups.

We cannot in good conscience keep our medals while the present system remains in place.

Thank you

Ebola Workers