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Court of Appeal rejects challenge to sharing of NHS debt data for immigration sanction purposes


R (WXYZ) v Secretary of State for Health

The Court of Appeal has unanimously rejected a challenge to the sharing of NHS debt data for the purpose of imposing immigration sanctions.

In doing so, the Court of Appeal confirmed the judgment of Mr Justice Silber handed down on 15 May 2014 [2014] EWHC 1532 (Admin).  A news item summarising that judgment can be found here.

Whilst in general, health services in England and Wales are provided free of charge, individuals who are not ordinarily resident in the UK are (subject to various exceptions and exemptions) obliged to pay for NHS treatment.  The Immigration Rules allow immigration sanctions to be imposed on individuals who have unpaid NHS debts of at least £1,000.  NHS trusts are therefore required to provide the Secretary of State for Health with certain data about individuals who owe such debts, including their name, date of birth, address and the amount and date of the debt and the name of the NHS body to which it is owed.  This “NHS debt data” is then passed on to the Home Office, which administers the immigration sanction system.

Four individuals who owed NHS debts brought a claim for judicial review challenging the transmission of NHS debt data.  Rejecting the challenge, the Court of Appeal found as follows:

  1. The NHS debt data was in general not private information vis-à-vis the Secretary of State for Health and the Home Office, because individuals who were made aware that the information would be shared for the purpose of the immigration sanction system could have no reasonable expectation of privacy in relation to the sharing of that information.  In certain special circumstances where the debtor was not aware that their data would be shared in this way, the information might be private.  Even where this was the case, however, the patient’s right to privacy and confidentiality would not be infringed by disclosure of the NHS debt data, because the interest in disclosure outweighed the interest in privacy.
  2. The Secretary of State for Health had the requisite powers to require NHS bodies to transmit the data to him and then to pass the data on to the Home Office.  The guidance requiring NHS bodies to pass the data to the Secretary of State did not unlawfully fetter their discretion, because they were required to provide the data and therefore had no discretion to fetter.
  3. Whether or not the nature of the NHS debt data was such as to engage the right to private life under Article 8 ECHR, the sharing of that information was in accordance with the law and therefore Article 8 was not infringed.

The judgment is here.

The Secretary of State for Health was represented by Marie Demetriou QC, Sarah Love and Sarah Abram.