HC2 Certificate Eligibility, Immigration Compliance and NHS Funding Divergence: FOI release

Information requested

1. Immigration Status Verification and Policy Divergence

a.What formal process exists in Scotland to verify immigration status (including leave to remain and NRPF conditions) when assessing HC2 certificate eligibility for NHS-funded care?

b. On what legal or devolved policy basis does the Scottish Government permit divergence from the UK-wide NHS Cost Recovery Programme and immigration enforcement rules under the Immigration Act 2014, particularly regarding the exclusion of illegal entrants and NRPF individuals from routine NHS treatment?

c. Has the Scottish Government received or commissioned any legal advice or briefing papers justifying divergence from UK NHS eligibility rules for those without lawful status?

2. Use of Public Funds and Fiscal Governance

a. Does the Scottish Government consider the use of devolved NHS funds for the treatment of persons without legal immigration status or with NRPF to be compliant with the Scottish Public Finance Manual (SPFM), specifically regarding regularity, propriety, and value for money

b. Has any internal audit, financial risk assessment, or ministerial discussion taken place regarding the fiscal impact or legality of issuing HC2 certificates to ineligible non-UK nationals?

c. What is the total number and cost of HC2 certificates issued in Scotland over the past five financial years to individuals who:

• had no valid leave to remain,
• were subject to NRPF conditions, or
• were otherwise ineligible under UK-wide NHS entitlement rules?

3. Equality and Public Confidence

a. Has the Scottish Government assessed whether granting free NHS access via HC2 certificates to individuals without legal immigration status could:

• Constitute indirect discrimination against low-income or Scottish-born residents under the Equality Act 2010,
• Breach the public sector equality duty,
• Undermine public confidence in lawful, fair, and consistent healthcare access?

4. Communications, Third-Party Influence, and Public Transparency

a. Has the Scottish Government issued, received, or rejected any internal or public communications guidance relating to the political sensitivity or reputational risk of this issue?

b. Please provide any correspondence, guidance, or lobbying materials received from third-party organisations (e.g. migrant charities, NGOs, or advocacy groups) in the past five years regarding HC2 certificate access, immigration-based eligibility, or divergence from UK policy.

c. Has the Government received or responded to any press enquiries or parliamentary questions relating to this matter since 2020?

5. Legal Accountability and Related Complaints

a. Is the Scottish Government aware of any formal legal challenge, ministerial concern, or whistleblower disclosure relating to the misuse of HC2 certificates or the failure to apply immigration-based NHS eligibility checks?

b. Has the Scottish Government responded to or been made aware of any related complaints raised to:

• Audit Scotland,
• The National Audit Office,
• The Public Audit Committee,
• The Department of Health and Social Care, or
• The Home Office?

If so, please provide all internal records of these interactions, including advice or follow-up actions.

Response

While our aim is to provide information whenever possible, in this instance the Scottish Government does not have the information you have requested.

This is because the Scottish Government does not grant HC2 status, this is done by the NHS Business Services Authority (BSA) in collaboration with relevant Scottish and UK government bodies. For the majority of patients this is via an HC1 application with appropriate evidence of proof, but where an asylum seeker or refugee is concerned, NHSBSA do this automatically where the person has been granted a section 95 letter. A section 95 letter is provided by the Home Office.

With regards to questions 1(a), 1(b), 1(c), 2(a), 2(b), 2(c), 3(a) we do not hold this information so in the spirt of advice and assistance you may wish to direct these questions to the relevant public authority by email at: foirequests@nhsbsa.nhs.uk.

​​​​​​​Under section 17(1) of FOISA that the Scottish Government does not have the information you have requested for questions 4(a), 4(c), 5(a) and 5(b). However here are some links to websites and documents you may find helpful.

• ​​​​​​​Healthcare for refugees and asylum seekers | NHS inform.
• Section 95: Asylum support application: help and guidance - GOV.UK

For question 4(b) we have found the following document which you may find helpful. Migrants’ Rights and Entitlements to Local Authority Services and Support - National Guidance

About FOI

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