The United Kingdom’s National Health Service (NHS) announced Tuesday that, under new rules for the agency coming in April, medical care providers can refuse to give non-critical care to patients who are “racist,” sexist,” “homophobic,” or are otherwise insulting and aggressive towards hospital staff.
Right now, the NHS can refuse to treat anyone who are “aggressive” or “violent” out of concern for the well-being of health care workers, but the new rules, set to take effect in April of 2020, expand who the NHS can turn away — though it’s not entirely clear how the NHS would know a possible patient was “racist,” sexist,” or “homophobic,” or whether there are procedures in place to separate the truly mentally ill from the merely problematic.
Sky News reports that much of the decision may be made by front-line hospital workers: “these protections will extend to any harassment, bullying or discrimination, including homophobic, sexist or racist remarks.”
The UK’s Health Secretary Matt Hancock, a conservative serving under Prime Minister Boris Johnson, told NHS employees that “no act of violence or abuse is minor,” in a statement made earlier this week and that “[b]eing assaulted or abused is not part of the job.”
The NHS already allows medical workers to refuse to treat patients who are aggressive or violent and, theoretically, this rule would simply extend that allowance to cover those patients who are overtly insulting to staff, perhaps indicating that they do not want treatment from a woman or someone with specific religious garb, if what ails that patient is non life-threatening.
Hancock’s statement, though, seems to indicate that staff will make value judgements about patients even in emergency situations.
“Far too often I hear stories that the people you are trying to help lash out. I’ve seen it for myself in A&Es, on night shifts, and on ambulances,” Hancock said, referring to UK hospitals’ “accidents and emergency” departments, the equivalent of American ERs and EDs. Hancock added that he is “horrified that any member of the public would abuse or physically assault a member of our NHS staff but it happens too often.”
While the rule poses a host of problems, including who might be placed in charge of determining what behavior is considered racist, sexist, and homophobic, and what might constitute verbal harassment or abuse, the biggest concern appears to be for the mentally ill, who may seek treatment, even for non life-threatening ailments, but be unable to control their behavior. If they are labeled “abusive,” “aggressive,” or “harmful,” they will be turned away from medical care.
According to a study taken by the Parliamentary and Health Service Ombudsman last year, Sky News says, the issue is already a problem for the NHS: “one in five mental health patients do not feel safe in NHS care,” the study reported, and “[m]ore than half of people with mental health problems in England also said their treatment was delayed, while 42% said they were diagnosed too late.”
Johnson’s government is trying to get a handle, overall, on problem — specifically financial problems — that are threatening the longevity of the UK’s national health service, and the new rules are part of a plan to help stabilize the system, but they make come too little too late. According to the BBC, the NHS’s budget has exploded and 30% of Britain’s domestic spending now goes to public health.