The High Court has rejected a challenge to the NHS charging regulations. In a decision handed down just before Christmas, Mrs Justice Foster found against a Ghanaian woman who was billed £100,000 for her daughter’s life-saving liver transplant. The case is R (Shu & Anor) v Secretary of State for Health and Social Care & Anor [2019] EWHC 3569 (Admin).

The family had no leave to remain in the UK at the time, meaning that they weren’t entitled to free NHS care. But the daughter, referred to as E in the judgment, has since become a British citizen. The family argued that the failure of the charging system to extinguish the debt in such circumstances amounted to unlawful discrimination.

Foster J disagreed:

The argument on both sides ranged far and wide, however put simply, the issue is in essence can the Defendants justify the fact that SHU has a debt in respect of her child E’s NHS treatment, which has the potential, theoretically, to impact her own immigration status, whereas the children of others who were also once without ordinary residence status (although not at the time of treatment), do not have to pay, meaning their parents’ equivalent position would not be so burdened?

In my judgement the answer is yes, they plainly can.

This is not the first unsuccessful challenge to the charging regulations: see Advance NHS charges for overseas visitors comply with the Equality Act.