Politics of Hospitality in the NHS: Immigration Enforcement through the Provision of Healthcare in England.

Abstract

Healthcare provision by the NHS is framed by an ethical framework fleshed out in values and principles that should inform the service in everything it does. Values such as dignity and everyone counts as well as principles such as healthcare based on clinical need, and not ability to pay reveal a normative commitment to humanity and a sense of universal care on the basis of equal human worth. Not only is this ethics concerned with the delivery of improvements in the health and wellbeing of patients, but also with the provision of healthcare in a cordial and generous manner so that patients can feel welcomed into the service. In other words, the ethics underpinning the operation of the NHS construes healthcare provision as an offer of hospitality: The NHS constitutes the home which welcomes the ill by providing the gifts of curing bodies and alleviating suffering. This promise of hospitality, however, is troubled by healthcare provision for migrants. Data-sharing policies operating through the system for charging migrants for health services allow for the transfer of migrant patients personal information to the Home Office for purposes of immigration enforcement. Hospitality, viewed in this light, blurs the boundaries between health enhancement and border control, and enables the enactment of hostility towards migrants under the care of clinical staff. In this thesis, I investigate what happens when migrants are welcomed into the NHS. In carrying out my analysis, I flesh out the argument that, once migrants are welcomed into the service, practices of hospitality which deliver improvements in their health and wellbeing also subject them to hostility by means of technologies of power which control borders through the provision of healthcare. In doing so, I examine how the welcome of migrants into the NHS brings about ethical dilemmas for healthcare workers which cannot be resolved by the mere application of the moral guidelines orienting the professional practice of medicine. In this vein, the thesis interrogates hospitality as an entirely benevolent act, as well as healthcare as an intrinsic good delivered through medical interventions.

Date of Award	1 Aug 2023
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Anna Coleman (Supervisor) & Andreja Zevnik (Supervisor)