Date: Mon, 12 Feb 1996 16:42:33 +0000 From: Mark Watson Subject: HIV & AIDS Policy in the UK Dear Friends, PLease find below a copy of the current policy in the UK as regards cases where the applicant has HIV or is AIDS symptamtic. The document is circulated to caseworkers in the Home Office and is therefore more detailed than any "public" policy. You will see that the plicy is rather vague but gives some idea of their processes, particularly when it comes to publicity. Mark Leaked BDI 3/95: Instructions to caseworkers: IMMIGRATION AND NATIONALITY DEPARTMENT B DIVISION INSTRUCTIONS AIDS AND HIV POSITIVE CASES 1. Introduction 1.1 This instruction gives guidance to staff on how to proceed in cases involving those suffering from AIDS or who are HIV positive. This instruction also applies to EEA nationals and their family members. 2. Policy 2.1 There is as yet no cure for AIDS and treatments currently available are unable to extend a person's life expectancy significantly. The fact that a person is suffering from AIDS or is HIV positive is not grounds for refusing entry clearance or leave to remain if the person concerned otherwise qualifies under the Immigration Rules. 2.2 Equally, the fact that an applicant has AIDS or is HIV positive is not in itself sufficient grounds to justify the exercise of discretion where the requirements of the Rules are not met. As a general rule, AIDS cases requiring the exercise of discretion should be evaluated in the same way as any other case where the applicant has a terminal illness, eg cancer. Cases involving persons certified as having AIDS should be distinguished from those where the person concerned has been diagnosed as HIV positive. A person who has been diagnosed as HIV positive may still be well and a serious case for exceptional treatment is unlikely to arise. 3. Entry clearance 3.1 Applications for entry clearance from persons who disclose that they are suffering from AIDS/HIV may be referred by the ECO to the Home Office via MVD. The applicant should fully meet the requirements of the Immigration Rules for the category specified. If there is evidence to suggest that the applicant is currently in need of regular medication or treatment, he should provide evidence of his ability to meet the costs of such medication or treatment during his stay. This is in addition to the usual requirements as regards maintenance and accommodation. A person with AIDS/HIV seeking an entry clearance to come to the United Kingdom for medical treatment should meet the usual requirements of the medical visitors' rules. 3.2 As explained in paragraph 2.1, the fact that a person suffers from AIDS or is HIV positive is not in itself grounds for refusing entry clearance. However, where in any cases it appears that public health may be at risk, advice should be sought from: Department of Health International Relations Unit 18 Room 538, Richmond House 79 Whitehall London SW1A 2NA Tel: 0171 210 4866 4. On entry 4.1 The policy and practice adopted on entry at ports will be to adhere to the provisions of the Rules. Where a passenger is found to be suffering from AIDS, the advice of the PMI will be sought in the normal way in order to determine whether the passenger can satisfy the Rules. Where a passenger does not qualify, entry is to be refused. 5. After entry 5.1 Any application for leave to remain where there is evidence that AIDS/HIV is a factor should normally be determined on its merits under the Immigration Rules. However, in some cases there may be strong compassionate circumstances which justify the exercise of discretion outside the Rules even though treatment is provided on the NHS. 5.2 Where an applicant seeks leave to remain outside the Rules on compassionate grounds relating to the fact that he has AIDS or is HIV positive, he should be asked to provide a letter from his consultant confirming: (a) that he has AIDS or is HIV positive (b) his life expectancy (c) the nature and location of the treatment he is receiving (d) his fitness to travel if required to leave the country 5.3 In considering an application for leave to remain, it may be necessary to confirm the availability of treatment for AIDS in the applicant's own country. In cases of doubt details should be sought from the relevant post abroad. 5.4 In many cases the medical facilities and treatment available in the person's country of origin will be substantially less advanced than those available in the United Kingdom. This is likely to be true as regards any serious illness and does not in itself constitute grounds for allowing someone with AIDS/HIV to remain. However, there may be cases where it is apparent that there are no facilities for treatment available in the applicant's own country. Where evidence suggests that this absence of treatment would significantly shorten the life expectancy of the applicant it will normally be appropriate to grant leave to remain. 5.5 Cases where the exercise of discretion does not seem to be appropriate should be refused in the normal way. They need not be referred to IS(E). Caseworkers should, however, be aware that, allowing time for appeals etc., the medical picture may look very different by the time enforcement is being considered. IS(E) will not proceed where there is no prospect of effecting removal, eg where the person concerned is not fit to travel or has only a few months to live. Such cases will be referred back to S1 to reconsider the merits of allowing the person to remain for a limited period on compassionate grounds. 5.6 Cases involving AIDS/HIV are emotive and have the potential for considerable publicity. Equally, given the scale of the problem, there is a risk of adverse publicity if it became clear that we were routinely permitting anyone with AIDS or who was HIV positive to remain here to receive treatment at public expense. Cases relating to the grant or refusal of leave to remain on compassionate grounds should be referred to SEO level for decision and passed to B2 to note after action. 6 EEA nationals 6.1 A broadly similar approach will be applied to EEA nationals and their family members. Such persons coming specifically for NHS treatment cannot, under Community law, be refused entry on those grounds alone. They would, however, be expected, under a Department of Health operated scheme, to have a certificate confirming that their parent state will bear the cost of treatment before being allowed access to specialist NHS treatment. 7 Friends or relatives coming to care for someone with AIDS/HIV 7.1 A person who wishes to come to the United Kingdom for a short period to care for a friend or relative may be admitted as a visitor provided we are satisfied that the requirements of the Immigration Rules relating to visitors have been met, including that the provision of care will not constitute employment, paid or unpaid. 7.2 The maximum period allowed for a visit is six months, although it may be appropriate to allow a short extension to this period in exceptional circumstances (see BDI2/95: "Carers"). 8 Enquiries Any enquiries about this instruction should be addressed to Jon Payne ext. 2957 or Nicola Hearn ext. 2470, B2 Policy Division. BDI 3/95 Reference: IMG/94 36/77/1 Date: August 1995 Mark Watson Stonewall 16 Clerkenwell Close London EC1R 0AA Tel. 0171 336 8860 Fax. 0171 336 8864 http://www.tyger.co.uk/sig/