Grenfell laid raw the harsh realities for many living in London today. Many stories unfolded in the aftermath. There was the tale of two cities. The question of worth. The story of inexcusable inequality, and lives cut short by political failings. There was also the story of invisibility and fear. The undocumented migrants who died in the fire, forever anonymous, and the survivors who went into hiding, too scared to seek help.

I went to Grenfell with the charity Doctors of the world UK, a week after the fire. At Westway, the pop-up relief centre, we enquired who to liaise with and were told to speak to Sheena*, she appeared to be coordinating the medical response. We arranged a meeting, she explained what medical support was currently happening and we discussed the logistics of how our charity could help. At the end of the meeting, I asked what was her position. I had assumed she was from the government, or Public Health England, or at least from the council. She told us she was a filmmaker, lived locally, and had come to help the day after the fire. In the void of any eminence of leadership, she ended up as the unofficial coordinator of the medical response. I was dumbfounded.

There was no doubt that Sheena* and all the other volunteers at Westway, were doing incredible work to provide their best support for the Grenfell victims. But I couldn’t help ask myself the question; Had it been the neighbouring luxury flats in flames, would the medical relief effort be left to be coordinated by a filmmaker? It just seemed ludicrous.

In the weeks after the fire, the question I heard repeatedly, how did this happen in the richest borough in London? The question we should have been asking, prior to Grenfell, is why in Kensington borough, is there a 14-year difference in average life expectancy between the richest and the poor? Why, since 2010, did that century-long increase in life expectancy plateau?

Across the UK lives every day are silently cut short, from austerity, poor housing, deprivation and political decisions. According to DoH own data, in all of their 15 markers, health inequality among rich and poor has widened under the coalition and the Tories (after improving over the previous decade). Grenfell laid it raw. But the squeeze on public finances since 2010 is linked to nearly 120,000 excess deaths in England. Housing is core factor. 100,000s live in squalid, unsafe housing. Research by Shelter found that 48% of families in social housing who reported issues about unsafe conditions felt ignored or were refused help. The health implications of this we will be felt for decades.

It also became very clear within our first few hours at Westway, that in Grenfell tower there had been many asylum seekers and undocumented migrants residing. Many had since gone into hiding, too scared to seek help or medical care as they feared deportation. A volunteer told me there was a family that had escaped and were worried about their baby’s breathing but was too scared to seek help as they had a teenage son who was undocumented. We were told of an African woman in her 40s, who had fallen down the stairs on escaping the fire. Her partner and relatives were missing, She was experiencing dizziness and memory loss, but was too scared to go to A&E.

Unfortunately, their fears are not ill-founded. Migrants too scared to access care is not a new story. At the Doctors of the World clinic, regularly see pregnant women, cancer patients, victims of trafficking and abuse, too scared to access mainstream health services. This is due to laws brought in under Theresa May’s ‘hostile environment’ policy, which uses health care as an anti-immigration tool. The most recent, brought in 2 months before Grenfell, made it a mandatory legal requirement for healthcare staff to refer migrant patients to the home office if they access hospital care.

Thee were also concerns about visiting the GP surgeries. This is due to a controversial deal the home office has with NHS Digital (that was introduced without the knowledge of NHS staff) allowing the home office to access migrants data held by GP surgeries. The British Medical Association has vehemently opposed this, stating this breach of confidentiality undermines the sacred doctor-patient relationship and will deter the potentially vulnerable from seeking care. In January, after years of us campaigning, the Health Select committee enquired into this data sharing, determining “We are seriously concerned about the way NHS Digital has approached its duty to respect and promote confidentiality”, calling a halt and full review. Yet, the data sharing continues. It appears migrants do not have the right to medical confidentiality as the rest of us.

It was under these circumstances that Doctors of the World was forced to launch a safe and confidential pop-up clinic near Grenfell Tower, staffed by volunteers, to help survivors who were too afraid to get NHS care. We also had to write Jeremy Hunt, urging him to publicly state that survivors will not have their details shared with the Home Office. It was shameful this needed to be done, in the aftermath of this horrific tragedy. These racial ‘hostile environment’ policies remain in place in the NHS, as highlighted by the Windrush scandal. Encouraging fear around accessing services is a dangerous policy, makes migrants vulnerable, marginalized and invisible.

Grenfell exposed the human cost of austerity. To give justice to the victims, we need to ask the difficult questions. Do the lives of those on our streets have equal worth? Have our politicians addressed the structural discrimination, classism, and racism that underlaid the tragedy?

Lessons learnt? I’ll let you answer that.

*name changed to maintain anonymity

Dr Sonia Adesara – NHS Doctor and activist

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One Comment

  1. shyn43 says:

    I am sad but not surprised to hear that ”lessons have not been learned”.

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