Disability & Immigration Law in the United Kingdom

The United Kingdom’s Immigration Rules

The United Kingdom’s Immigration Rules outline possible medical grounds of exclusion for visa applicants. Rule 36 provides for an Immigration Officer to refer any person seeking entry to the UK to a Medical Inspector at the port of entry for medical examination and to refuse entry if the person is not cleared. Usually, only persons intending to remain in the UK for 6 months or more are required to have medical clearance.

A medical examination is not mandatory. Each post can make its own policy based on regional factors. Where a post is satisfied that the health care system in a host country provides adequate guarantees that applicants will be in good health, medical examinations can be waived.

Medical Examination

The medical examination of an entry clearance applicant will be undertaken by a Medical Officer who will then pass the results to the Medical Referee. The function of a Medical Referee is to make a recommendation to the ECO concerning the suitability of the applicant for entry to the UK on medical grounds. In some countries, the posts of Medical Officer and Medical Referee are combined.

The objective of the medical examination is to prevent the entry of, or bring to notice, persons who if admitted to the UK might:
a. endanger the health of other persons in the UK; or
b. be unable for medical reasons to support themselves and/or dependants in the UK; or
c. require major medical treatment (for which an entry clearance application has not been made).

Where an applicant has been diagnosed with pulmonary tuberculosis, leprosy, trachoma, a mental disorder, senility, conduct disorder (e.g. alcoholism, drug addiction, serious sexual aberration, etc) or any disease, physical defect, bodily deformity or fits of any kind which would prevent them from supporting themselves or their dependants, the Rules recommend the applicant be refused on medical grounds.

When appropriate, the Medical Referee may recommend that a person should not be issued with an entry clearance until he/she has undergone a course of treatment, or until after a stipulated length of time. The Referee may also recommend that the person undergo a course of medical treatment after arrival in the UK.

According to Rule 320(7), where the Medical Inspector finds that an applicant is undesirable based on medical grounds, the applicant will be refused unless there are “strong compassionate reasons” to justify admission. This determination is made by the Home Office.

Whether a medical refusal attracts a full right of appeal or a limited right of appeal depends on the reason for entry to the UK. Visitor visa applicants do not have a right of appeal however applicants for visas which would allow them to stay longer than six months do.

Comparison to Canada

UK medical examination requirements are much less stringent than Canadian requirements. Unlike in Canada, medical examinations are not required of all visa applicants. Screening for HIV and tuberculosis is also not standard. Waivers are available where an applicant agrees not to rely on publicly-funded medical treatement through the National Health Service.

Although the UK does not bar applicants based on prospective excessive demand on social or health services, applicants can be refused where they may require “major medical treatment” and there are insufficient compassionate grounds to issue a waiver. Overall, the issue of disability and immigration is not a particularly controversial one in the UK. There has been periodic debate on whether the immigration system is too open resulting in immigrants burdening the health system. An ongoing debate has taken place in the UK regarding whether mandatory medical testing should be implemented for all immigrants. In 2004, the UK Home Ministry shelved plans for mandatory HIV testing of all immigrants, fearing the rule may encourage illegal immigration and push the disease underground.