Things Fall Apart: the British Health Crisis 2010-2020.

BACKGROUND: A very large number of studies have reported a stalling of health improvements in the UK since 2010. SOURCES OF DATA: Almost all relevant data are produced by the Office for National Statistics and other national statistical agencies. AREAS OF AGREEMENT: There has been a dramatic slowdown in life expectancy and diverging trends in infant mortality in the UK as a whole and England and Wales, respectively. AREAS OF CONTROVERSY: Many commentators are loath to describe the falls in life expectancy as actual falls or to ascribe blame to the political situation in the UK. GROWING POINTS: Health trends in the UK are worrying and raise important questions about government policies. AREAS TIMELY FOR DEVELOPING RESEARCH: These findings point to a need for greater investment in research on the political determinants of health, on the timely detection and interpretation of evidence of worsening health, and on how political and policy processes respond to such findings.

Creating a 'hostile environment for migrants': the British government's use of health service data to restrict immigration is a very bad idea.

In January 2017, the UK Government made public a Memorandum of Understanding (MoU) between the Department of Health, National Health Service (NHS) Digital and the Home Office. This Memorandum allows for the more expedited sharing of a patient's non-clinical data, specifically from the NHS England to the Home Office. The Government justified the MoU as in the 'public interest to support effective immigration enforcement'. In this review, we seek to unpack this justification by providing, first, a background to the MoU, placing it in the context of creating a 'hostile environment' for migrants - a project initially sought by Theresa May in her time as Home Secretary. We then explore the potential impact of data sharing on individual health, public health and on health professionals. We conclude that the MoU could threaten both individual and public health, while placing health professionals in an unworkable position both practically and in terms of their duties to patients around confidentiality. As such, we agree with colleagues' position that it should be suspended, at least until a full consultation and health impact assessment can be carried out.