Can the Home Office use health records for ILR determination?

Hi all, thanks for reading my post. I'm new to the forums.
I've been in the UK on continuous visas since 2014 and will be applying for ILR next year. I've always paid the immigration health surcharge (or was eligible for NHS treatment before the surcharge existed), and so have always been eligible to access the NHS like a permanent resident. I don't owe any debt to the NHS.

However, I have complex health issues, and my GP is currently asking the local NHS trust for some NHS funding to support a specific treatment they argue that I need. I have confirmation that this is OK for them to do for someone on a visa who has paid the surcharge, so I know it's fine for the GP to make this application and for me to get the treatment. It's covered under my immigration health surcharge.

My question is: when I go to make my ILR application, can the Home Office see my clinical health records (like, diagnoses, details of treatment, etc), and use that to make a determination about, say, 'conduciveness to the public good' to grant me ILR? My concern is that they'd see that I have complex health issues/have needed special medical treatment and argue that I'm a burden on the NHS or something and refuse my ILR on that basis.

I'm considering asking my GP to wait to apply for the treatment funding until after ILR just to be safe.

I've tried to research data sharing between the NHS and the Home Office and it's an absolute mess of litigation and unclear information. I know that the Home Office has accessed patient clinical notes before - for a girl's family claiming asylum (but obviously this is a different situation): https://www.bmj.com/content/365/bmj.l1811

Any clarity (and hopefully reassurance?) would be really appreciated.

Anyone who is not “ordinarily resident” (i.e without ILR) in the UK is liable to be charged for most secondary healthcare treatments. But the regulations go on to exempt anyone who has paid the Immigration Health Surcharge. The Surcharge is levied on most applications to enter or remain in the UK for more than six months. As a result, people with immigration permission who have paid the surcharge are “generally entitled to relevant services on the same basis as a person ordinarily resident in the UK”. That means there is no effect on your ILR as you are entitled to use the NHS services just like anyone else

Thank you for your response! So I'm not sure if my question was clear - let me clarify a bit:

I know that I am entitled to use the NHS as an ordinarily resident person. I'm just worried that using it a lot/having really complex medical needs will harm my ILR application (because I would theoretically cost the NHS more than your average resident). Hence me asking if they have access to my NHS medical records.

Or were you saying that all they care about is that I've been entitled to use the NHS and they don't care how much? Did you mean that I have a right to access the NHS as usual and therefore it can't be used against me in a residency application?

Debt to the NHS grounds

9.11.1. An application for entry clearance, permission to enter or permission to stay may be refused where a relevant NHS body has notified the Secretary of State that the applicant has failed to pay charges under relevant NHS regulations on charges to overseas visitors and the outstanding charges have a total value of at least £500.

or equivalent may be the NHS grounds for a refusing. If you don’t have a debt to the NHS, then they would not have this ground to refuse.

I doubt that using the NHS, without incurring a debt, falls for a refusal under Non-conducive grounds.

Historian93 wrote: ↑

Tue Apr 18, 2023 11:46 pm

Thank you for your response! So I'm not sure if my question was clear - let me clarify a bit:

I know that I am entitled to use the NHS as an ordinarily resident person. I'm just worried that using it a lot/having really complex medical needs will harm my ILR application (because I would theoretically cost the NHS more than your average resident). Hence me asking if they have access to my NHS medical records.

Or were you saying that all they care about is that I've been entitled to use the NHS and they don't care how much? Did you mean that I have a right to access the NHS as usual and therefore it can't be used against me in a residency application? Correct, it is the charges to access the treatment that you have paid for and the level or frequency of usage of NHS services wouldn't be a determinant of your conduciveness to be in the UK. What of those who despite paying didn't have to use NHS services?

Do not overthink the matter, won't work against you.

Historian93 wrote: ↑

Tue Apr 18, 2023 11:46 pm

Thank you for your response! So I'm not sure if my question was clear - let me clarify a bit:

I know that I am entitled to use the NHS as an ordinarily resident person. I'm just worried that using it a lot/having really complex medical needs will harm my ILR application (because I would theoretically cost the NHS more than your average resident). Hence me asking if they have access to my NHS medical records.

Or were you saying that all they care about is that I've been entitled to use the NHS and they don't care how much? Did you mean that I have a right to access the NHS as usual and therefore it can't be used against me in a residency application?

Your concerns have no basis in the immigration rules.