How were migrants and healthcare framed in UK newspapers during the so-called Windrush scandal?

Problem

The relationship between migrants and healthcare is topical and increasingly politicised. Indeed in some framings of this relationship a migrant crisis is the cause of a crisis in the NHS. The "hostile environment" has resulted in restricted access to healthcare for migrants with incomplete documentation. The impact of this policy on migrants from the Windrush generation led to the resignation of the then Home Secretary Amber Rudd in 2018. This study aimed to increase understanding of the use of frames and their intended impact on public opinion, policy, service providers and vulnerable groups. This may shed new light on the wider determinants of health.

Approach

This study (by a fourth-year medical student) uses frame analysis : an approach informed by symbolic interactionism that examines systematically human communication identifying underlying messages as problems, solutions and moral/political discourses. Daily newspapers published in the UK were searched using Lexus online database covering one month before and one week after the resignation of Amber Rudd. Search terms included migrants/immigration + NHS/healthcare. After checking and sorting 97 articles were included in the analysis. All articles were analysed for framing of problems and those held responsible (diagnostics/ moral evaluation), and solutions (prognostics) including what needs to be done, what is the "calls to arms" and overall sociopolitical discourse. These were displayed matrices. Subsequently frame clusters and meta frames were generated from the frames set.

Findings

Analysis is still in progress but a number of frame clusters and meta frames are emerging. These include explicit calls to arms framing migrants as victims (of the hostile environment) or villains (causally responsible for the NHS crisis). Many seemingly factual articles also present frames but often in more subtle and nuanced ways. A initial finding relates to the concept of legitimacy (or candidacy) distinguishing some undocumented migrants (Windrush generation) as the entitled to healthcare than others (visa over stayers or perceived health tourists). We are also looking at Amber Rudd's resignation as the "solution" to an immediate problem and any mentions of Brexit.

Consequences

There is evidence hostile environment has had a negative impact on access to care some of the most vulnerable in society. The relationship between migrants and the NHS has become charged politicised issues that have underpinned recent debate, informed public opinion and policy. Frame analysis is a valuable tool to provide insight into how formal (and informal) communication is used to pass on predetermined messages that may inspire, mobilise, manipulate or actively divide and deceive. As truth and fake information are increasingly difficult distinguish employing techniques that systematically help us understand how messages are used to shapes perceptions and experiences may have wider value in healthcare research and education.