The innate right of settled migrants, including those providing vital services in the health and care sectors, to care for their elderly parents in a familial setting has been hampered by the Government’s Adult Dependent Relative Rules.
The current ADR rules and the impact of their enforcement on families and children and grandchildren was forcefully described by the Joint Council for the Welfare of Immigrants (JCWI) Report (2014) as “Harsh, Unjust, and Unnecessary”. The current criteria is very prescriptive and limits any reasonable chance of successful applications as the Rules and their interpretation stipulate the elderly person must demonstrate that s/he “requires long-term personal care to perform everyday tasks; and be unable to obtain the required level of care in the country where they are living, ” an extremely insuperable thresholdupheld by the Court of Appeal in Britcits v Secretary of State for the Home Department  EWCA Civ 368
As a consequence, families have been deliberately fragmented and segregated for many years, and many key workers, (including doctors and health care professionals) have had to make multiple annual journeys, whenever their parents, or a surviving parent falls ill, causing much disruption to their patient/client groups and work teams.
A significant number of essential health professionals have abandoned careers here when the filial importance of caring for their parent became the priority, and as they do not want to abandon a parent to care or housing or social help which is often unregulated, non- accredited and unreliable.
As a senior Court of Appeal Judge noted in a previous landmark case:
“The availability of medical care (public or private) is no substitute for the ordinary expectation that an elderly and ailing parent would be looked after by his family, and that the ability to do that was an important part of family life for both the carers and the cared-for.”
It is not about the adequacy of care alone, but also the importance and relevance of bonded support and care from the children and grandchildren, and such care should be seen as alleviating the loneliness, lack of dignity and lack of purpose felt by those parents abandoned to institutional care.
When he was Health Secretary, Jeremy Hunt opined that “loneliness and isolation” among the elderly is “something that we actually want to do something about”, and that entering old age “should not involve waving goodbye to one’s dignity” (at the National Children and Adults Services (NCAS) conference in 2013).
Applying that objective humanely to all families would mean that no elderly parent is made vulnerable, and UK law does not discriminate against migrants or many British citizens in relation to the right to safeguard, and provide such care to an older parent.
A leading psycho-geriatrician, Dr Junaid, has noted that research shows that depression and morbidity are decreased by such familial care, stating:
“Families provide essential financial, practical and emotional support. When children are abroad, in addition to the social isolation, it is much more difficult to put in place practical help and support. It is possible to make the argument that those left behind are in greatest need of support.”
During the Covid-19 pandemic, the non-viability of travel has brought the needs of an elderly parent abroad into focus. Their adult children here face the prospect of being unable to provide care for their elderly parent within a home setting, especially if they become ill. These children are also unable to be sensitive to carry the terminal wishes and needs of the parent and are also unable to perform post death rites.
This Government is asked to commit now to the immediate reform of the ADR rules and policy, and to ensure that the stringencies of its interpretation are removed by urgent legislation, to ensure a family care centered approach for the reunification of settled migrants and their elderly parents.
British Association of Physicians of Indian Origin (BAPIO) and Association of Pakistani Physicians of Northern Europe. (APPNE) have joined hands to take up this humanitarian issue for a campaign.