Falling ill on a visit from Jamaica became costly nightmare for Pauline Pennant, who had worked in UK for 30 years

When Pauline Pennant, 70, and her 80-year-old husband, Basil, visited London for their nephew’s wedding three years ago, it was supposed to be the happiest occasion. Instead it was the start of an ongoing nightmare.

Pennant, a former nurse, became seriously ill and was admitted to Croydon University hospital on 25 August 2015. She received the worst news: a CT scan had found secondary bone cancer. The doctor advised her to see an orthopaedic oncologist and referred her for further tests to find the primary cancer.

“That was when they started to pursue me for money,” she said. As she lay on her hospital bed absorbing the devastating news, Pennant was quizzed about her status in the UK.

Q&A What is the Windrush deportation crisis? Show Hide Who are the Windrush generation? They are people who arrived in the UK after the second world war from Caribbean countries at the invitation of the British government. The first group arrived on the ship MV Empire Windrush in June 1948. What happened to them? An estimated 50,000 people faced the risk of deportation if they had never formalised their residency status and did not have the required documentation to prove it. Why now? It stems from a policy, set out by Theresa May when she was home secretary, to make the UK 'a really hostile environment for illegal immigrants'. It requires employers, NHS staff, private landlords and other bodies to demand evidence of people’s citizenship or immigration status. Why do they not have the correct paperwork and status? Some children, often travelling on their parents’ passports, were never formally naturalised and many moved to the UK before the countries in which they were born became independent, so they assumed they were British. In some cases, they did not apply for passports. The Home Office did not keep a record of people entering the country and granted leave to remain, which was conferred on anyone living continuously in the country since before 1 January 1973. What did the government try and do to resolve the problem? A Home Office team was set up to ensure Commonwealth-born long-term UK residents would no longer find themselves classified as being in the UK illegally. But a month after one minister promised the cases would be resolved within two weeks, many remained destitute. In November 2018 home secretary Sajid Javid revealed that at least 11 Britons who had been wrongly deported had died. In April 2019 the government agreed to pay up to £200m in compensation. Photograph: Douglas Miller/Hulton Archive

It was the beginning of her descent into a Kafkaesque world that has become familiar over recent months as the Guardian has revealed the scale of the effects of Britain’s “hostile environment” immigration policy on the Windrush generation.

Pennant told them the truth: she was a British citizen with a UK passport and had retired to Jamaica in 1993 to care for her parents, after 30 years working in Britain – mostly for the NHS. She did not have a GP because she saw no need for one. But none of it mattered, and she was handed a bill for £4,388.

“I was told quite clearly from the doctor that this [cancer] is what is taking place, I need to have this test done. And the sister of the ward said you won’t be able to have any more tests until you pay,” she said.

“The chief finance officer came round and said this is what I owe and I need to pay it and they won’t be able to continue to give me any treatment. I was warned that if I didn’t then I would be blocked from coming back to the UK. It’s like a death sentence.”

The law changed in April 2015 – three months before Pennant’s cancer diagnosis – so that overseas visitors would be charged for NHS healthcare. Despite being a British citizen and still paying UK taxes through her state pension, Pennant’s retirement to Jamaica means she is no longer entitled to free NHS healthcare. She appealed to the hospital’s patient advice and liaison service (Pals) but heard nothing back.

Facebook Twitter Pinterest Pauline Pennant and her husband, Basil. During their decades living in Britain they were never unemployed.

She said she was not told about the law change or warned she would be charged when admitted to hospital. Nor, she said, was she given any detailed information about her condition. “I said to them: ‘Look, if I’ve got bone cancer, I need to know because it’s now becoming part of my family history,’ and they wouldn’t even do that. They were withholding treatment and crucial information that they should have given me. That is what was more upsetting than anything else.”

It is a cruel irony that Pennant, her twin sister and their mother had all worked at Croydon University hospital for over 30 years between them, since the 1950s. “I was very ill, having to battle with all of this, not knowing what was happening, and as far as they’re concerned I’m ready to die. I said to Basil, I want to get back to Jamaica. If I’m dying, let me die in Jamaica,” she said.

Everything is collapsing in England because they’re not taking care of the people they should be taking care of Pauline Pennant

Desperate for information, Pennant paid for a positron emission tomography test at the privately run Cancer Centre London. To her surprise, and contrary to the earlier diagnosis, it found no sign of cancer. After returning to their home in the port town of Ocho Rios, on Jamaica’s scenic north coast, Pennant wrote to Croydon University hospital requesting an update on the Pals investigation. Again, she heard nothing back.

Then, on 26 October 2017, she received a letter from a debt collection agency, CCCI Credit Management. It warned her it would “instruct a field officer to visit you in order to discuss repayment of the debt” and “notify the Home Office that the account remains unpaid” unless she paid the £4,388 immediately. In bold red lettering, it added that she could be detained by the UK Border Agency unless she paid within 60 days.

Faced with the prospect of being unable to visit her children, grandchildren and brother, who is seriously ill in hospital, Pennant felt forced to pay back £50 a month from her UK pension, pending the outcome of an investigation into her case.

Play Video 2:00 Who are the Windrush generation? – video explainer

Pennant’s parents came to Britain from Jamaica in the early 1950s, in one of the first waves of the Windrush generation. Her mother was a hospital orderly and her father a carpenter, who helped rebuild schools, hospitals and factories after the second world war. Neither her parents, herself or Basil, were unemployed for a single day in the 40 years they lived in Britain, she said. “I’ve never taken anything from that system. I’ve never been unemployed, never been ill. To me now they’re saying: ‘Go and die, we’re not interested.’

“It really makes me ill to think I could have died there. England is a place I love dearly, I’ve got very good memories there and, in my estimation, everything is collapsing there because they’re not taking care of the people they should be taking care of,” she said, as we talk on her veranda on a typically humid May afternoon.

Pennant emphasises she is not interested in compensation. She will be 77 before the £4,388 is paid off and has not been able to visit Britain since the ordeal. She hopes the NHS or the government will cancel her debt, but more than anything she simply wants a letter of assurance from the Home Office that she will not be arrested when she next visits her family in Britain.

A spokesman for Croydon health services NHS trust said he had “absolutely every sympathy” with Pennant and that the hospital had gone “as far as we can, within the law, to help her”. However, he said the trust was legally required to charge non-UK residents for NHS care. He added: “We have worked hard to help Mrs Pennant by investigating her circumstances to identify any possible exemptions – but unfortunately none applied.”