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Gold, incentives and meh

Americans in second position in league table of NHS tourists

So-called NHS tourists most commonly consult GPs for routine reproductive health care and to get treatment for cardiac problems, a survey has found.

The study also revealed Americans are the second largest group to visit the UK to take advantage of free NHS care.

The survey by the Centre for Health Economics at the University of York, commissioned by the BBC, found 51.6 per cent of 159 GPs had seen patients in the past three months they suspected were not eligible for free treatment.

Most of the GPs had seen between one and 10 patients they suspected were ineligible but 6.4 per cent had seen 21 or more such patients.

Women accounted for 64 per cent of the patients GPs believed were ineligible. Some 14 per cent of suspected NHS tourists were from Pakistan, 9.1 per cent from the USA and 6.6 per cent India.

British patients whom GPs thought were ex-pats accounted for 5.8 per cent of cases, the same as people from Nigeria. GPs listed 41 nationalities in total.

Of 89 casenotes provided by GPs, 19.1 per cent related to reproductive conditions, including miscarriage, infertility, menopause and pregnancy.

Cardiac problems and related conditions including hypertension and varicose veins were the next biggest group at 16.9 per cent of cases.

Only 3.4 per cent of consultations related to HIV, a similar figure to

more minor problems such as toenail infections, rashes, eye problems and abdominal pain.

Dr Paul Kind, who compiled the survey, said the findings tallied with hospital surveys. Dr Kind, a senior research fellow for the centre, said profound ethical considerations as well as cost concerns were thrown up by NHS tourism.

One of the GPs surveyed treated a patient he believed was a victim of torture while others raised the issue of treating women who go into early labour while on holiday in the UK.

Dr Kind said: 'Where do we draw the line? Do we go the American way and only provide treatment if patients have insurance?'

The Department of Health, which recently launched a consultation into NHS tourism in secondary care, said it was considering extending the process to primary care.

Origins of suspected

NHS tourists %

Pakistani 14

American 9.1

'Asian' 8.3

Indian 6.6

British/UK 5.8

Nigerian 5.8

Conditions sought for

treatment by suspected

NHS tourists %

Reproductive health 19.1

Cardiac problems 16.9

Hand/leg injuries 7.9

Diabetes 6.7

Back pain/rheumatism 5.6

Eye problems 3.4

HIV worries 3.4

'Get patients to show NHS cards'

Dr Ian Burton believes patients should have to show their NHS card when they register to prove eligibility for free treatment.

Having faced the threat of being taken to the Commission for Racial Equality after he attempted to combat NHS tourism in his practice, he said GPs were powerless to reduce the number of tourists. GPs could offer to treat patients without an NHS card privately if the Government forced patients to show it, Dr Burton, a GP in Didsbury, Manchester, added.

'So many patients enter the NHS through GPs, but if you say anything you are in the realms of racism.'

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