Charging medical students for viral screening
1Some medical schools refer prospective students for an intensive schedule of viral screening and immunisation to ensure the student is fit and fully immunised at the start of training. Am I permitted to charge an NHS patient for this service?
It is the responsibility of the medical school, not the GP, to ensure students are fit to start training and have been properly screened and immunised before starting clinical attachments that could place them or their patients at risk.
However, this is an occupational health issue and universities/trusts should undertake to provide and fund this service themselves.
Under the terms of service a GP cannot charge patients for providing medical treatment that a GP would normally be expected to provide.
But GPs are not required by the terms of service to provide an occupational health service and it is unreasonable for medical schools to transfer their responsibilities to GPs who are already
struggling to cope.
Preventing the transmission of disease, especially potentially fatal blood-borne infections, is an extremely serious occupational health issue that requires far more than a series of tests and immunisations.
It is unreasonable to allow newly-enrolled students to have such close clinical contact as to create a significant possibility of transmitting infection. Relying on screening and immunisation carried out by a third party could well create a false sense of security with increased risk of transmitting potentially lethal infections, including those for which immunisation is not yet available.
Some medical schools accept students who have not been screened or immunised and organise comprehensive screening and immunisation together with thorough training in infection control before allowing close clinical contact. This seems an eminently sensible approach.
It is incumbent upon medical schools to develop proper policies for implementing and funding an effective occupational health programme. This could be based upon a private occupational health service, perhaps provided by those doctors with the relevant interest and expertise to participate.
Until then we would advise all GPs to resist the pressure to provide a free occupational health service for medical schools.
Dr Christine Dewbury, Wessex LMCs
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