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GPs call for primary care charges to prevent 'health tourism'

Exclusive GPs should be able to charge overseas visitors if there is any doubt over their eligibility for healthcare in order to prevent ‘health tourism’, LMC leaders have urged ministers.

Bedfordshire and Herfordshire LMC has written to the Department of Health and the Home Office to urge them to to tackle the ‘difficulties’ faced by GP practices, who often have to treat visitors even if think they may not be eligible for care.

The intervention comes after Pulse revealed that more than half of GPs believe NHS entitlements for migrants are too generous, with some practices refusing to register patients they believe to be illegal immigrants or failed asylum seekers.

A Government review into the rules around migrant access to NHS services is due to be published shortly, and will look at whether charges for GP services should be considered.

In the letters to Mark Harper, the minister for immigration, health secretary Jeremy Hunt and local MPs, the LMC urges them to ensure that visitors entering the country have their eligiblity stamped on their passport.

Click here to read LMC letter

It cites ‘many examples’ where GPs have felt compelled to treat patients who are overseas visitors, even though they suspect they have come to the UK to gain health services.

Chief executive of Bedfordshire and Hertfordshire LMC, Dr Peter Graves, wrote: ‘Those of us who pay our taxes do not expect to see precious NHS resources abused by people coming from abroad with the sole purpose of accessing free healthcare.

‘The main message of my letter is to ensure that you understand the difficulties faced by GPs, who are not the gatekeepers into the NHS and who find it impossible to police the abuse of the NHS by such visitors.’

Dr Graves called on the Government to make the rules on eligibility much clearer and for border controls to ensure they are aware when they arrive whether they are able to access free healthcare.

The letter states: ‘We would suggest that, if there is any doubt, GPs and hospitals should be instructed to charge patients and leave it up to the patient to make a case that they should be reimbursed.’

Dr Graves told Pulse that health tourists were a ‘national issue’ and that he will be meeting three MPs in the area to discuss how to tackle it.

He said: ‘If someone has an accident or falls acutely ill while they are visiting our country, we would treat them compassionately and they would almost certainly not end up with a bill. It’s the people who come here specifically to abuse the system.’

A reply from the Department of Health to the LMC said it was conducting a review of the rules, which it agreed were ‘too complex, overly generous and inconsistently applied’.

Click here to read DH’s reply

It said: ‘Ministers believe that measures are needed to provide a balance of fairness and affordability in the provision of NHS treatment for overseas visitors.

‘Therefore, the Government announced in March 2011 that we would undertake a thorough and wide-ranging review of the rules. The review has been concluded and the next steps are being considered.’

The review will consider: whether overseas visitors should be eligible for primary care charges; whether the term ‘ordinarily resident’ needs to be changed; and whether health insurance should be a requirement for visas.

Dr Richard Vautrey, deputy GPC chair, said ‘it was right’ that border controls should determine the eligibility of patients, rather than GPs.

But he added: ‘But my fear is that the Government will choose the easier option from their point of view and place the burden on practices and that would be completely unacceptable.’

Readers' comments (7)

  • Vinci Ho

    GPs can only exercise 'common sense' if the government stops avoiding the issue......

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  • Just wonder if GP's were allowed to charge them would they be creating so much fuss about it. I agree those who come here specifically to take advantage of free healthcare should be charged. But we are now tending to generalise this issue and put all oversease visitors in one category which is also unacceptable. Government has its own obligations. GP ' s must remember that this governments health service not their private practice. It would be interesting to know if GP's would like to submit the statistics about those who have come here to specifically take advantage of the free service

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  • Medicine may be still worthwhile

    No one more than me would like to see the 'health tourism' flourishin as this would mean that we are doing so well to attract people from Abroad. The truth is that I have instead seen people going Abroad for surgery and treatments and as yet I have not seen the opposite happening. Perhaps in London may be a different story? I don't know. I see an average of 45 patients per day, but no sign to my desk of "health turism" in this Country. However, I wonder what happens to the many of us going to Spain, Italy, or France to retire. I wonder, if anyone has ever checked the figures...I think no one would oppose, even clients, if GP's were allowed to charge. But I agree with the previous post in full: "we are now tending to generalise this issue and put all oversease visitors in one category which is also unacceptable".

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  • Anonymous @ 9.26:

    You're missing the point. This is not about GPs treating their surgeries as private practices, this is about undertaking work that is funded. GPs receive funding for the patients on their list and additionally for legitimate temporary residents and immediate treatments required by people in the area ( this is an oversimplification). What they do NOT receive funding for is patients attending for chronic problems from countries such as Pakistan / America / Nigeria with whom we have no reciprocal arrangement.

    Seeing such patients inconveniences existing patients, ties up appointments, and costs GPs (essentially out of their own pockets) for the staff time etc involved.

    Why should GPs incur financial losses in order to see patients that should not have been seen 'free at the point of delivery' in the first place? All that is being asked for is a clarification of the rules.

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  • Fine-but give us a workable and clear set of rules. Adn are we expected to run up the admin time / costs in administering this? And who gets the blame if it goes to litigation?The current ones are a joke. I am not an immigration or DSS officer and don't want to be one. I suspect that if someone really thinks about this they will realise that the actual costs of putting in controls will be extremely high compared to the savings achieved. Also, at least some of the abuse is from UK patients who now live abroad (mostly France / Spain) wanting 6 months of prescriptions to avoid incurring health charges there. I have seen very few clearcut cases of health care tourism in the past few years and am deeply skeptical. On the other hand , where else in the world can you go and access free treatment as easily as here? This one need to be properly thought through, we have enough back of a beer mat policy going on at the moment.

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  • Plenty of health tourism in this city centre - e.g. a patient came from outwith Europe for antenatal care as the flights were cheaper than care at home. Nearly impossible to police without being accused of xenophobia / racism.

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  • It is going to be impossible to police the issue.
    1.How do we know they are tourist?
    2. if we ask ' tourist ' to show their paasport', then we need to request this from all patients to avoid breaking Human Right legislation.
    3. the goverment neds to come up with a solution.

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