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GPs can refer overseas visitors for free in cases of violence, says DH

GPs who identify overseas visitors who are victims of torture, female genital mutilation or sexual or domestic violence should inform hospitals to treat them without charge, DH guidance has said.

New Government guidance published yesterday said that migrants not ordinarily resident in the UK who were from outside the European Economic Area (EEA) or a country with a reciprocal agreement with the UK - who are normally charged for secondary care - would be exempt from charging in these ‘special circumstances’.

The guidance, which focuses on the new hospital charging regime for migrants, says that ‘GPs have a duty to provide free of charge treatment which they consider to be immediately necessary or emergency, regardless of whether that person is an overseas visitor or registered with that practice.’

Further, GPs are ‘encouraged to’, but not responsible for, determining the charging status of patients referred in any circumstance, it said.

This comes as the Government is due to pilot a system of GP practices asking all patients to present an European Health Insurance Card (EHIC), if they have one, when registering at the practice.

The guidance said: ‘GPs should not be discouraged from referring their patients to the relevant NHS body. It is the relevant NHS body’s duty, not the GP’s, to establish entitlement for free NHS hospital treatment.’

It added that GPs are ‘encouraged to help inform this process by indicating on referral letters when they understand a patient is not OR, or is an EHIC holder, and inform patients that they may be chargeable for some hospital services’.

On special circumstances, it added: ‘An overseas visitor who has been subjected to certain types of violence will not be charged for treatment or services needed to treat conditions caused by that violence.’

As for how this could be determined, the guidance suggesteed as one option ‘confirmation from a medical professional, including a referring GP, who could most appropriately identify signs and symptoms’.

As previously revealed by Pulse, the Government is also still looking at how it could introduce standardised NHS charging for ineligible overseas migrants not usually resident in the UK for primary care services, but this will be subject to consultation later in the year.

Note: This article was amended at 11.34 on 27 March to better reflect the wording regarding when GP practices have a duty to provide treatment free of charge

Readers' comments (3)

  • GPs should not be told to 'snitch' on patients to hospital. If we know the patients are likely to be told to pay we should be telling the patient, but as the provider of the care it is the hospital's job to determine eligibility or need to pay.

    I'm not an immigration specialist, border control officer or accountant. As far as I'm concerned every one of my patients can access secondary care based on need and the hospital should determine who pays the fee.

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  • to Pulse -

    You say in the article above -
    "The guidance, which focuses on the new hospital charging regime for migrants, also rubberstamps the Government’s current position that GPs are not, as it stands, able to charge any patients for routine or emergency care, regardless of migration status."

    I have read through the guidance and nowhere can I find that. The guidance as I read it allows us to charge foreign visitors except for emergency and immed necessary treatment though we have the discretion to take them on as NHS if we wish. We may not refuse them treatment based on any conditions in the equalities act but being a foreign visitor is not in the equalities act.

    Would you please show where you got your interpretation that the guidance says we can not treat foreign visitors for routine care.

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  • Thanks for pointing this out and please note that we have amended the article to better reflect the text of the guidance.

  • Correction to above, " please show where you got your interpretation that the guidance says we can not CHARGE foreign visitors for routine care."

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