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Gold, incentives and meh

GPs to conduct nationality checks in all new patients under health tourism crackdown

Exclusive GP practices with high populations of EU migrants will be asked to check whether patients are eligible for free NHS care under Government pilots due to launch later this year, Pulse has learnt.

The pilots will be rolled out in 10 areas, and will involve GP practices asking all new patients if they have a valid European Health Insurance Card (EHIC), which entitles them to access primary care and certain secondary care treatment without an upfront charge.

Practices will also be asked to collect information on so-called S1 forms from UK state pensioners resident elsewhere in EEA.

Under the EHIC pilots, no patient will be charged for accessing primary care. However, the DH said they were designed to test the feasibility of practices routinely asking patients for documents to enable the NHS to recover the costs of primary care from their home countries.

The pilots come as the Department of Health prepares to launch a consultation on new ways of recovering the costs of primary care from overseas residents. But a spokesperson refused to confirm if this would include any upfront patient charges for primary care.

Under the Immigration Act 2014 only UK residents with ‘indefinite leave to remain’ are entitled to free healthcare, but there is an estimated £200m cost from ‘health tourism’ to the UK every year.

A DH spokesperson told Pulse: ‘We are absolutely committed to improving the way the NHS recovers costs from international visitors for primary care. We’re now planning to pilot different ways of doing this effectively without burdening busy GPs.’

The GPC is working with the DH on the plans, a GPC briefing paper seen by Pulse says under the heading of ‘charging for primary care’ that Government will launch two new consultations in the Spring.

The note says: ‘Two consultations will be launched in the Spring to look further at extensions to charging.’

It added: ‘There are plans to start an EHIC pilot in primary care, to encourage the collection of EHICs, increase identification of chargeable patients and increase the engagement of GPs with the cost-recovery programme generally. GPC will be involved with a view to starting the pilot as early as possible.’

Last year, the Government shelved a suggestion for charging non-EEA migrants a £200-500 levy upon entry to the UK, or when they went to renew their visa, after admitting it would probably cost more in administration costs than it would recover in charges.

When asked if this position had changed, a DH spokesperson said any plans to extend direct charging for primary care for migrants ‘will require further consultation’.

GPC negotiator Dr Dean Marshall said the pilot was to get GPs ‘used to asking for’ EHIC cards routinely.

He added: ‘We need to pilot it and see how much work it is. It will be extra administrative work potentially but it will hopefully clarify who is and who isn’t entitled to NHS care and clearly there is a huge amount of money being spent in the NHS on people who are not entitled to it.

‘What we have been absolutely clear about is that this isn’t about the GPs becoming a police force and policing the system. It is about the administrative work. Anything we do is about how it can be done with the least amount of burden and of course an electronic solution would be what we are looking for.’

He said that any consultation on recovering money owed by migrants for primary care ‘wouldn’t affect people who need emergency treatment’.

He said: ‘If they need emergency treatment they will get emergency treatment. This is about people who come from other countries and then frequently turn up at practices wanting treatment for a condition that they have been treated for previously.’

But Dr Kailash Chand, BMA deputy chair and a retired GP in Lancashire, said: ‘The health secretary would be wise to concentrate on the major pressures on the NHS rather than being distracted by imposing an unworkable system of charging for health tourism. If this plan comes to fruition it will at best reduce the role of doctors to debt collectors.

‘At worst it will deter them from registering migrants and asylum seekers as well as setting up a new system of charging that could be extended to others. Tampering with the core principle of the NHS , that it is free at the point of delivery, runs the risk of loading scarce resources on a minority issue, while the more meaty challenges remain unresolved.’

This story was changed at 16:00 on 5 February 2015, to reflect that the Government has said health tourism costs the NHS £200m a year, and not £2bn a year as previously stated

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Readers' comments (34)

  • The DoH needs to sort the large dying Donkey in its plate before it turns to searching for fleas in someone else's. Deal with the main problems rather than sensationalizing the fringes.

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  • Clutching at chest - gasping for breath ; sorry you're not a national - go away.

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  • Oh my dear Lord!

    Conducting Nationality checks!

    NOT OUR JOB!!!

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  • Easy to sort bring in a copayment system like the rest of the western world,then only those with rights can claim back.Ditch this arcaic free at the point of service nonsense, abuse and health tourism killed in one fair swoop.The mess the NHS is on the way to be sorted.

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  • "Anonymous | GP Partner | 05 February 2015 9:50am
    Easy to sort bring in a copayment system like the rest of the western world,then only those with rights can claim back.Ditch this arcaic free at the point of service nonsense, abuse and health tourism killed in one fair swoop"

    Totally agree, the "free" NHS is a cult religion that is destroying its brainwashed people like all cult religions do.

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  • So my elderly neighbour who has never had a passport or driving licence in her life, has no form of ID let alone a photo ID, tries to register at a new surgery and has nothing to show to prove she is UK resident rather than an EU migrant, how will she be dealt with? No documents = no registration or treatment?
    This is the scum politicians and DoH trying to divert Daily hate Mail readers' attention away from their disastrous mismanagement with their standard anti-foreigner rallying cry.

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  • Every one of us knows this is inherently morally wrong and presents us with an irreconcilable conflict of interest.

    Someone will actually die very clearly and even then the GP will be blamed, not the government.

    RCGP should be standing up and unequiovally saying NO, nothing, else, no ifs and buts , just NO. Start a petition, or just actually refuse to do it.

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  • Is there election due soon?

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  • "Anonymous | GP Partner | 05 February 2015 10:18am
    RCGP should be standing up and unequiovally saying NO, nothing, else, no ifs and buts , just NO"

    What, and jeopardise their MBEs? Oh no, that won't do at all. No doubt Maureen will be along soon to praise the scheme and say how it adds to the already overwhelming enjoyment of being a GP.

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  • but Ed wants me to check if they are lonely.....

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  • Peter Swinyard

    Chill. It's Election Silly Season.
    Populist policy of "GPs are ideally placed to....(fill in your own political aim/notion)"
    Brings me out in a rash.

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  • Anonymous | Practice Manager | 05 February 2015 10:15am

    Good to see that Practice Managers are also reading the Daily Mail and using it as a pathetic excuse for whingeing on this forum.

    Stop using a Daily Rag for an excuse and come up with something worth reading, you are a front line Manager and as such ought to be able to come up with a much more evidence based argument either for or against any proposal that adds to the General Practice workload.

    Daily Mail, Daily Misery, Daily Nasty, they've all been overused on this site.

    Put forward an intelligent argument for yourself or stop getting involved with these forums.

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  • 10:57am - I thought the argument about patients who should legitimately get NHS treatment but don't have identification documents seemed a fairly intelligent argument to me...

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  • I thought EU migrants were entitled to reciprocal care. Are we saying they will only get it, if they registered to get a card from their own country ?

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  • Anonymous | NHS Manager | 05 February 2015 10:57am

    Ooh your tail got well tweaked didn't it! Was this your idea and you don't like it being criticised?

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  • Peter: this is being piloted in multiple areas. I'm afraid it aint just election fever.

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  • Is this really going to be any more onerous than checking photo ID & proof of address as many practices already choose to do under best practice guidelines? Isn't it nice to know the patient is actually who they say they are? Always handy should they subsequently give the Doc a good kicking in the consultation room. UK nationals have to present their EHIC when seeking treatment in the EU so not sure what the problem is with us expecting visitors from the EU to do the same? What about people from outside the EU though? Is that just a blanket - No, you aren't entitled to free primary care unless it's an emergency?

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  • Oh dear I think e should all stop having a go at each other and sort this out. We DO charge for any non eu traveller (I am not talking about migrants) turning up wanting an appointment/treatment unless there is a reciprocal or bilateral agreement in place – they should have travel insurance – think about it you go to USA get sick you or your travel insurance have to pay – simples. We apply the same principle BUT if it is urgent/emergency then it is free. The definition of urgent /emergency is for the clinician to decide BUT the patient pays up front before they see the clinical and if free they get it back.

    We already ask for the relevant ID so cannot see any issues here. The snipe about the elderly neighbour wanting to move surgery is not relevant as she will have an NHS number – again simples.

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  • Patients can still be treated just not on the NHS.

    Why is that difficult for buinessmen - partners to grasp?

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  • Why don't they just build a porch onto the front of every practice, have airport-style security, check ID, start finger-printing patients?

    Seriously, few years back I was was treating a patient (later found to be a non-UK resident with an NHS number) wanted by Interpol for a "double murder" in Country of origin. Police call me at 10pm before swooping on his house!

    We need a "Danger & Identity Checking DES" please....

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