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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

Related images

  • Richmond House - DH - Department of Health - online

Readers' comments (34)

  • Health tourism after you advrrtised it at the olympic games ceremony. Great idea. Make dentists do it. Let us get on with trying somewhere in our job to be doctors.

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  • So GPs have to learn all the European languages to be able to read the details on the passports. Great !!!!

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  • if we are heading in this direction why not go all the way and follow our dental colleagues - we will be more free than we are now?

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  • Are there any further details about these pilots? I was under the impression the EHIC system allowed EU members to reclaim costs for any treatment that became necessary whilst visiting another member country. It doesn't cover routine care while you are on holiday in Europe. This does not cover migrants who choose to come and live in the UK, in which case they are entitled to free NHS primary care irrespective of having an EHIC card.

    They really need to simplify the rules about who is entitled to what from the NHS. Reciprocal/Bilateral agreements only apply to secondary care and they can't make their mind up about who is eligible for primary care. I think I read they have sort of maybe stopped using the 'ordinarily resident with a defined purpose' rule but not given us anything to replace it.

    It would make sense to determine eligibility at the point of entry to the UK, although this would prove problematic for EU citizens who have free movement. Being an EU citizen is not an automatic right to free NHS care if only visiting the UK.

    Sort out the rules before trying to run pilots on the existing rules that aren't really clear!!!

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