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CAMHS won't see you now

Why GPs may soon be routinely checking the migration status of new patients

The Department of Health is considering rolling out a scheme that will see practices asking patients for proof of identity, Sofia Lind finds

eu health card 3x2

eu health card 3x2

GPs could be required routinely to check the migration status of new registrants, with a view to charging them for services such as blood and lung function tests.

The Department of Health is consulting on new proposals that will see non-residents charged for certain services in England, but not routine GP appointments.

It claims a pilot scheme showed that checking new patients’ migration status during registration adds just 30 minutes’ work a month for practices, and has reiterated its intention for GPs ‘to be part of administering’ extended migrant charging in primary care.

The consultation comes as Pulse has revealed the UK pays out 15 times more to other European Economic Area countries for healthcare than it reclaims.

Figures given to Pulse by the DH reveal the UK paid out a total of £660m to EEA countries for the care of UK residents abroad, but took in just £43m, although the DH said a large share of the money went on UK pensioners retiring abroad.

But under the proposed new arrangements, the Government says it will recover £500m a year for treating non-UK residents.

It will also reclaim more money from EEA countries whose residents are accessing free care in the UK with a European Health Insurance Card (EHIC).

The consultation document says: ‘The DH aims to recover up to £500m per year from charging overseas migrants and visitors by the middle of this Parliament (2017/18). This can only be achieved through encouraging fair contributions from visitors and migrants, and behaviour changes in the NHS.

‘The recovery of up to £500m per year will contribute to the £22bn savings required to ensure the long-term sustainability of the NHS and deliver the Five Year Forward View.’

migration box 290px wide

migration box 290px wide

Since April, overseas visitors have been charged at 150% of the tariff price for hospital treatments. Now, the DH is proposing to extend charging to GP and primary care services, including blood tests, physiotherapy, lung function tests, dental care, eye care and prescriptions.

However, the consultation document states there will be no charges for routine GP appointments, adding: ‘No patient will be denied emergency care – where treatment is deemed immediately necessary, it will always be given without seeking prior payment or a deposit.’

But GPs could be expected to check new patients’ migration status when registering them, after pilots run in nine practices from April to June last year found routinely asking new patients for an EHIC card was feasible in practice.

The document says: ‘We have worked with a number of practices as part of the EHIC pilot to establish the most effective options for doing this. We are exploring changes to the GMS1/GMS3 registration forms to embed these changes.’

It adds: ‘On average, collecting the additional data at the point of registration added a minute or two per patient. Practices spent around a further 30 minutes each month processing and uploading data to the portal.’

The DH says it will work with the BMA, the RCGP and others ‘to identify the best way to implement the proposals’.

But BMA chair Dr Mark Porter said: ‘Not only will this arrangement cause confusion among patients, it will also require GPs and hospital doctors to spend more time on the paperwork and bureaucracy needed to regulate these charges. The administration of the new system could end up costing more to run than it collects in revenue.’


Department of Health, 2015. Making a fair contribution: consultation on the extension of charging overseas visitors and migrants using the NHS in England

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Readers' comments (12)

  • DH: You have to register toursits without checking ID!

    GPs: Boooooo!

    DH: You have to check migration status (and therefore ID).

    GPs: Boooooo!

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  • if we are going to charge one group of patients then morally we may as well charge them all. thanks for showing the way out of the contract.

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  • Has any practice ever got into trouble for failing to treat an unwell patient who had arrived at reception. to register, without necessary paperwork?
    As soon as they got in the door (in my book) the practice had a duty of care.
    Why should I and my staff act as NHS gatekeepers? As a single handed GP of many years, I saw first and worried about the immigration status/travel insurance later.

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  • Paul Siggins, - yes, I am aware of a few cases. Your approach is in line with current NHSE guidance.

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  • Surely the figures are meaningless, since the EU treaty requires that care is given equivalent to the service in their home country the UK will always be charged more because we give more for free.

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  • 8:24

    I agree on the meaningless figures but, - the government consultation document (link in the article) present £120 million over 5 years as the best case scenario.

    £500-million-a-year figure seems to have been quoted by the government on someones gut feeling.

    If it's not too much bother, - can you reference the EU Treaty regarding care bit?

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  • So we cannot charge for our time which is to be given away but we are to be expected to run the admin so that other specific services can charge....?

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  • Agree with 10.46 entirely. GPs can just keep giving more as it costs the government nothing.

    Interesting that you cannot insist on proof of address to ensure patients live within your boundaries, but it seems its ok to "discriminate" if it is to protect the DoH's interests.

    Ditch the contract comrades.

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  • 10:46, - you charge NHS for your time under GMS/PMS.

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  • Not until we charge per hour, we don't. The point is that the proposal is to give non-resident patients "free" GP time while being charged for everything else and GPs are to be expected to administer the system for nothing. Actually, less than nothing given how far the annual capitation fee stretches, assuming the patient is registered long enough to generate any capitation payment in the first place. It doesn't make sense.

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