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GP leaders vote in favour of charging overseas patients

GP leaders have voted in favour of implementing private fees for overseas visitors, with any fees being retained by general practice.

The motion, proposed at the annual LMCs conference in London today, argues the Government can still offer free care in urgent care settings like walk-in centres and A&Es.

But the GPC is now compelled to lobby for overseas patient attendances to only occur on a ‘private fee-paying basis’ and that ‘any fees paid should be retained in full by general practice.’

Proposing the motion, Dr Russell Brown of Surrey and Sussex LMCs argued that in his Eastbourne practice the unremunerated cost of seeing holiday makers or short term student visitors was significant.

The motion was passed in full by representatives, despite no other arguments in favour and other representatives speaking against the issue which they argued makes GPs middle-men for immigration control.

Dr Brown told delegates: ’This is not about GP surgeries policing eligibility for NHS care, but there is no funding recognition for the workload involved in seeing these people - which can be considerable.

’In Eastbourne we have many young, foreign students visiting for a few weeks of the year, some of whom need to see a GP. Many of them are from countries where we have no reciprocal arrangements for healthcare. Even if there are reciprocal arrangements, that funding doesn’t reach us.’

He added: ’Travel insurance is not hard to organise.’

Opposing the motion, Dr Frances O’Hagan, representing Southern Northern Ireland LMC warned that the bureacracy involved in verifying and following up charges for every patient they see from the Republic of Ireland would be a ‘nightmare’.

She said: ’I do not want to start policing for the immigration, I agree that we should not be funding it. But it should  be funded in some other way, like secondary care is funded to do it.’

Dr Jan Kletta, from Morganwyg LMC, quipped that his heritage gave him a slight vested interest, saying in the practice ‘I’m called Polish Pete, even though I was born in Kent’.

He asked whether the motion was neccesary in much of the UK, saying: ‘ I accept that on the South Coast where they may see a lot of overseas visitiors and this might be a very practical problem for them, but in Bridgend it wouldn’t be a huge problem.’

He also questioned whether private fees were an appropriate method and said ‘if we pass this, it causes problems in terms of EU law’.

Speaking for GPC, negotiator Dr Dean Marshall said motion was made ’difficult because the laws in England were different from the rest of the UK.’

He added: ’I have absolutely no doubt that the Government’s plan is to make us do the work and then direct the money to them, and that’s something that we’re discussing with them again next week. That doesn’t neccesarily, in my view, mean we should start charging.’

This comes after this week’s Queen’s Speech said that migrants would be charged for NHS services that they are not entitled to, and the Department of Health has already launched a consultation on charging foreign visitors for some GP services, such as blood and lung-function tests, but keeping consultations free.

Motion in full

EAST SUSSEX: That conference believes that overseas visitors should be able to attend UK general practitioners but:

(i) this should only be on a private fee-paying basis

(ii) any fees paid should be retained in full by the general practice

(iii) it remains open to the government to offer NHS care free to overseas visitors at walk-in-centre, urgent care centres, and accident and emergency departments, and patients can be offered these alternatives.

Readers' comments (9)

  • in a way good as we will get used to charging some patients so it will be easy to transition to charging all patients when we leave the current contract.

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  • Time to charge Everyone copayment system needed in the UK.

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  • This will only increase routine problems that inappropriately present as 'urgent'. This wont work until ALL appointments are changed for.

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  • And who collects the money?

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  • I find it hard to believe this even needs passing as a motion. If the patient is not registered with you and not eligible for UK health care ie you're not being paid to see them then surely its a no brainer that you would charge them. If you want to that is. If you don't then that's up to you. Why do we need this motion. If your an independent contractor cant you do what you want. Its nothing to do with your contract surely?

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  • psychologically it's a move away from the mindset that we treat all patients equally with care free at the point of use.

    this idea has now been broken and once it becomes routine it will make the transition to charge all patients easier to 'sell' as the argument will be 'we already charge a certain group of patients'. It's a moral issue but sadly it is one that society wants to push through.

    Basically it's the end of one of the core NHS principles as such the NHS as we know it no longer exists - we may as well walk out of the contract and charge everyone - that will be fairer.

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  • I can't understand those who are against charging, since until recently it was what we all did (or should have been doing!)

    For years the rule for general practice was that we charged overseas visitors who were not resident, the rough definition being not here for a settled purpose for 6 months or more.

    Then a handful of years ago the government changed it to a more complex flow-chart depending on which country they came from.

    It was only 2 or 3 years ago that this government changed it yet again to demand that GPs work for free in treating overseas visitors.

    For the vast majority of my 21 years in general practice, we could and we did charge overseas visitors. It is only very recently that we have been prevented from doing so.

    So I ask, why the sudden attack of bleeding heart liberals acting as if charging overseas visitors is some new terrible idea?

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  • |Anonymous | Sessional/Locum GP|20 May 2016 11:10pm - Like you I thought they were not entitled to NHS services but NHS England recently changed operating procedures that insist all GPs in England provide free health care to any overseas visitor!

    Gps in Wales can still charge.

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  • I agree with the overseas visitors part, but playing devils advocate here, for people resident in the UK, charging for GP appointments seems like a shift shift back to health depending on wealth, with the penny club the next step. How do you decide on who to charge? Those who work pay into the NHS already, so should they pay twice? Of those who don't many won't be able to afford to pay to attend. My main concern is those who do work but on minimum wage, so dont qualify for benefits, not paid when attending health appointments and then having to pay for it as well, seems like a double whammy to me.

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