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GPs to charge migrants for prescriptions under Government health tourism crackdown

GPs will be expected to issue private prescriptions and charge for other services they provide - such as diabetic clinics - if their patients are not eligible for free treatment, under the Government’s proposed scheme to recover more of the costs of NHS care from short-term migrants.

The proposals add detail to an announcement last week of a Government U-turn on previous proposals that GPs should charge non-EU migrants for all primary care ‘at the point of delivery’ unless they paid a new levy of between £200 and £500 per year.

The Government said last week that GP appointments will continue to be free to access for all temporary migrants to the UK, whether they paid the new levy or not.

But details in a response to a consultation on their plans published on the Department of Health website today reveal that anything other than a GP consultation may have to be paid for under the new scheme.

The document says: ‘Primary care outside of a GP consultation (or equivalent) will be chargeable. A final list of services included in this charging extension will be designed in conjunction with NHS colleagues. NHS care given in the community will be chargeable where charging is practicable and not detrimental to public health.’

It goes on to detail that it is looking at charging for use of walk-in centres, prescriptions and other services, such as diabetic clinics.

It says: ‘Primary care includes a broader range of treatment services, mainly but not solely triggered by GP consultation. These include community based services, dental and optical services. The weight of the argument for charging in these is much stronger, e.g. for drug prescribing where there is evidence of otherwise chargeable non-residents accessing NHS prescriptions at the subsidised fixed tariff or even free if, for example, they are exempt on the basis of age.’

The plans also detail plans to modify the way the NHS number is used on GP systems, although it stresses that it wants to introduce a scheme that is not ‘unduly burdensome’ on practices.

It proposes flagging the NHS number to indicate that a migrant has paid their surcharge and is eligible for free treatment, and charging all patients without a flag - or who do not have an NHS number yet - for all NHS care, apart from GP consultations.

The documents say that the DH will develop plans on how the registration process will be changed to ensure short-term migrants pay for NHS care, but that there was no clear consensus from their consultation on whether this should be done by GPs or not.

It says: ‘There was no firm consensus on whether this should be done through individual GP practices or through a more centralised system. There are advantages to both, but in either case we will ensure that GPs do not have to be directly involved in the process of identification and
establishing eligibility. We will explore and test options with stakeholders including costing proposals in time and money, and set out further plans in our full implementation plan in March 2014.’

Plans to charge migrants to see a GP had countered stinging critique from doctor leaders, including the BMA and the RCGP, which said they could lead to adverse effects on public health and cause GPs to become a ‘new border agency’.

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Readers' comments (6)

  • Here we go again make it so complex that you cannot implement it and GPs will undertake a load of work for free. This job is sh*t.

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  • So we can give a free GP consultation & a private prescription for a month's antihypertensives to a foreigner but not to an NHS patient. So if you are not a UK resident you may get cheaper healthcare than a Brit paying prescription charges!

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  • Nebulous lip service. It will never happen.

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  • Would this require a rewrite or modification of GP systems - and massive central systems to identify those ineligible for health care under the NHS?
    Would the administrative costs - including all the systems for accounting for any bills and enforcing collection - (not counting GPs and practices who wouldn't cost anything) far exceed any potential "savings"?
    After all, the vast majority of short-term visitors/migrant workers are healthy enough to work or travel...

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  • Why should we be the ones to determine who pays and who doesn't depending on their immigration status? If health should be 'free at the point of need' it should be so regardless of the race, gender, immigration status etc of the patient.

    Equally, you could argue why should some 'local' patients who have never contributed to the tax system be eligible for free care just because they happen to be British citizens whereas those immigrants who potentially could have paid more into the treasury are now forced to pay!

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  • Wrong heading !!! 'GPs to charge' -NO - It's the government that is going to charge. We GPs don't sit in hospitals - this stupid article gives an impression that we GPs will be charging for everything everywhere in the system.
    Why not say 'All services in NHS will be chargeable for x y and z.'

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