This site is intended for health professionals only

At the heart of general practice since 1960

Read the latest issue online

GPs buried under trusts' workload dump

EU citizens may be charged for NHS services in a no-deal Brexit

EU citizens living in the UK may have to prove their immigration status in order to receive free NHS care in the event of a no-deal Brexit, according to a leaked memo to NHS trusts.

In a new move by the Government, the leaked documents reveal citizens from EEA and European free trade countries (EFTA) who are legally residing in the UK will still be able to access free NHS services they are entitled to, but will have to prove so by confirming their address for the last six months.

The updated guidance states health services not currently charged will remain 'exempt', which includes GP and A&E services, meaning that EU citizens will still be able to access primary care services for free.

A Department of Health and Social Care spokesperson said: 'Primary care services are free of charge for everyone, including EU residents and overseas visitors from around the world, and this will not change as a result of us leaving the EU.'

But the 'chaotic' measures mean hospital staff will have to check the immigration status of patients, which is a 'mammoth' task to an already overstretched staff, according to the BMA.

BMA council deputy chair Dr David Wrigley said: 'This is another example of a chaotic, poorly planned result of a no-deal Brexit. This system would present hospitals with the mammoth task of determining where a patient was born, and, if they are from one of the 27 EU nations, whether they are eligible for free care.

'With most people not carrying documentation to prove this – and the deadline to apply for settled status not until the end of December 2020 – it is a nigh-on impossible ask for any workforce – let alone overstretched NHS staff.

'It is a doctor’s job to treat the patient in front of them, not determine how the treatment is being paid for – and we have significant concerns that healthcare staff would be expected to be familiar with and to administer these complex arrangements.'

The DH has provided a toolkit for NHS staff dealing with patients who have an unclear residency.

Tower Hamlets LMC chair Dr Jackie Applebee thinks the move will mean that EU citizens may be liable to be treated the same way as non-EU citizens.

She said: I think it probably just means that EU citizens will become liable to be charged in the same way that non-EU citizens already are i.e. 150% of the NHS tariff up-front for secondary care unless it's an emergency.

'No one pays for GP care at the moment but we have to remain vigilant as I wouldn't be at all surprised if the Government tried to introduce charging overseas visitors for primary care.'

She adds there have been instances where GPs have been asked to determine the eligibility of free care for patients, but persisted that GPs are not 'border guards'.

She said: 'There have been a couple of attempts by some trusts to ask GPs to determine eligibility for free care before referring but we say "no, not our job." We are not border guards.'

Elsewhere, the Scottish health secretary Jeane Freeman clarified this would not be the case for Europeans in Scotland.

EU citizens living in Scotland will not need to provide evidence of their eligibility for free NHS healthcare.

Ms Freeman said: 'A no-deal Brexit would be particularly damaging and the First Minister made clear the Scottish Government’s strong opposition to such a scenario during her recent meeting with the new Prime Minister.

'We’re committed to doing all we can to support EU citizens, not least in ensuring that those residents in Scotland can access services when they need them.

'The reports on steps by the UK Government for the NHS in England do not apply here and we are seeking clarity from them on these actions.'

For UK citizens, European health insurance cards (EHIC) may no longer be valid in a no-deal Brexit, depending on arrangements made with EU member states.

It comes after DHSC's announcement yesterday for an 'express freight service' to deliver medicine following the UK's exit from the EU on 31 October.

Readers' comments (5)

  • Yes...and if this happens then UK citizens will be charged for health services in the EU. NHS will somehow have to find some extra capacity to treat all these people who suddenly won’t be able to afford healthcare abroad. Everyone knows the nhs wouldn’t cope with this. It’s all a cheap bluff really who are these people kidding. They bark louder than they can bite

    Unsuitable or offensive? Report this comment

  • Why exempt primary care, why are we still the free health service to the world. About time all visitors to the uk paid to access all components of the NHS.

    Unsuitable or offensive? Report this comment

  • Agreed, the EU never provide free heath care to UK citizens.

    The E111 has never worked for me...

    Unsuitable or offensive? Report this comment

  • Only payment per service leads to results. The block contract sucks.

    Unsuitable or offensive? Report this comment

  • ‘The block contract sucks.’
    Can’t think of any other large organisation that will provide product on the basis of ‘all you can eat’, anytime and forever, for a modest sum. Funny that!

    Unsuitable or offensive? Report this comment

Have your say