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GPs 'could do more' to help NHS recover costs from overseas patients, MPs say

GPs ‘could do more to help’ the NHS recover costs from overseas patients who are not entitled to free treatment in other parts of the system, according to a new report by MPs.

The Commons Public Accounts Committee recommends that the Department of Health should issue guidance by this summer setting out how GPs can help in this role – despite it not being a contractual obligation.

But the RCGP said the report’s recommendations undermine ‘crucial trust’ between doctors and patients and said politicians should stop ‘perpetuating the idea that GPs should assist with border control’.

The ‘NHS treatment for overseas patients’ report says that NHS hospital trusts have been ‘recovering much less than they should’ from overseas patients, despite it being a statutory duty for 30 years.

This improved after the DH introduced an overseas visitor and migrant cost recovery programme in 2014 - £289m was recovered in 2015/16 compared with £97m in 2013/14.

But the report says this was not down to trusts implementing the ‘chaotic’ rules any more effectively, adding: ‘The Department and the NHS are still a long way from meeting the target to recover up to £500 million a year by 2017–18.’

The PAC says it is ‘not confident’ that the DH and NHS are taking effective action, adding the NHS is failing to identify potentially chargable patients and this is where GPs could play a role.

When treating patients with a European Health Insurance Card (EHIC) the report says that ‘needs arising’ treatment costs in primary care can be reclaimed if the EHIC is recorded.

The report says: ‘There is also scope for GPs to report European Economic Area patients through the EHIC scheme, which would allow the UK to recover costs from other EEA countries and thereby increase income for the health system.’

It recommends: ‘NHS England should clarify what it expects of GPs in relation to identifying chargeable overseas patients, and issue guidance by the end of June 2017. The guidance should set out the role of GPs in the charging system and how they might best fulfil this role.’

Though the DH is supportive of GPs doing this there is no system in place for this and the report states GPs are ‘not contractually obliged to do anything to identify overseas visitors.’

Meg Hillier MP, chair of the PAC, said today: ‘The Government’s failure to get a grip on recovering the costs of treating overseas visitors is depriving the NHS of vital funds.

“Our Committee has reported extensively on the financial pressures facing the health service and it is simply unacceptable that so much money owed should continue to go uncollected.'

But RCGP chair Dr Helen Stokes-Lampard said the report was ‘overstating’ the financial gains to be had from greater enforcement of overseas charging.

Dr Stokes-Lampard said: ‘It is the role of GPs and our teams to deliver care to our patients, free at the point of need, regardless of their individual circumstances. We must stop perpetuating this idea that general practice should, in whatever way, assist with border control.’

'The entire NHS is in a dire financial situation, but we shouldn’t exaggerate the amount of money that can be raised through GPs getting involved in cost recovery - particularly when balanced against the administrative and training costs that introducing such a process would incur.’

Readers' comments (22)

  • Having been distracted before sending above post, I did not see Sceptic Monkey's post. I wonder if that is an NHS England thing as current advice in Scotland is (or was until very recently) different, quite detailed with, for example, specified minimum intended stays for different groups, usually including dependents but not non-dependent relatives.
    Certainly the English DOH advice needs revised. I wonder if the idiots who drafted it confused getting seen by a GP with actually registering. At one level better for GPs to have them registered rather than seeing for free, but there are significant disadvantages too.

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  • treat and charge them and keep money yourself. give private script and refer privately. non nhs treatment for all not entitled. keep gov out of it.

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  • I'm told from my local CCG (in North West) we have been top sliced for "oversea visitor" in CCG's budget. I assume this is to cover the cost of providing treatmen for that group. As we don't get much oversea visitor in our locality, I assume the money is pooled to cover all oversea visitors?

    This of course means there is less money to be spent on local health for people living in my city. Well done NHSE, you've really out done yourself (again)

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  • Politicians could do a lot more for us but they don't

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  • It is clear from the document which the article links to that the DoH doesn't have a system for doing it. It's mad that the NHS reimburses the French system etc for my treatment over there but they don't necessarily reimburse us when their residents need tx over here. If the DoH gets a simple system in place and shows us how to use it I would be more than happy to comply. I suspect I will be retired first, though

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  • We have tourists coming from abroad - delivering a baby who gets UK citizenship and then leaving without having proper vaccinations - thus punishing the Practice whose payments are cut due to lower percentage of childhood imms.
    Let the govt get its act together and close loopholes. Don't ask us to police patients, not our job. Time these politicians moved their butts and did something themselves instead of putting GPs in the firing line.

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  • National Hopeless Service

    Once upon a time we used to charge all overseas visitors a fee, even had a menu of fees on our website. It was DoH who changed the rules. Make up your mind.

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  • Dr Grumpy, indeed NHS England have made all English GPs see overseas visitors for free and so provide a free worldwide health service, so there is no incentive to report such patients.

    Scotland and Wales have different regulations and GPs can charge.

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  • Just make it mandatory for you to have medical insurance if you want a visa.

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  • Alternately, present the relevant bills to the relevant embassies.

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