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Majority of GPs back Government's plans to charge migrants, Pulse survey finds

Exclusive GPs support the Government’s plans to charge migrants to access the NHS by a margin of almost two-to-one, despite strong opposition from the BMA and the RCGP, according to a Pulse survey.

A snapshot poll of 647 GPs from across the UK, conducted over the past week, found that 55% of respondents supported the proposed levy on migrants before they use the NHS. Some 30% were opposed to the plans, with the remainder ‘don’t knows’.

The Government’s plans also appear to have support even among GPs who studied overseas. Some 48% of the 113 survey respondents who are international medical graduates said they backed the levy, with 34% opposed.

The results follow the publication of an independent report commissioned and published by the Department of Health earlier this week, which found that such a levy could raise £200m a year. It also concluded that the public supported the idea ‘in principle.’

The report prompted the RCGP to warn that GPs must not become a ‘new border agency’ policing the NHS, while the BMA has previously said the plans could be ‘detrimental’ to patients and also affect the NHS workforce.

Under the new system, the levy will be set at around £150 for students and at around £200 for other temporary migrants. The DH predicts the levy could raise up to £1.9bn over a ten-year period, based on approximately 490,000 applicants who would be required to pay.

Responding to the Pulse survey, Dr Maurice Eakin, a GP in County Armagh, Northern Ireland, said: ‘They [migrants] get better care here than in their own countries and if we went to their countries even on holiday we are expected to take out private medical insurance.’

Manchester GP Dr Ravi Mene said: ‘All visitors must have health insurance which should be chargeable at the point of use. This happens even in European countries.’

Another GP who asked not to be named added: ‘I work in an area with a high level of migrants accessing our services. This often involves interpreters, double and multiple appointments and a high level of referral onwards. In the past we also had a large number of people moving to our areas from EU countries and presenting with infertility requesting referral for IVF.’

However many GPs who supported the plans said practices should not be responsible for policing the system. Dr George Paige said he supported the plans ‘as long as the area team administers it’, while another GP who asked not to be named said administration of the scheme should not be ‘dumped’ on GP practices.

Other survey respondents were strongly opposed to the plans. Dr Nick Mann, a GP in Hackney, east London, warned that the plans were ‘a slippery slope’, ‘not cost-effective’ and would encourage xenophobia.

Kent GP Dr Hester Blaber questioned why the Government did not do more to claim back the money spent on treating overseas patients visiting the UK. ‘Much more money could be recouped this way than by trying to police a levy,’ he said.

Commenting on the independent review earlier this week, health secretary Jeremy Hunt said: ‘Having a universal health service free at the point of use rightly makes us the envy of the world, but we must make sure the system is fair to the hardworking British taxpayers who fund it. We have one of the most generous systems in the world when it comes to healthcare for foreign visitors, but it’s time for action to ensure the NHS is a national health service - not an international one.’

But RCGP chair Professor Clare Gerada said: ‘It is imperative that GPs are not tasked with being a “new border agency” in policing the NHS.’

‘Limiting access to NHS services will fundamentally change one of the founding principles of general practice – that healthcare is free at the point of need,’ she added.

‘GPs have a duty of care to all people seeking healthcare, and should not be expected to police access to healthcare and turn people away when they are at their most vulnerable.’

Survey results in full

Do you support the Government’s plans to introduce a levy for migrants to use the NHS?

Yes - 358 (55.3%)

No - 197 (30.4%)

Don’t know - 92 (14.2%)


Of 113 international medical graduates who responded:

Yes - 54 (47.8%)

No - 39 (34.5%)

Don’t know - 20 (17.7%)


About the survey

Pulse launched this survey of readers on 15 October, collating responses using the SurveyMonkey tool. The 26 questions asked covered a wide range of GP topics, to avoid selection bias on any one issue. The survey was advertised to readers via our website and email newsletters, with a prize draw for a Samsung Tab 2 tablet as an incentive to complete the survey.

As part of the survey, respondents were asked to specify their job title. A small number of non-GPs were screened out to analyse the results for this question. GPs were also asked on a voluntary basis to provide their GMC number and 549 of the 647 GP respondents did so, although these were not verified or used to screen out respondents.

Readers' comments (17)

  • To those who voted "no", I have a question. Do you have a patient list/practice list?? If we are to be responsible for everybody irrespective of nationality or status ie a World Health Service then surely the whole idea of practice lists should be abandoned as the principle underlying this is finite numerical responsibility for patients.
    Also do you know these patients are in need? I have had some health tourists trying to get free operations who have considerable wealth in their home country and have lied about residency status. One then simply admitted this and then paid for a routine procedure at the expensive private hospital so not all health tourists are on the breadline and being chased by people traffickers as you might stereotype.

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  • It looks a great idea to charge migrants. But in real world, it could get the doctors in front of the GMC, if
    he or she refuses to treat a patient on failing to pay the charges. If a mother without medical insurance or don't
    have enough fund to pay for her child with severe
    medical problem like asthma, .or croup been refused at
    the surgery and later ended in A&E for admission, the
    GP could be called in front of the GMC.
    Also there should be more staff to collect the charges
    and the practices needs to be registered with the
    credit card companies like the dentists .

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  • All UK citizens should be provided with a health card and asked to show it during GP registration and every time they present to hospital outpatient appointment or inpatient admission. All EU citizens should be ensured that they carry their card when they enter UK. Non-EU citizens should be provided with a health card with an expiry date at the border after verifying their health insurance. If any rich or affordable people who do not want an insurance and are willing to pay for their medical care should also be provided witha health card at the border after getting a cash deposit or debit/credit card deposit. If the UK border staff work efficiently then many things can be sorted out in this country- such as health tourism. terrorism, crime, people and drug smuggling, etc.

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  • Nobody is talking about Emergency care so I am baffled why this is now being thrown into the arena??
    Persistently and knowingly failing the declare NHS fraud by a GP should trigger an NHS Counterfraud investigation into the GP. There is an attitude by some that since this money is not mine, who cares if the DOH wastes money. Those GPs who do not show ownership of the NHS or financial loyalty to the taxpayer should be ashamed of themselves.

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  • We cannot be the providers of global healthcare otherwise NHS services will be diminished to the point of ineffectiveness. There are safeguards by way of immediately necessary treatment. At a primary care level the only way we can sensibly manage this is for it to be mandatory that all patients bring in a medical card (no longer issued in some areas) or dare I say it, a national ID card is required. I have travelled arounfd many parts of the world where treatment is not automatically given and insurance is a pre-requisite to gaining treatment. Why should we be any different?

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  • As long as the GPS gain no reward from the charges and they are ploughed back into UK patient care then I see no problem. But if these are just used by greedy GPs who only see paying immigrant patients to bolster already obscene practice and personal incomes to the detriment of UK patient access!
    Sorry - I thought I was working for the Daily Mail next year for a moment!

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  • The Daily Mail reports that Dr Clare Gerada, chair of the Royal College of GPs, said the crackdown is "xenophobic" and doctors were not willing to act as a 'new border agency' by checking the immigration status of patients. Health secretary Jeremy Hunt said: "No-one is suggesting that GPs should act as border guards." He said there will be small changes to patient registr ation system

    So any doctor who supports the policy is a xenophobe?

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  • Any one who pay tax and contribute to NI ( big or small amount ) should be entitled to free NHS care .

    some people above are suggesting to charge anyone who does not have Uk nationality, that will be right thing to do only if you do not charge NI or tax them.
    Just be ready for the financial implication of such a move. Students would not come to universities and working people would not come to this country. if you are happy with isolating yourself - good luck with it.

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  • So according to some, as I'm a foreign natioal with permanent residency, I should not be entitled to free NHS care despite paying tax and NI for over 10 years and in amount far exceeds average contribution?

    Bring it on, I'll be happy not to pay tax and NI and arrange my own care!

    On a more serious note, I do agree with not providing free care for everyone. I tell my friends/family what we have here and they can't believe out health care hasn't collapsed yet. It will soon though - unless a reasonable measure is put in place.

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  • Good, we certainly should charge foreigners who have no right to NHS treatment. The UK is a soft touch and the UK tax payer shouldn't fund these people.
    I insist on all patients, trying to register at my surgery, showing me their passport/Visa which demonstrates their entitlement. If they won't they don't get registered, simple. Let them complain.

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