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DH considering where to 'draw the line' on charging overseas patients for GP services


I think this response I had to an email from Dept of Health should be public domain. > Dear Sir/Madam > Regarding your publication on 15th February 2015 on page link > The statement "Treatment in A&E departments and at GP surgeries will remain free for all." is incorrect and misleading. > As a GP I can comment that, we are only obliged to treat EU residents for free. We are under no obligation to treat "for free" residents of other countries e.g USA. We are permitted to charge a private fee which the patient may be able to reclaim from their insurer. > This statement is misleading and likely to swamp general practices with inappropriate workloads. > Please ensure a correction ASAP. > Yours sincerely -- A common misunderstaning of mine I would assume then. When I rang the DH the chap on the end of the line insisted we should provide free treatment for any and all visitors regardless of country of origin. We are not an emergency service like A&E and I thought they appear to be mixing up hospital and GP services. He said I should send an email to the address he gave, so I did and have asked the GPC to look into it. Our ref: DE00000921350 Dear Dr Barrett, Thank you for your email of 18 February about visitors’ access to primary care services. I note your concerns that information published by the Government is incorrect. However, primary care services, including GP and nurse consultations, are currently free to all who require them. No patient should be refused or charged for NHS primary medical care services on the basis of their nationality or immigration status. The Government’s position is that people should continue to have unrestricted access to early diagnosis and intervention in the health interests of both the public and the individual. As set out in the National Health Service (General Medical Services Contracts) Regulations 2004 (as amended), under the terms of their primary medical services contracts, GPs have a measure of discretion in accepting applications to join their lists of NHS patients as a permanent or a temporary resident (a GP practice may accept a patient as a temporary resident if they are in the practice area for more than 24 hours and less than 3 months). GP practices cannot refuse an application to join its list of NHS patients on the grounds of race, gender, social class, age, religion, sexual orientation, appearance, disability or medical condition. They can only turn down an application if NHS England has agreed that they can close their list to new patients or if they have other reasonable grounds. In practice, this means that the GP’s discretion to refuse a patient is limited. Examples of where a GP may refuse to register a patient would be if the patient was abusive or if there was a good clinical reason, such as the GP believing that the patient would be better served if registered at a different practice. A person’s nationality or immigration status are not considered reasonable grounds to refuse to register them as an NHS patient. Within the Visitor and Migrant NHS Cost-Recovery programme, the Department will consider amending and extending the current charging regulations as they apply to overseas visitors and migrants. This will include considering introducing charging for primary medical services as well as other primary care services such as pharmacy, optics and dentistry. Whilst I appreciate that this may be a disappointing reply, I hope it clarifies the Government’s position on this matter. Yours sincerely, Ryan Diggory Ministerial Correspondence and Public Enquiries Department of Health

Posted date

18 Mar 2015

Posted time