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Secret practice trials to check NHS tourism

The Department of Health is to conduct a secret trial at practices to investigate the scale and cost of NHS tourism.

Ministers hope the research will provide evidence for new proposals to clamp down on supposed widespread abuse of NHS primary care services by overseas visitors.

Health minister John Hutton has admitted the department has only anecdotal evidence the problem exists.

The department refused to reveal how many GPs will be involved in the trial, but it is expected to cover 12 primary care trusts.

Under the proposed regulations, released for consultation earlier this month, patients will have to supply evidence they are eligible for free NHS care but practices must carry out the checks and report patients to their primary care trust (see box).

GPs would then be able to either treat the patient privately or refuse to provide care.

The department has asked for comment on whether GPs should set their own fees for private treatment or the NHS should set the rates.

Dr Sue Allan, a GP in Ealing, west London, said rates set by practices would be fairer. She added it would allow GPs to either 'opt out' of treating non-NHS patients by deliberately setting charges too high, or to set up a distinct business to cash in on the demand from overseas visitors.

'Most GPs feel at least irritated and at most quite angry about NHS tourists,' she said. 'If rules are clearer we can say we don't think you live here and we want to charge you.'

GPC negotiator Dr Laurence Buckman also said GPs should set their own rates. But he added that far more detail was needed about how the proposals would work and warned it was not a GP's job to check patients' eligibility.

How regulations

would work

lUrgent and necessary treatment remains free in all instances. Patient does not have to be registered.

lFor new registrants, practice must ask for either passport, NHS card, utility bill or national identity card to prove residency, or valid visa, proof of employment in the UK, intention to take up residency or certificate of asylum.

lFailure to provide such evidence means practices can refuse to register, or offer treatment for a fee.

lTwo ways to charge ineligible patients are proposed:

– the NHS would set rates, money would be collected by practices and accounted

for at PCTs. By local agreement, GPs could keep the private

fees.

– GPs set their own rates, treat privately and keep the money without reference to PCTs.

By Ian Cameron

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