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CAMHS won't see you now

Use 'entitlement cards' to curb tourists' abuse

Dr Christine Dewbury's response to the query on immigrants and eligibility for NHS primary care (Practice Q&A, October 27) highlights the difficulties faced by primary care staff when applicants seek to register with a GP.

Although secondary care staff are provided with official guidance to assess eligibility before NHS hospital treatment is allowed, the position is equally unsatisfactory as the staff have no means of verifying whether factual information is provided. The status quo is unacceptable and in urgent need of radical reform.

It is unfortunate, therefore, after years of abuse of the NHS by 'health tourists' and others not entitled to free access that the Government is now consulting on a limited review of the NHS (Charges to Overseas Visitors) Regulations 1989 (www.doh.gov.uk/consultations) which relate to secondary care only. Any tightening of the rules for access to secondary care will exacerbate the pressure on GPs as applicants will seek to register in order to gain access to secondary care.

The burden on primary and secondary care staff of establishing eligibility could be lifted and the scope for abuse curtailed if 'entitlement cards' were introduced. They would have to be issued centrally after necessary checks are made with the Home Office. All that primary and secondary staff would then have to do is to check the validity of the card by computer access to the central register.

Judith Fernandes

Practice nurse

Pinner

Middlesex

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