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Q&A: How the new 'health tourism' crackdown will affect GPs

The Government has unveiled a number of proposals for charging patients for the use of primary care as part of a crackdown on health tourism. Sofia Lind looks at what is on the table.

The Government has unveiled a number of proposals for charging patients for the use of primary care as part of a crackdown on health tourism.

What has been proposed?

The Government has proposed that primary care stops being free at the point of use for non-EU migrants in the UK for a ‘limited period’. It has proposed two options: either for a healthcare ‘levy’ to be paid on entry to the UK or for a mandatory health insurance to cover costs. The Government said it favours the levy for practical reasons, based on its own analysis.

What would the levy cover?

The levy would cover all NHS care, including primary care. However, the consultation document has said it will exclude expensive elective procedures, for which patients would be made to pay separate fees.

What would be the cost to patients?

The size of the levy is part of the consultation and the Government has given three options: a, £200 per year or b, £500 per year or c, another amount. If the levy was set at £200 per year, a migrant granted a five-year visa to the UK would be paying an upfront fee of £1,000. Should it be set at £500, a migrant granted a five-year visa would be asked to pay £2,500 upfront.

What will GPs be expected to do?

Under the Government proposals, GPs would be asked to check that each patient is eligible for free healthcare or charge them ‘at the point delivery’. Although the plans are not yet finalised, the Government intends for eligibility to be recorded in patient records and linked with NHS numbers. It said that, ideally, patients would register separately for an NHS number before registering with a particular GP practice.

What are the practical concerns?

GP leaders have expressed concern with GPs being made to act as ‘border police’ on migration status. The Government has also raised the issue of some patients being deterred from attending necessary appointments with doctors if they were made to pay, potentially creating public health risks. The GPC warned that patients may spread infectious diseases such tuberculosis in their local communities if they are deterred from accessing primary care freely.

What are the ethical concerns?

The GPC has highlighted ethical concerns with GPs refusing to treat patients in need of emergency care unless they are willing to/can pay.

Who can respond to the consultation?

Anyone, it is an open consultation.

By when should you respond?

The consultation opens today (3 July). It will run for eight weeks and will close on 28 August 2013.

What about outside England?

A separate parallel Home Office consultation is looking at three specific elements of these proposals on a UK-wide basis: redefining qualifying redidency; using a visa levy to ensure some migrants make a fair contribution and extending charging to primary care services.

Readers' comments (10)

  • What about short stay tourists? I still find it bizarre that an American short-stay tourist can get 'emergency' NHS GP care for free when I have to take out insurance every time I go there.

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  • Anonymous: Under proposals they would be made to pay or not be treated.

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  • I think they should pay as it is not free to get treatment abroad I have had to pay on various ocasions. They should to. They need to pay for their treatment as they would pay if they were in there own country

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  • not treating patients with possible infectious diseases could lead to a situation that costs alot more than the possible savings.

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  • Anonymous | 04 July 2013 10:10am - I think the public health risk of this argument is overstated, it will cost a lot more to deal with thousands of minor ailments than the exceptional cases. If you have the financial resources to travel internationally to the UK, you are not poor, you can afford healthcare. There are safeguards in the system which will be maintained for STDs and other infectious diseases.

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  • could you post a link please where the consultation document is.

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  • Surely for GPs this is a non issue.
    See the patient privately and charge.
    No complications.

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  • The best option would be to charge everybody to see GPs with higher charges on those who are not ordinarily resident (which could subsidize the poor). Managing charges as the norm would be simple and effective. This is how it works everywhere else in the world, why is the UK so arrogant that we think we can do it differently?

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  • VISITOR COMING TO UK SHOULD HAVE A HEALTH INURANCE BEFORE THEY ARE ALLOWED TO ENTER IN THE COUNTRY AND GP SHOULD BE ALLOWED CHARGE HIM/HER AS PRIVATE PATIENT FOR GIVING SERVICES AS REQUIRED. THE VISITOR CAN CLAIM BACK THE FEES FROM THEIR INSURER LATER ON.

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  • I was ill in Japan that resulted in a hospital stay,suspected meningitis would not let me leave hospital unless I paid the bill cash,yen,not dollars,sterling,card,or any other means.
    before they did any thing,ex rays,blood,etc,was told what the charge would be or they would not do it.
    I did health insurance.Any one visiting the UK should be
    charged.

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