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GPC instructed to support GPs who breach contract on immigration registration

The BMA’s GP Committee has been instructed to push for the removal of a patient registration form that makes them self declare whether they are entitled to NHS care.

Local leaders members at the LMCs Conference in Belfast narrowly voted for the GPC to support GPs who breach their contract by refusing to make patients fill out the parts of the supplementary ‘GMS1 form’ that ask them to self declare they are entitled to NHS care.

GPs said they should not ‘be border guards’ for the Home Office.

The GPC said before the vote that it ‘cannot support’ the motion for GPs to take action that breaches GPs contracts.

All parts of the motion were passed in a tight vote.

Chair of Tower Hamlets LMC Dr Jackie Applebee, who proposed the motion, said that GPs are’not agents of the UK immigration agency.’

She said: ‘Yet, here we all are collecting data which NHS Digital can still share with the Home Office. Trust is fundamental to the doctor-patient relationship. If we are seen to be assisting the Home Office, that trust would be seriously undermined.

‘Conference, we are not border guards and we should have no part in collecting data which the government will use to fuel hostile environment when we have already seen so many examples of the harm it does. The Windrush scandal is a lesson. We cannot trust the data we collect via the supplementary question on the GMS1 form will not be used for immigration enforcement.’

Dr Thilla Rajasekar, who opposed the motion said: ‘Accountability is paramount to a universal healthcare system like NHS, which prides in being free at the point of care. We should never let this principle be compromised through a lack of accountability. So I’m not proposing that GP surgeries and its staff enforce Home Office policy. I’m proposing that we should never have to choose who we offer treatment to. I do implore you to not accept the false dichotomy that is being proposed in this motion.’

Dr Bob Morley, GPC policy lead for contracts and regulation said: ‘We do have clear policy, that GPs shouldn’t be involved in policing the immigration status of our patients. It’s important to understand that the basic reason for the supplementary forms is to ensure that patients who aren’t entitled to free secondary care are identified so those costs can be recouped.’

He continued: ‘In terms of part ii, we do have concerns about this, it calls for GPs to breach their contract. The motion itself isn’t something that the GPC can support and should any GPs try to do that, then its going to be very difficult for GPC to support.’

In response the reasoning behind the supplementary forms, Dr Applebee added: ‘I know why they’re there. I dont think its up to us to be policing the system, certainly not for secondary care. Patients do not have to fill the forms out so I don’t really know why this motion would disrupt legitimate data collection.’

It was recently reported that the DWP were developing an IT system to access patient data to determine benefits assessments.

More recently, GPs receiving misleading benefits letters from the DWP could put patients at risk of homelessness.

Motion in full

22 TOWER HAMLETS: That conference notes that it is GPC policy that GPs should not do the work of the home office by checking immigration status of patients and:

(i) opposes the obligation on practices to send a copy of the GMS1 form to NHS Digital of patients who self-declare that they hold either a non-UK issued EHIC card, PRC or S1 form and opposes the obligation to manually record this information in the patient’s medical record

(ii) calls on GPC to support practices who wish to cross out the supplementary questions (Patient Declaration for all patients who are not ordinarily resident in the UK) on the GMS1 Form

(iii) instructs GPC to insist that the supplementary questions are removed during the next round of contract negotiations

(iv) instructs GPC to insist that the obligation on practices to send information regarding patient’s residency status to NHS Digital is removed during the next round of contract negotiations.