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Charging non-EU visitors to the UK for GP appointments ‘would backfire’, researchers say

Charging non-EU migrants for access to primary care would increase health risks to the rest of the population and place an even bigger financial burden on the NHS, experts from the London School of Hygiene and Tropical Medicine have warned.

Their research revealed that undocumented migrants would not go to a GP and were more likely to end up in A&E if they had to pay for appointments.

The research team, led by global health lecturer Dr Helena Legido-Quigley and leading public health expert Professor Martin McKee, also reported that many migrants already find it difficult to get access to the care they are entitled to, and called for better training for practices on what non-EU residents were entitled to receive.

It comes as Pulse has revealed that the DH is considering ‘where to draw the line’ on charging non-UK resident patients to use general practice services.

In light of the debate around immigration and potential introduction of charges in the run-up to the general election, the researchers carried out a series of interviews with 16 undocumented migrants, and four volunteers working with refugees and asylum seekers.

All of the migrants said they would not be able to afford to access primary care if the proposed charges were introduced.

Most did not know they were already entitled to free care from a GP, but many were aware they could get emergency treatment at A&E departments for free and as a result considered A&E the first place to seek medical attention.

In addition, the researchers said many migrants had found it difficult to register with a GP practice, with practice staff demanding ‘excessive’ documentation, with inconsistencies in requirements between practices, combined with language barriers, creating a ‘sense of confusion’ and ‘helplessness’.

Meanwhile support volunteers who were interviewed said they believe charges would increase the spread of infectious disease and the chance people would become more sick and end up in hospital.

The researchers said their findings ‘support concerns that further restrictions on access may increase public health risks and costs to the NHS’.

They concluded: ‘Existing guidance on access to care for all migrants needs to be clearer and more accessible. Staff working in primary care need better training on government guidance and regulations.

‘Additionally, policymakers need to examine the financial consequences of limiting access to primary care among migrants, as less preventative treatment can be expected to lead to migrants presenting to secondary care with more serious complications and a greater financial burden on the NHS.’

The report comes as the Department of Health is exploring ways to tackle so-called ‘health tourism’ by getting GP practices to check all new patients in areas with large numbers of EU migrants have a European Health Insurance Card entitling them to free treatment.

A recent Pulse survey revealed most GPs support the introduction of charges for foreign visitors to the UK.

Int J Health Serv 2015