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DH to push ahead with plans for GPs to record patients’ migration status



The Department of Health has rubberstamped plans for GP practices to check and record the migration status of new patients when they register.

The DH will also go ahead with bringing in charges for overseas patients for all primary care services, except GP and nurse consultations, but will ‘take a phased approach to implementing this over a longer time scale’.

As previously reported, this would include charging for things like blood tests and lung function tests.

In its response to a consultation regarding NHS health tourism, published today, the DH said that ‘primary care has an important role in establishing chargeable status and charging overseas visitors and migrants’.

It added: ‘We believe that this starts with being able to determine whether a patient is chargeable when they register at a GP practice and that putting in place the processes for charging for primary care services will take longer to implement.’

Following this it will look at changing the rules for qualifing for free prescriptions, it said, and would then ‘work with the BMA GPC to consider how we extend charging to primary medical services so that overseas visitors and migrants… will have to pay for these services, (excluding GP/nurse consultations)’.

The DH said ‘the pace of this work will need to take into account contractual amendments and additional legislative changes’.

But GP leaders have previously warned against the plans which they feared could have potential public health ramifications if patients are deterred from seeking healthcare.

Responding, the DH said it would ‘ensure that the implementation of these proposals mitigates public health concerns and operational challenges as far as possible and we will work with colleagues at Public Health England in particular to achieve this’.

It added that the decision to keep GP and nurse consultations free of charge was ‘principally based on recognition that they are best placed to routinely monitor and assess several conditions that might have an impact on the public’s health’.

GP leaders have also warned practices don’t have the capacity to handle the additional workload of becoming ‘border guards’ for the NHS.

The DH document said ‘some professional bodies and GP practices were concerned that GP practice staff would find it too burdensome to assess new patients’ chargeable status or apply charges and recover money for providing services that become chargeable’. It noted that ‘this was especially so in the face of rising workloads and if there was to be no remuneration for doing so’.

But it added: ‘The Government is very clear – we do not expect the NHS medical professions to act as border guards. All staff providing NHS-funded healthcare do, however, have a duty to protect vital services from misuse and ensure that taxpayers’ money is spent wisely.’

Under the Immigration Act 2014 only UK residents with ‘indefinite leave to remain’ are entitled to free healthcare, and hospital trusts do retroactively charge ineligible patients for their treatment. But in an announcement today, health secretary Jeremy Hunt said that going forward trusts would ask for payment upfront instead.

He said: ‘We have no problem with overseas visitors using our NHS – as long as they make a fair contribution, just as the British taxpayer does.

‘So today we are announcing plans to change the law which means those who aren’t eligible for free care will be asked to pay upfront for non-urgent treatment.

‘We aim to recover up to £500 million a year by the middle of this Parliament – money that can then be reinvested in patient care.’

Primary care services to become chargable under DH plans

  • physiotherapy
  • blood tests
  • lung function tests
  • prescriptions
  • dental treatment
  • eye care costs

GP and nurse consultations will be excluded from charging, as will testing and treatment for infectious or sexually transmitted diseases.

Source: Department of Health