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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.

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.