Doctors should not be “health tourism police”

DOCTORS should not be used to police new laws requiring non-EU patients to pay for NHS hospital treatment in England, the Royal College of GPs has said.

RCGP chair Professor Helen Stokes-Lampard said the College had “a number of concerns” about the new rules.

From October 23, NHS hospitals must collect payment “in full, in advance” from those who are not entitled to free care. Upfront payments are not required for treatment deemed “immediately necessary or urgent”.

Department of Health (DoH) guidance sets out a list of 32 questions hospital staff should ask patients, including evidence of “a settled home address in the UK.” This could include utility bills, proof of property ownership or insurance policies.

While staff are not expected to question every patient, separate guidance warns that trusts could breach laws on discrimination if they only target non-white patients.

The DoH recommends hospitals have a designated staff member to handle cost recovery, adding: “[T]he role of the clinician… is to focus only on assessing whether the patient requires immediately necessary or urgent treatment. It is not the role of the clinician to identify patients who may be required to pay for treatment.”

Professor Stokes-Lampard said: "We recognise that the NHS must not be abused and measures need to be taken to tackle health tourism - but it should not be the role of doctors or other healthcare professionals to police this.

"Whilst the charges being introduced will not be applicable to general practice services, we have concerns about the unintended consequences of increasing demand on GPs and our teams from patients who are unable to get free treatment in secondary care.”

She also raised concerns about the risk of ill patients not seeking medical care because they cannot afford treatment – something she says has the potential to affect some of the most vulnerable in society.

A price list of treatment charges has also been published, recommending non-EU patients should be charged 50 per cent more than the working costs to the NHS. Examples include rates of £15,802 for spinal surgery, £10,277 for paediatric brain surgery or £4,138 for delivery of a child, and £1,825 for an eye operation.

British Medical Association Council chair Dr Chaand Nagpaul criticised the lack of consultation about how the scheme would work. He said: “It is vital that patients do not face bureaucratic or financial obstacles that prevent acutely sick and vulnerable individuals from seeking necessary treatment. This would be morally unacceptable and could end up costing the NHS more money due to lack of timely treatment.”

Detailed guidance on the regulations is available on the DoH website

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