GPs should not police healthcare access

Prioritise the treatment of patients on the basis of need rather than considerations of legal eligibility.

MDDUS advises that GPs should not police access to NHS healthcare for failed asylum seekers and other vulnerable migrants.

This advice comes in response to recent comment from the Royal College of General Practitioners on government strategy aimed at charging or restricting access to NHS care for overseas visitors. Regulations from the Department of Health (England) which came into force on 1 April 2004 identified groups who were not considered "lawfully resident" in the UK and made them liable for National Health Service hospital charges. A later consultation proposed extending the charging regime to GP services. There has been no formal government response to the 2004 consultation but a cross-Government enforcement strategy (entitled 'Enforcing the Rules') has been recently published. This suggests that primary care be brought into line with the regulations that exist for secondary care. The Home Office document describes the purpose of the strategy as "To ensure that living illegally becomes ever more uncomfortable and constrained until they leave or are removed".

MDDUS in support of the RCGP view advises that GPs have a duty of care to all people seeking healthcare and "should not be expected to police access to healthcare and turn people away when they are at their most vulnerable". The GMC states in Good Medical Practice: "You must give priority to the investigation and treatment of patients on the basis of clinical need, when such decisions are within your power".

Making judgements on eligibility to necessary treatment should not be a primary concern of doctors faced with sick patients. Indeed MDDUS has defended cases on the behalf of members where refusing or delaying treatment on the basis of eligibility has led to claims of negligence.

ACTION: Prioritise the treatment of patients on the basis of need rather than considerations of legal eligibility.

Link: RCGP statement - Failed Asylum Seekers / Vulnerable Migrants and Access to Primary Care