GPs To Check Nationality of New Patients to Combat Health Tourism


General Practitioners will be asked to check whether patients are eligible for free NHS care in a new pilot scheme to be rolled out in ten areas with high populations of EU migrants.

According to GP magazine Pulse, surgeries will have to ask all new patients if they have a valid European Health Insurance Card which entitles them to access primary care services without paying upfront.

The scheme comes as the Department of Health prepares to launch a consultation on recovering the costs of primary care treatment from non UK residents which have been estimated at £2 billion a year. The pilot project would not result in patients being charged for accessing GP facilities, but the DH say they are designed to test the feasibility of surgeries routinely asking for documents in order to recover the cost from their home country.

Under last year’s changes to immigration rules, only UK residents with ‘indefinite leave to remain’ are entitled to free health care. But EU freedom of movement makes it difficult to track foreign patients using services who are not fully resident and may access on a temporary residency basis or for urgent medical attention.

A spokesman from the department said they were “absolutely committed to improving the way the NHS recovers costs from international visitors for primary care. We’re now planning to pilot different ways of doing this effectively without burdening busy GPs.”

The spokesman refused to confirm if in future patients will be charged for accessing primary care services. But according to a briefing paper by the General Practitioners Committee titled, ‘charging for primary care’, the Government will launch two new consultations in the coming months.

‘Two consultations will be launched in the Spring to look further at extensions to charging,’ it says, adding, ‘There are plans to start an EHIC pilot in primary care, to encourage the collection of EHICs, increase identification of chargeable patients and increase the engagement of GPs with the cost-recovery programme generally. GPC will be involved with a view to starting the pilot as early as possible.’

Plans last year to charge non EEA migrants an entry levy to the UK of £200-£500 were shelves over fears of administrative costs outweighing the fees. The spokesman said that any plans to extent direct charging “will require further consultation” but this would only be applicable to those from outside the European Union.

Committee member Dr Dean Marshall said the pilot was to get GPs ‘used to asking for’ EHIC cards.

 “‘We need to pilot it and see how much work it is. It will be extra administrative work potentially but it will hopefully clarify who is and who isn’t entitled to NHS care and clearly there is a huge amount of money being spent in the NHS on people who are not entitled to it.

“What we have been absolutely clear about is that this isn’t about the GPs becoming a police force and policing the system. It is about the administrative work. Anything we do is about how it can be done with the least amount of burden and of course an electronic solution would be what we are looking for.”

The scheme will not be covering access to emergency treatment, he said.

“If they [patients] need emergency treatment they will get emergency treatment. This is about people who come from other countries and then frequently turn up at practices wanting treatment for a condition that they have been treated for previously.”

But it has drawn criticism from within the profession, with some GPs fearing they will be expected to policy the system. British Medical Association deputy chair Dr Kailash Chand said, ‘The health secretary would be wise to concentrate on the major pressures on the NHS rather than being distracted by imposing an unworkable system of charging for health tourism. If this plan comes to fruition it will at best reduce the role of doctors to debt collectors.

“At worst it will deter them from registering migrants and asylum seekers as well as setting up a new system of charging that could be extended to others. Tampering with the core principle of the NHS , that it is free at the point of delivery, runs the risk of loading scarce resources on a minority issue, while the more meaty challenges remain unresolved.”

According to a letter from Spelthorne MP Kwarsi Kwartang, ‘It is very much up to the discretion of each GP practice whether or not they ask for proof of identity and residency status when new patients register. The rules surrounding registration and treatment for foreign nationals at GP practices are not as clearly defined as they are within the hospital service.’