Charging foreigners would damage NHS, doctors say

Government plan would force GPs to do the work of immigration service, says BMA chairman

Plans to charge more foreigners for using NHS services could mean every patient, including British nationals, having to prove their identity when they register with their GP, doctors have warned.

The British Medical Association (BMA) says it can see no way in which the Government’s plan could work without family doctors being forced to make identity checks that would be an “intrusion and inconvenience” for patients and would risk damage to the doctor-patient relationship.

The Department of Health argues the proposals, which were set out earlier in the summer, would “protect the NHS from costly abuse”. Under the plans, aimed at reducing the economic impact of so-called “health tourism”, people from outside Europe staying in the UK for up to five years would be charged at least £200 a year for access to NHS healthcare.

Charges already in place for non-European Economic Area migrants accessing hospital care would be extended to GP visits. The BMA said the plans were “impractical, inefficient, uneconomic and could cause unintended damage to NHS services”.

They added that there was no evidence to show the new charges would recoup the NHS the cost of implementing the scheme and warned that discouraging migrants from visiting GPs could pose public health risks.

In their response to the Government consultation, the BMA said: “Doctors’ primary ethical duty… is to respond to the needs of their patients. It is our view that doctors should not be  required to make judgements on  the immigration status of patients  or their entitlement to treatment under the regulations.”

Several doctors’ groups, including the BMA, had previously raised  concerns that medical staff would  become de facto immigration control officers.

The BMA also raised concerns over the impact a health levy would have on the number of migrant health workers willing to live in the UK. Although migrants needing immediate care would not be charged, the doctors’ union also raised concerns that patients would be put off from seeking care.

The Department of Health sought to reassure doctors that they wouldn’t be expected “to become immigration guards”.

“We want to work alongside doctors to bring about improvements, but we must all work together to protect the NHS from costly abuse. We want a system that is fair for the British taxpayer by ensuring that foreign nationals pay for their NHS treatment,” a spokesperson said.

However, there is still uncertainty over the true cost of immigration to the NHS. A Government audit is  due to report in the autumn, but  estimates range between £12m to £200m per year – from a total NHS budget of £109bn.

Dr Mark Porter, chair of the BMA Council, said the Government’s “entire approach” was flawed. “The NHS does not have the infrastructure or resources to administrate a charging system that is not likely to produce enough revenue to cover the cost of setting up its own bureaucracy,” he said.

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