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i Editor's Letter: More changes for the NHS



Today’s front-page story looks likely to affect many millions of people. Migrants to England will soon have to pay for accident and emergency care from the NHS.  The change also means that  English patients will have to  prove that they have the right to be treated for free.

How will the Government’s “clampdown on abuse” in the NHS actually work in Accident & Emergency units? The Department of Health won’t tell us – too early to say, they’ll get back to us in March. (And too early to know whether the health services in Wales, Scotland and Northern Ireland will follow suit.)

The announcement is heavy on headline and airy on detail. The Department of Health is putting out the “top line” of the story now – that foreigners can no longer expect unfettered access to the NHS – to try to seize the media narrative on immigration before the predicted arrival of new  Bulgarian and Romanian migrants this week.

Undoubtedly, some “health tourism” does take place, although medical staff disagree a great deal about the scale of it. But tackling  that in A&E is politically  hazardous. And this reform has the potential to put hospital staff in an invidious position. Sound or look a bit foreign? Please prove your entitlement to free care.

In its briefing to journalists yesterday, the Department of Health fleetingly dances over these logistics. It does acknowledge that the NHS will need “a new system for identifying and recording patients who should be charged for NHS services”. But after the tens of billions blown on failed government IT contracts  – disgusting squandering of  public money – who can have  faith in the NHS’s ability to  introduce new IT?

I look forward to the fine print...


Twitter: @olyduff