NHS trusts to make overseas patients pay upfront for non-urgent care

24th Feb 2017
NHS trusts to make overseas patients pay upfront for non-urgent care

The Government has announced that from April this year all NHS trusts in England will be required to ask foreign patients attending for non-urgent medical care to provide documents showing they are entitled to free NHS treatment or pay an upfront fee for treatment.

This change in the law will mean that hospitals can refuse to schedule non-urgent operations unless the cost is met beforehand. The Government says that the NHS currently spends around £500 million on overseas visitors who are not eligible for free health care. Visitors needing urgent care will still be treated by the NHS and can be invoiced later.

The change in the law comes as Health Secretary, Jeremy Hunt, announces a clamp down on so-called ‘health tourism’. He intends to reinvest the £500 million that is currently being spent on overseas visitors for non-urgent treatment back into the NHS. Currently, hospitals do charge patients living outside the European Economic Area for care such as hip operations or cataract removal, but this is done by invoice, rather than upfront. After April this year hospitals can refuse operations for foreign patients unless they pay for them in advance. This will also reduce the time hospitals have to spend chasing up money they are owed for treatment or on patients who they later realise cannot pay for the treatment.

A pilot scheme has already been trialled by Peterborough and Stamford Hospitals NHS Foundation Trust since 2013. In the trial, all patients were asked to show two proofs of identity before undergoing planned treatment. Appointment letters requested that patients bring suitable ID, such as a passport, birth certificate and evidence they are registered in the UK such as a utility bill.Non-EEA patients are asked to prove that they have paid the health surcharge. On average, the trust has received £350,000 income for the treatment of chargeable patients each year.

Whilst many welcome the change in the law there are those who are concerned how it is going to work in practice. It will be up to each individual health trust to decide how they implement the law and perform their checks, with many requesting the appropriate identification and proof of address be brought to appointments, but one concern is with an already stretched NHS, who will have the responsibility to check eligibility. Doctors and nurses have already voiced concern saying they are not trained for this role and are already busy dealing with patients, without having to perform background checks. The doctors’ union, the BMA, warned of potential “chaos and confusion” from the changes. Questions are also being asked about how much it will cost to implement the system.

Dr Mark Porter, BMA Council Chairman, said: “There is no detail as to how upfront charging will be introduced from scratch in just three months, in an NHS already unable to cope with normal operations.”

It is unclear how many patients come to English hospitals for planned, non-urgent care, but the Government hopes that forcing hospitals to discuss payment before scheduling treatment will mean payment is made and cost covered in advance rather than patients being invoiced after their care has begun, and NHS Trusts having to follow up to ensure payments are made.

Hunt said: “We have no problem with overseas visitors using our NHS – as long as they make a fair contribution, just as the British taxpayer does.”

Rachel Kayani

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