GP leaders voice concern over new health tourism rules

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GP leaders have again voiced concerns over new rules introduced this week relating to charging certain overseas patients for non-emergency NHS treatment.

NHS trusts, NHS foundation trusts and local authorities as well as any provider of NHS-funded community and secondary care are now legally obligated to check whether a patient is an overseas visitor to whom charges apply, or whether they are exempt from charges.

When charges apply, the relevant NHS body must make and recover charges from the person liable to pay for the NHS services provided to the overseas visitor in full in advance of providing them, unless doing so would prevent or delay the provision of immediately necessary or urgent services.

The move is the result of the government’s attempt to claw back £500 million a year from overseas visitors not eligible for free care, which health secretary Jeremy Hunt claims "can be reinvested in patient care".

But Professor Helen Stokes-Lampard, chair of the RCGP, says while measures need to be taken to tackle health tourism “it should not be the role of doctors or other healthcare professionals to police this”.

“Whilst the charges being introduced will not be applicable to general practice services, we have concerns about the unintended consequences of increasing demand on GPs and our teams from patients who are unable to get free treatment in secondary care,” she argued, and added: “We are also concerned about the risk of ill patients not seeking medical care because they cannot afford treatment – something that has the potential to affect some of the most vulnerable in society.”

Writing in an editorial published in the BMJ, Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine, and Lucinda Hiam, GP and health adviser, note that not only does the new guidance have "obvious implications for those who are not entitled to care, but its implications extend to everyone using the NHS.

“The system is under unprecedented pressure, with many emergency departments failing to meet performance targets. Adding to the work of clinicians already struggling simply to diagnose and treat people entitled to care seems dangerous, especially when the performance of the NHS has been implicated as a possible reason for rising death rates.”

Furthermore, they argue that “it is not even clear that these measures will save appreciable amounts of money, with evidence consistently challenging the myth of widespread health tourism.”

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