GPs urge boycott of ID-on-referral hospital charging scheme

GPs in the Unite union have condemned NHS requests for primary care to participate in immigration checks on patients referred for secondary care treatment and called on practices to refuse to co-operate.

GP referral (Photo: JH Lancy)
GP referral (Photo: JH Lancy)

Under a programme being piloted by 20 NHS trusts, patients are being asked to provide identification when they are referred for hospital treatment. The initiative is part of the government’s crackdown on free services provided to overseas patients announced earlier this year, requiring NHS bodies to identify patients eligible for charges.

GP practices in parts of London have been asked to co-operate with the pilot by telling patients about the new requirements when referring them.

GPs have said they fear the plans could be detrimental to public health, hit the most vulnerable and turn doctors into 'border guards'.

The bid to boycott the ID-on-referral scheme comes after GPonline reported last week that practices in some areas were registering undocumented migrants as 'no fixed abode' to prevent the Home Office using GP data to check on patients' immigration status.

GP referral

In north-west London, patients referred for cardiology and maternity services at three hospitals operated by London North West Healthcare NHS Trust are being required to provide two forms of ID at their first clinic attendance.

Practices in the Brent CCG area were sent a letter requesting their co-operation by asking patients to provide the required ID. The letter said the trust was working with DH and the Home Office on the pilot to monitor and collect payments for non-emergency overseas patients who are ineligible for free treatment. ‘The pilot will start in cardiology and maternity,' it said, at the Northwick Park, Central Middlesex and Ealing hospitals.

Practices have been asked by the CCG, on behalf of the trust, to inform all patients referred that they should bring two forms of identification to their first appointment.

In a motion proposed by London GP Dr Coral Jones, the Unite union's healthworkers’ section opposed the pilot. The union said the plans could cost the NHS more to implement than it would collect from patients.

Such measures, they said, could have a ‘detrimental public health effect’ by frightening those with infectious diseases off from seeking treatment.

Patient safety

Doctors in Unite representative to the GPC Dr Jackie Applebee said the measures would ‘disproportionately affect the most poor and disadvantaged’ people for the sake of trying to recover a ‘drop in the ocean’. ‘It is a distraction,' she added, ‘from the real issue, which is the massive, relentless underfunding of the NHS.’

Doctors in Unite called on all health workers, including GPs, to refuse to participate in any similar schemes.

Dr Applebee added that east London LMCs had submitted a motion to next month’s LMCs conference calling on GPs to refuse to check the immigration status of patients or provide patient data to the home office for immigration checks.

Under the pilot 20 trusts are being helped to better identify overseas patients who are not entitled to free care, an NHS Improvement spokesman told GPonline.

The trusts involved were identified as those most in need of support in ensuring services are provided free only to those entitled to it.

The scheme is being tested in maternity and one elective service in each hospital. Trusts are being provided with extra clinical and admin support.

Earlier this year the government announced new regulations which from April require hospitals and NHS bodies to flag patients’ chargeable status so that other parts of the NHS can more easily recoup costs where charges apply. The government wants to recover up to £500m a year from overseas visitors who are not eligible for free secondary care treatment.

Announcing the new regime in February, health secretary Jeremy 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.

‘We are announcing plans to change the law which means those who aren’t eligible for free care will be asked to pay upfront for non-urgent treatment.’

The 2017/18 GP contract also requires practices to use a revised GMS1 form for patients to identify those with non-UK EHIC or S1 forms or who may be subject to NHS charges.

As spokesman for London North West Healthcare NHS Trust said the pilot was being run by DH nationally across 20 trusts, but declined to comment on GPs’ concerns.

DH declined to comment because of election period restrictions. NHS England also declined to comment.

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