In scathing submissions to consultations launched by the DH and the Home Office, the BMA rejected plans to extend charging into primary care.
GPC chairman Dr Chaand Nagpaul said the ‘ill thought out’ government plans would inconvenience patients and waste GPs’ time.
Ministers announced in July that non-European long-term visitors could be charged £200 a year for NHS care including GP visits, and short-term visitors charged a fee to see a doctor.
The consultation set out plans to abandon the principle of free access for anyone ordinarily resident in the UK, and for practices to record patients’ immigration status when they register.
Launching to proposals, health secretary Jeremy Hunt said: 'We need to ensure that those residing in or visiting the UK are contributing to the system, but we want to implement a system that limits red tape for NHS professionals.'
The BMA response claimed there was no evidence that fees would cover the cost of running the system, and that all patients would be inconvenienced if practices are forced to police access to the NHS.
But the BMA response warned of:
- Implications for public health by taking away opportunities to identify symptoms
- An administrative burden on GP practices
- Unintentionally disenfranchising disadvantaged groups by requiring proof of eligibility
- Increased pressure on A&E, where there are no charges
- Major concerns over the lack of an impact assessment
The doctors’ organisation said rather than expanding the fees system, ministers should look at how to improve the current regime to ensure charges are made when they should be. The BMA said it supported maintaining the current ordinary residence principle.
Dr Nagpaul said: ‘GPs, like many other NHS staff, do not have the capacity to administer a complicated bureaucratic system that is of questionable benefit to taxpayers and patients.
‘Asking patients to produce documentation to prove their residency faces a number of problems. It would mean all patients would have to have their eligibility checked each time they register with their GP.
'This would be a huge inconvenience to all members of the public and would take up valuable time that practices could be using to treat patients. Some UK residents, especially many older people, will not have a passport or a bank account which raises the concern that some of the most vulnerable members of our society will face delays in accessing care.
‘We have seen with the recent NHS 111 debacle what happens when an ill thought out policy is rushed through without proper consideration of the practical and clinical implications. Ministers need to learn from recent experiences and work with healthcare professionals to find workable solutions to this issue.’
BMA chairman Dr Mark Porter called on ministers to rethink their ‘unworkable’ and ‘damaging’ plans: 'The government’s plans for extending charging to migrants and short term visitors are impractical, uneconomic and inefficient. 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. The NHS does not need more administrators; it should be spending its money on caring for patients.
'More worryingly, the proposals could have an impact on the care all patients receive. If non-EEA doctors are forced to make contributions to their healthcare this could discourage them from coming to practice in the UK and working in key services, such as emergency departments, which are experiencing doctor shortages. This could exacerbate the current workload pressures already facing the NHS.
'The government needs to rethink it is entire approach to this issue as in their current form these proposals are unworkable and potentially damaging to the NHS.'