LMC representatives at the 2019 UK LMCs conference in Belfast backed a motion calling on the BMA's GP committee to negotiate for the form to be scrapped in the next round of contract negotiations, and to support practices that choose to cross it out when they register patients.
A supplementary section added to GMS1 forms as part of the 2017/18 contract asks patients ‘not ordinarily resident in the UK’ to sign a declaration accepting that they may have to pay for NHS treatment outside of the GP practice when they register with a practice. The form also asks these patients to provide information on how they should be charged.
Under the existing GMS contract, practices are required to hand the form to patients during registration, although they should still register patients if they choose not to complete it.
However, some practices have refused to comply - with the charity Doctors of the World reporting in 2017 that some of its members had begun crossing through the section so that migrant patients feel safer accessing GP services.
Tower Hamlets LMC chair Dr Jacqui Applebee told the conference: 'Surely it is up to secondary care to find out if people are eligible, not us. Everyone is eligible for primary care. These questions are voluntary, patients do not have to fill them in - but we have to think about why this is happening, and the sense of otherness that the hostile environment fosters.'
Dr Applebee warned that elements of 'anti-immigrant bureaucracy' such as the supplementary questions fed alienation and division that could ultimately contribute to events such as the recent terrorist attacks in Christchurch, New Zealand.
'Sometimes we have to stand up and say this is wrong, we have to stop fostering this hostile environment,' she told GPs.
GPC member Dr Bob Morley told the conference that the BMA's GP leaders could not support motions that conflict with existing contractual requirements on GPs, but agreed it was already GPC policy that GPs 'shouldn’t be involved in policing the immigration status of our patients'. He said this was not the 'primary purpose' of the supplementary questions.
LMCs backed all parts of the motion despite the GPC warning.
Read the motion in full:
That conference notes that it is GPC policy that GPs should not do the work of the home office by checking immigration status of patients and:
(i) opposes the obligation on practices to send a copy of the GMS1 form to NHS Digital of patients who self-declare that they hold either a non-UK issued EHIC card, PRC or S1 form and opposes the obligation to manually record this information in the patient’s medical record
(ii) calls on GPC to support practices who wish to cross out the supplementary questions (patient declaration for all patients who are not ordinarily resident in the UK) on the GMS1 form
(iii) instructs GPC to insist that the supplementary questions are removed during the next round of contract negotiations
(iv) instructs GPC to insist that the obligation on practices to send information regarding patient’s residency status to NHS Digital is removed during the next round of contract negotiations.