Viewpoint: Scrap plan to charge foreign nationals for GP visits

Based on the attention the government (aided and abetted by the media) is devoting to introducing charges for patients from non-EU countries, you could be forgiven for believing that health tourism is a significant problem, writes BMA deputy chairman Dr Kailash Chand.

Dr Chand: 'This proposal is totally unworkable and should be scrapped.'

Health secretary Jeremy Hunt now plans to introduce a registration and tracking system to spot people not eligible for free care on the NHS.

But how costly is this ‘abuse’? The estimated cost of foreign nationals' illegitimate use of health services varies, Cameron put the figure at £20m, and Mr Hunt then randomly upped it to £200m.

Treating foreign nationals worth two NHS hours

The truth is that in 2011/12, the NHS officially spent £33m on treating foreign nationals, £21m of which was recovered. RCGP chairwoman Professor Clare Gerada reminds us that this was the equivalent of just two hours of NHS annual spending. Further, when immigration is discussed, it’s also important to remember that foreign nationals contribute far more in taxes than they receive in benefits and services. This is a response to political pressure rather than patient needs and human rights.

I am not against plugging this hole, whatever the true figure is.

What matters is GPs should not be asked to be agents of border controls and become an arm of the immigration service. GPs have a duty of care to all people seeking healthcare, and should not be expected to police access to healthcare and turn people away when they are at their most vulnerable. It is important to protect individuals and public health.

We as doctors are trained and committed to deal with humanity, its wellbeing and not a Jelly Baby production line. An emergency (life or death) presentation in GP surgery/A&E draws on the skills of medics who are expertly trained and indeed must adhere to a professional code to preserve life.

We cannot expect our receptionists to ask these questions

This is diametrically opposed to the 'Where is your wallet please?' notion that is quite rightly mooted to fend off health tourists. But this is an impasse, and unless the individuals concerned can be stopped before they reach the doors of a GP surgery then I don't see a proper solution ever being in place because we simply cannot expect our receptionists to ask these questions.

How can you ask for evidence of immigration status or residency from one patient, but not every patient? That would be applying discrimination. So either we do it for every patient or do it for none. Do we have resources or time to enforce a politically motivated policy? This proposal by Mr Hunt is totally unworkable in general practice and should be scrapped.

If the government is concerned about health tourism, it should change the law, and require all visitors to have insurance cover before they are granted a visa.

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