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Charging migrants for healthcare too costly say doctors leaders

NHS resources should be spent on patient care rather than checking and charging migrant and short-term visitors for treatment, the BMA says.

money pillsDoctors leaders say while they accept the need to protect NHS resources by limiting access to healthcare, new government proposals on charging go too far.

The government has been conducting two linked consultations on its proposals to charge migrant and short-term visitors for access to NHS services.

Doctors leaders say they could result in every GP practice having to check the immigration status of patients on registration.

BMA council chair Mark Porter (pictured below) described the government plans for extending charging as ‘impractical, uneconomic and inefficient’.

He said the BMA believed that anyone accessing NHS services should be eligible to do so.


Administrative burden

Dr Porter insisted: ‘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.’

Mark PorterHe added that the proposals, set out in separate Department of Health and Home Office consultations, could also impact on the care all patients received.

‘If non-European Economic Area doctors are forced to make contributions to their healthcare, this could discourage them from coming to practise 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,’ he said.

In its responses to the consultations, the BMA also points out the lack of clarity about the documentation that patients will require to prove they have permanent residency.


Proof of residence

UK residents do not have to hold a passport and the documentation some practices currently require, such as utility bills, would not prove permanent residence.

BMA GPs committee chair Chaand Nagpaul (pictured below) 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.’

Chaand Nagpaul Arm 2013He added that asking patients to prove their residency 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,’ Dr Nagpaul said.

He said the government needed to work with healthcare professionals to find a workable solution.


Primary care charges

The BMA believes improvements should be made within the current charging system in order to ensure that charges are imposed when they should be, and costs are recouped.

The system in secondary care places a legal obligation on trusts to recoup unpaid debts from chargeable overseas visitors. However, it is not clear whether this would apply to primary care if charging were introduced there and who would have responsibility for it, the BMA response says. Some debts are also allowed to be written off if the patient genuinely cannot afford to pay them.

Read the Department of Health consultation Sustaining Services, Ensuring Fairness: a Consultation on Migrant Access and the Financial Contribution to NHS Provision

Read the Home Office consultation Controlling Immigration: Regulating Access to Health Services in the UK

 Read the BMA's response to the government's consultations