Changing foreign patients for NHS care is “fundamentally racist” according to doctors who have said controversial rules forcing people to pay upfront before they can receive NHS care for serious illnesses such as cancer should be scrapped.
Hundreds of delegates at the British Medical Association’s annual conference in Belfast overwhelmingly backed a motion that said asking overseas visitors to pay made medical staff “complicit” in racism.
It is the first time a body representing medical staff has called for the complete abolition of the charges, which have been heavily criticised by MPs and health charities.
Doctors who opposed the move were booed as they spoke.
There is sympathy for patients in poor countries that simply do not have the medical facilities or staff but what happens when patients from the U.S. start jumping on a plain for treatment?
Conservative MPs said that opening up the NHS to the rest of the world was reckless when its resources were so stretched.
Health tourism is thought to cost anything from £200million to £2billion a year. The BMA, which is one of the country’s most powerful trade unions, will now lobby the Department of Health to overhaul the charging system.
Although the Government sets the rules, they function only if doctors follow them.
Tory MP Andrew Percy said: ‘It is incredible that some doctors want to open up the NHS to health tourism from people overseas who haven’t paid in.
‘Perhaps instead doctors who support this could pay for the treatment of these people themselves.
‘Most people would expect our NHS services to be reserved for those who are living here permanently and who are contributing to our system.’
Fellow Conservative MP Philip Hollobone said: ‘The BMA is completely out of touch with public opinion on this issue.
‘There is nothing racist about charging international tourists for the care they receive over here. Every pound spent treating health tourists is a pound not spend on British citizens.’
Only patients ‘ordinarily resident’ in the UK – usually for at least six months – are eligible for free NHS care.
EU citizens can also get it for free, provided they have an EHIC card.
Everyone else should be charged up front before treatment begins and doctors, nurses and receptionists are legally obliged to check a patient’s status first.
The only situations where this does not apply are those involving lifesaving procedures or treatment in A&E units. GP surgeries are also free for all.
But the rules will work only if doctors cooperate, particularly as they hold so much authority in individual hospitals and departments.
In the BMA debate on the issue on Monday night, a motion was proposed arguing that it was ‘not cost effective to monitor eligibility for NHS Care’. It called for ‘the policy of charging migrants for NHS care to be abandoned and for the NHS to be free for all at the point of delivery’.
Dr Jackie Appleby, who proposed the motion, said charging immigrants for NHS care was a form of ‘racial profiling’ and not cost-effective.
She said: ‘The cost of treating migrants and overseas visitors on the NHS is a drop in the ocean compared to the overall budget. The cost of health tourism is disputed. It’s peanuts in the grand scheme of things.’
Speaking against the motion, Dr George Rae said dropping fees would undoubtedly encourage health tourism.
He said: ‘The message coming from the BMA is … get on the plane, get on the boat because you will get treatment on the NHS for nothing.’
Dr Duried Syad Ali, also opposing the motion, said: ‘Every year we complain about a lack of resources and complain about how much pressure the NHS is under.
Making ‘contribution’
In a pilot scheme in London designed to check people’s eligibility for healthcare, only one of the 180 people whose cases were looked at were found not to qualify, she added.
The National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2017 compels hospitals in England to check on the eligibility of overseas visitors to free NHS care and seek payment upfront from those deemed ineligible, such as asylum seekers and visa overstayers.
The Department of Health and Social Care said: “British taxpayers support the NHS, and it is only right that overseas visitors also make a contribution to our health service so everyone can receive urgent care when they need it.”
‘Health tourism’: What are the rules?
What is ‘health tourism’?
This is when patients who are not entitled to free NHS care are treated without paying their bills. It covers short-term migrants, holidaymakers and foreigners who deliberately target the NHS. The exact cost is put between £200million and £2billion a year.
What are the rules?
Only patients who are ‘ordinarily resident’ in the UK are entitled to free care, which usually means being here for at least six months. This excludes care in A&E units and GP surgeries which are free for everyone. In all other situations, staff are legally obliged to check eligibility. Anyone who isn’t eligible for free care should be invoiced.
What about EU citizens?
Staff should record details and the Government will then invoice their member state. But the UK is notoriously inefficient at billing or collecting the cash. Other EU member states are better at charging the UK.
Who enforces these rules?
Hospitals are meant to employ officers to collect bills. But not all do and others have only one or two staff to check thousands of patients.
What if patients don’t pay?
If the treatment is urgent, patients will be treated and billed afterwards. If it is less serious patients may be refused care until they cover the costs. The situation varies between hospitals and some patients will be treated regardless. Many hospitals employ costly debt-collecting agencies to chase patients after they have been discharged.
What is the BMA doing?
It has voted to abandon the policy of charging overseas patients for free treatment. The union will now lobby for a change in the law. If this does not happen, doctors may decide to ignore the rules anyway.
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