PRESS RELEASE: Concerns at NHS charging system recommendations

In response to the House of Commons Public Accounts Committee report on NHS charging for overseas patients:

FEBRUARY 2017: The Migrants’ Rights Network (MRN), Docs Not Cops and health professionals are concerned by the recommendations of the Common Public Accounts Committee (PAC) in their report (1 Feb 2017), which states a need for a more radical approach to recoupment of charges for NHS treatment of overseas patients. We believe this report, besides admitting that the government is failing to meet its own targets, outlines an unworkable, impractical and discriminatory system – one that needs eliminating not expanding.

The report outlines the failures of the NHS charging system to recoup costs incurred by EEA patients through reciprocal agreements, as well as the low levels of return on bills sent to non-EEA patients. They are not even managing to reach the figure they intend to recoup – £500 million, actually a tiny figure at less than 0.5% of the overall NHS budget.The PAC report argues that these low “gains” are due to a lack of identification of chargeable patients, although it admits that forcing patients to prove their eligibility or entitlement is likely to penalise and discriminate those that are in need of dire medical attention. Discrimination in the NHS charging system has been well documented, and we believe that drawing more health professionals into the system to identify chargeable patients is not the answer.

The PAC recommends that GPs are recruited to identify chargeable patients. GPs, a group who are already overstretched because of an under-resourced NHS and additional responsibilities should not now also be pushed to identify patients who ‘may’ be chargeable, because they are ill-equipped to understand and apply the entitlement rules for free NHS care because of the complexity of the current UK immigration system. Their inclusion fundamentally undermines medical professionalism and confidentiality and will only lead to more discrimination and inappropriate refusal of treatment, or charging people in error.

Dr Philip Abiola, GP said: It is unfair to blame overseas patients as the cause of the stresses on NHS resources, this is clearly due to an inefficient system that is unable to recoup costs through its reciprocal agreements, as well as a wider picture of underfunding. Pursuing patients in GP surgeries to prove they are allowed to access healthcare will drive them into emergency services, which are more costly than primary care. Any expansion of this system to involve GPs, will undermine my professional duties and deter vulnerable and ill patients from accessing healthcare they are entitled to.”

Dr Aislinn Macklin-Doherty, cancer doctor and researcher, said: “This overblown blame on Health Tourism for the current NHS crisis is evidence of yet more spin from this Government to distract from the real problems facing the NHS. The £500 million quoted spent on Health Tourism is dwarfed by the £22 billion being intentionally cut from the NHS by the current Government by 2020 and the 10s of £billions that leak out of the NHS into the bank accounts of private companies every year. Introducing charges or checks for eligibility we know would cost more than the relatively small amount it would recoup, and would also undermine the universality of treatment by forcing doctors to focus on “policing” who they care for rather than delivering care. My duty is to treat patients, not to be a border guard.” ()

Fizza Qureshi, Director of MRN said “Scapegoating migrants, when the real issue is systematic underfunding, is unreasonable and divisive, as is expecting healthcare professionals to act as the unofficial border police.”

For further information, please contact Fizza Qureshi on 020 7336 9407 or us at; and

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