Quite aside from the obvious moral case, the new policy will impact the economic sustainability of the NHS and the health of the population for decades to comeby Timesh Pillay / October 23, 2017 / Leave a comment
As a doctor in the NHS, I’ve seen Jeremy Hunt’s Department of Health initiate a number of controversial reforms, including the widely unpopular junior doctors contract, mostly without proper consultation. However, none have had the destructive potential of the department’s latest intervention.
From today, it becomes mandatory for all patients seeking NHS care in England to undergo immigration checks, with those deemed ineligible to pay 150 per cent of the cost of care up front.The stated aim is to recover costs from so called ‘health tourists’ but there will be wide ranging and severely negative impacts on both the economic sustainability of the NHS and the health of the population in coming decades as a result.
The NHS is one of the most cost effective healthcare systems in the world. By being resident-based, it avoids the bureaucracy of insurance eligibility and by treating everyone, it maximises public health benefit. Both advantages of our pooled system are under threat from this policy.
The Government’s own research shows that overseas visitors not entitled to care cost the NHS at most £300 million per year, less than 0.3 per cent of its budget.
This broad and blunt attempt by the Department of Health at recouping this cost is complicated by a number of practical issues. Firstly,
17 per cent of the UK population doesn’t have a UK passport with which to prove their eligibility. Secondly, a majority of migrants are entitled to NHS care either through annual tariffs they pay as part of their visa or exemption status as refugees or asylum seekers. The proportion of ineligible patients able to pay the fee is likely to be insubstantial.
Since the 2014 Immigration Act, an ever more hostile NHS environment has developed. Patients’ stories are a sign of things to come. I saw one woman in recent months who told me she hadn’t come to her previous appointment for fear her asylum request would be rejected if she used her name. Sadly, this fear is justified. An agreement between the NHS and Home Office to share patient information shows a hidden motive behind this reform.
Another patient was threatened by a Trust with a rejected asylum claim if they didn’t pay the NHS bill they had received in the post. Many patients have reported being racially profiled in order to determine eligibility checks. One in-patient I was caring for was approached…