Health Services: Foreign Nationals
(asked on 3rd September 2018) - View Source
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, pursuant to Answer of 10 July 2018 to Question 160799 on Health Services: Foreign Nationals, what processes his Department has put in place to monitor the effectiveness of NHS care providers in relation to determining the eligibility of patients; and what steps he has taken to ensure that the eligibilty criteria does not result in discrimination.
The National Health Service is a residency-based healthcare system, with a requirement to be ordinarily resident in the United Kingdom in order to access NHS-funded healthcare. Providers of relevant NHS services are required to make and recover charges from overseas visitors where relevant services have been provided to them and no exemption applies.
The Department does not mandate any specific processes to determine the residence or chargeable status of patients. In order to identify those who may not be entitled to NHS-funded treatment, and to do so in a way that avoids racial profiling and discrimination, all patients need to be asked baseline questions to indicate whether they are ordinarily resident in the UK or if they may be an overseas visitor who should be assessed for charges.
However, it is up to providers of NHS care to assure themselves that they are doing everything reasonable to determine the eligibility of patients who are entitled to receive free NHS care, an entitlement based on residency not nationality.
The Department has published extensive guidance on implementing the overseas visitor charging regulations. This guidance is for use by all frontline staff providing National Health Service funded services, as well as the providers and commissioners of those services. It is available at the following link:
The guidance clearly sets out that urgent or immediately necessary care must never be withheld, regardless of an individual’s ability to pay for the treatment. Clinicians are required to make the decision on whether treatment is urgent or immediately necessary for those patients identified as not eligible for NHS-funded care, taking into account a realistic expectation of when the individual is expected to leave the UK. As a result of the National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2017 patients are required to pay in advance if treatment is decided by a clinician to not be non-urgent. The Department has been carrying out a review of these Amendment Regulations, with evidence submitted by 31 organisations or individuals representing vulnerable migrants. The evidence is currently being considered and stakeholders will receive an update in due course.
It is also worth noting that that the Charging Regulations already have extensive safeguards in place for the most vulnerable. Refugees, asylum seekers, some state supported failed asylum seekers and victims of modern slavery are all exempt from the Charging Regulations.