David Davies MP: Charge foreigners for using the NHS

This from Mr Davies on today's Cornerstone blog:

"The government funded “Visit Britain” website which is supposed to generate money for our nation, actually advertises to the world that “you are eligible for free emergency treatment in the Accident and Emergency departments of National Health Service hospitals.”! It goes on to state that foreign visitors (with many exceptions) will be charged for after-care. But of course nobody ever pays. An official might make a half-hearted attempt to chase up a large debt from someone living in the third world who has given a false name and address. He or she will fail...

A simple measure would put a halt to much of this abuse. We should insist that absolutely everyone arriving here from outside the EU, should be in receipt of a verifiable health insurance document that could be checked by immigration officials.  At a stroke we would put an end to a great deal of freeloading on our public services.  The idea is so simple it needs no more than a sentence to sum it up. It would be fair and would do no more than to bring Britain into line with the rest of the world. It would save the NHS tens of millions of pounds each year which could instead be spent treating British patients."

***
Earlier today we highlighted the Conservative priorities for the NHS.

Comments

[Chelloveck]

I do wish David Davies would stop coming out with all this common sense. It's very confusing.

[Dick Wishart]

What an excellent, simple, straight forward idea why cant we have a few more like this, whilst we're at it why should employees have to pay NI on £100 per week wages when people on benifits way above this figure pay nothing yet are more likely to use the services they do not contribute to.

[Jacob]

The 'Nasty Party' is back.....

[Richard]

"The 'Nasty Party' is back....."

I bet you anything most people in this country would back the idea. The NHS is a NATIONAL health service. It can't afford to to look after the entire world seeing as it is funded solely by British taxpayers.

[Tanuki]

In most other countries, foreign nationals seeking healthcare are either required to produce evidence of an insurance policy to cover medical costs, or some sort of reciprocal-agreement-documentation (like the old E111). If not, the doctors perform a "wallet-biopsy" to certify the patient's credit-card status. Methinks it would be a seriously smart move to more thoroughly enforce this here in the UK - even to the point of requiring a deposit to be paid before treatment commences.

[Rachel Joyce]

As regards Europe, we are meant to have reciprocity - if EU citizen, they get healthcare here and we get it there.
I do think however that we are likely to be net losers on this. Perhaps if we had an arrangement with a country, we could charge/ pay the difference between what our citizens receive over there and vice versa. And if no deal with their country of origin - charge them (either with insurance or credit card details taken in advance).
Very difficult to work in an emergency, but most "health tourism" is not an emergency.

[Andrew Lilico]

I didn't find this proposal very attractive when I first read it, but perhaps it could be made to work and wouldn't be totally unreasonable. That's a long way, yet, from saying it's a good idea - these are merely the first two hurdles.

To make it work, there would presumably have to be the alternative of having enough funds with one to be able to pay for healthcare directly. Some complexity would arise in the NHS probably doesn't produce very particular costings for most of its healthcare, so we'd have to work out how much to charge the individual or the relevant insurance company - I guess that already happens, though, so it must be feasible.

I guess the major downside would be the risk of deterring visitors from outside the EU, who might not want to buy health insurance. I never buy travel insurance myself, and I would consider it a significant imposition to be required to do so - for most countries in the world that would be enough reason for me to prefer to go somewhere else (for almost any foreign place there's a close substitute, and if it doesn't impose things on me that I don't want to pay for...). My suspicion is that the downside from the deterred visitors might well outweigh the upside from the deterred health tourists, but I guess it might be worth a more detailed impact assessment. I might even be able to suggest an economics consultancy that could do it for you... :-)

[Dick Wishart]

Well done Jacob, thats what I call a proper debate!.

[Traditional Tory]

Fantastic idea. Why the hell have we been treating these people free?

If that's a 'Nasty Party' policy I'm all for it.

A little nastiness won't come amiss where these scroungers are concerned.

[Ted]

Great idea except its already the case for anything but something minor that A&E can clear up. The legal position is "If you become ill while you are visiting, you can get free emergency treatment in the Accident and Emergency (A&E) departments of National Health Service (NHS) hospitals. If you are admitted to hospital to stay as a patient, even from A&E departments, you will be charged."

When my 80 year old aunt visiting from South Africa broke her leg, she was admitted to hospital and was asked to provide details of her health insurance. Hospital had no problem identifying cost of treatment and care and NHS no problem billing for after-care and follow ups. Most tourists do insure themselves or for EU get necessary documentation.

Now if David Davies is talking about NHS being firmer on following up debts and policing health tourism , maybe that's sensible. But really - an A&E turfing out an injured person for not having insurance?

[Paul Kennedy]

Seems an entirely reasonable idea to me and nothing nasty about it at all, by and large if I went abroad I/my insurers would be charged. I somehow think it unlikely that we would allow people to die in the street if they hadn't got any money/insurance.....and I hope that might be the case if I went abroad and fell ill.

[Comstock]

"At a stroke we would put an end to a great deal of freeloading on our public services."

Hmmm. Who is freeloading off whom? Think before you answer that one.

Where does your food come from? your oil? your cheap electrical goods?

[Ash Faulkner]

"Where does your food come from? your oil? your cheap electrical goods?"

From people who willingly trade and deal with us. They give us something, we give them something. It's called business.

The NHS is funded by the British taxpayer, so only British citizens should use it. Your analogy is completely false, because food, oil and goods are paid for - if foreigners were paying for NHS treatment, there'd be no issue.

[Richard Carey]

An interesting point in Davies' original post, regarding his Hungarian girlfriend's visit to a GP, was that the surgery probably wouldn't have any means of collecting payment anyway. It sounds like a technical point, and it probably is, but it is telling about our view of society that we're so unprepared for honesty from someone who doesn't expect something for nothing.

Ted's post was useful, too, pointing out the curent legal status. I hope that the headline of this piece isn't misinterpreted. We talk about trusting the professionals in healthcare. I can't imagine it wouldn't be anathema to any doctor to deny treatment to anyone presenting with an emergent condition, regardless of means of payment, and in fairness to contributors here I don't think that has really been raised.

We do need to try and deter people from coming here specifically for elective procedures, however, as posters have pointed out above that it obviously has not the resources to be a World Health Service. The interesting thought experiment would be in the crossover between the two, though - how do you classify the uninsured new arrival whose health condition, previously curable by a minor elective procedure if he had lived here, presents as an emergent case here as that treatment wasn't available to him through poverty or other circumstances at home?

Thought-provoking stuff, anyway...

[Mark Fulford]

What is the scale of the problem?

Refugees / asylum seeker's can't be expected to have travel insurance. This policy could therefore only apply to tourists. How many tourists get free emergency healthcare in the UK?

[Richard Carey]

This policy could therefore only apply to tourists.

That's a valuable point, Mark. You're quite right that refugees should never be refused medical treatment as a point of basic charity and civilisation. Genuine economic migrants under a well-managed system should be paying into the healthcare system at the same rate, it could be argued, so that it wouldn't be applicable there either (although you could validly make the case that the term of residency is a factor here).

I personally haven't seen any exact figures on the size of the "health tourism" problem, as it is headlined - I don't doubt it exists, but if it is significant then measures such as Davies' suggestion need to be carefully targeted directly at it.

[Justin Hinchckliffe]

In general, it's a good idea.

[Pete Berry]

As Mark said, the real effect would be on tourists, the comment was on a site called "Visit Britain", tourism is one of our more important foreign currency earners and a major source of employment (and hence votes).
Are we sure we've thought this one through?

[ToMTom]

You're quite right that refugees should never be refused medical treatment as a point of basic charity and civilisation.

That's good...HIV treatment only costs £10.000 pa so that will be fine for a PCT to carry....is it Northamptonshire that has 272 people on HIV treatment ?

Now when will the Government budget for all these foreigners and give PCTs extra funding ? Personally I favour a National Fund for Asylum paid for with a levy on all incomes over £200.000 pa - say 10% levy and the funds then allocated directly to areas with large extra costs due to population inflows

[Observer]

Blair

So The Washington Post reports Blair to be appointed as Official Poodle to the US President and Middle East Envoy .........

sounds sublime

[Richard Carey]

Your arrogance and sarcasm know no bounds as usual, "TomTom". It would just be far more wisely directed at someone who wasn't me.

[Drew SW London]

Sounds awfully like a new justification for ID cards. Expect a pronunciamento from El Gordo next Thursday morning.

[Gwendolyn]

I have to say that reciprocity between countries of the EU does not always work. In France they have discovered a new wheeze alled 'journalia' that means if hospitalised for longer than 45 days one pays a rate of 103 euros (£70) a week. Having a health insurance, as we have, does not alleviate the problem because one enters a strange circle that because we have health insurance, the local social security consider we are not entitled to full support. But as above the health insurance does not support after 45 days. My husband is in hospital having been diagnosed with a brain tumour, he is lucid but cannot walk because he falls over, so needs two people to assist him. Thus it is impossible for him to be at home. Our doctor is furious with this cavalier attitude and is trying to fight it, but I am left wondering where the reciprocity comes in for an English person, living in France, paying taxes etc etc.

[TomTom]

Gwendolyn, have you contacted your MEP or even a human rights lawyer to see if it can be twin-trcked through the European Parliament and through a French court. I bet they are acting extra vires......you should also contact a UK MP and get it raised as a question to the DoH

[Milton]

a) non-EU nationals are already supposed to get charged.

b) “you are eligible for free emergency treatment in the Accident and Emergency departments of National Health Service hospitals” is hardly an enticing offer. A&E treatment. Are people coming over here, breaking their arms and having them fixed?

[Charlie]

Aren't you all the same people who were outraged when Tul Bahadur Pun from Bhutan was refused entry to Britain for the sole purpose of using NHS services?

Goodness me, charging foreigners for Accident and Emergency care and running a campaign against asylum seekers with Aids. Yes, that's really the way to show that we're a responsible party fit for government.

TomTom, does HIV treatment really only cost £10 a year? That seems pretty cheap to me. Not sure I agree with the idea of a 10% tax on people earning over £200 a year though.

[Jake]

"How many tourists get free emergency healthcare in the UK?

Posted by: Mark Fulford | June 20, 2007 at 21:17 "

- large numbers of 'em , is the answer .

Due to the ossified , sacred cow status of the NHS we ahve an absurd situation where literally anyone who turns up on these shores is eligible for free NHS care - often very expensive and non emergency care . and very cynically exploited all the time .

1 it should be mandatory to have health insurance for all visitors . Most people of most countries will understand this and see the point and not object .

2 all peopl in the UK should have a health swipe card , producable at each patient/doctor contact
- should have been done years ago .

2 health care considered as an industry is about 8% of the entire economy , perhaps a bit more . This is a low and retarded figure and due to the weird status of the dominant health provider ie the four NHS's .

One could go on - --

[Gwendolyn]

Sorry to be late coming back on this but thanks TomTom I am registered as a voter in my old constituency so yes it is worth contacting my MP, I am hopeful that my doc will succeed he was blistering with anger about it, but on a general basis it is something that ought to be sorted.

[Teck]

I am a GP in one of Britain's top 10% most deprived areas. It's 99% home-grown white with many hard-working people, and I have looked after most for 25 years. With respect to healthcare, their growing resentment centres on their concerns about the dilution of resources available to treat them in the face of a rising tide of new entrants, NHS waste and mismanagement aside. There are sensible and ethical processes for discouraging exploitation and abuse of the NHS, just as there are ways of making the NHS more responsive and accountable. However, the bureaucratic barriers and the flawed policies that engender them are challenges that require careful manoeuvring. As chairman of the largest GP commissioning group in the East Midlands, I hope to work with a few key agencies and make a start in the right direction. As a Conservative, I would not wait for a change of Government, and finally as a committed professional I cannot countenance further attrition of the high quality of medicine and compassionate care that I qualified into.

[George Hinton]

This statement is a long time a coming.
The UK is known as an easy touch for foreigners coming here to have medical treatment. It's the attitude of many in the NHS that actually stops foreigners from being charged. NHS workers seem to feel that everyone has the right to free treatment, even if not resident in the UK. This sort of attitude has to be done away with and all employers taught the lesson that non-UK residents should be charged, will be charged and if they cannot provide ID/Passport, Insurance documents, credit card will not be treated.
I seem to recall a senior figure in the NHS and/or NHS union some years ago, brought her mother over from abroad (USA.?)to have a heart op on the NHS, free of charge of course, this is a typical example of what is wrong with our medical service.
I wish David Davies all the best on this one, its a real bastard to handle and he will no doubt receive a hostile reception, whilst being smeared.

[Jake]

As with most new departures in the NHS
ie the English NHS

do it on a pilot site basis initially and lubricate with a little bit of money and beaurocratice help . Most GP's are now seriously drenched in change often inexplicable and simply imposed on them .

I do not think that , in practice , there should be any problem with a swipe card system - agian on apilot site basis .

Politicians need to and must live in the real world. The issue might be "a real bastard", but I just had a family from Somali who did not get on so well in Holland and now come here to screw our NHS, to put it bluntly, wanting all manner of "get-me-more-well-than-I-am-already, doctor."

They are not the only ones. So David Davies has spoken out with plain common sense. And that's what connects with the public; we must be firm and decisive or voters out there will be just as disillusioned with us.

[Teck Khong]

Politicians need to and must live in the real world. The issue might be "a real bastard", but I just had a family from Somali who did not get on so well in Holland and now come here to screw our NHS, to put it bluntly, wanting all manner of "get-me-more-well-than-I-am-already, doctor."

They are not the only ones. So David Davies has spoken out with plain common sense. And that's what connects with the public; we must be firm and decisive or voters out there will be just as disillusioned with us.
(apologies for not signing earlier)

[Michael McGowan]

You cannot have a welfare state which is open to all comers free of charge......unless you are prepared to spend your entire GDP and more on funding it. Every other country in the world recognises that and acts accordingly. As usual, our politicians are being dishonest in pretending the opposite, passing the voters the rapidly growing bill while they make special arrangements for themselves. Ever noticed how the Blairs have never had to queue every time they make a much-hyped visit to an NHS hospital? It will be no different under the Tories.

[B.Stone]

More sensible comments from David Davies.
What a shame that David Cameron can't take a few lessons from him!

[David A. Moncaster]

More logical thinking from the man who should be in the top spot of the party.
D.Cameron would benefit greatly, acting as understudy to David Davies for a year or two.

[Charlie]

An interesting view of Conservative immigration policy: "we want to charge you different rates for using our hospitals, we don't want you in our schools, we don't want you living next door to us, in fact, we don't want you here at all and think there are too many of you here, and think you're to blame for everything from high house prices to transport gridlock to terrorism.....

now, having said all that, we want you to INTEGRATE!!!!"

[Adam]

Hilarious - even though Davies himself states that this only applies to people from outside the EU, loads of contributers on here are applauding restricting the NHS to UK residents only!

[passing leftie]

Yep, screw those foreign bastards. Let them die on the streets. It will save us UK citizens a pound a year each. Well worth it. Great work, cuddly Cameron and crew.