Foreign patients to pay up front for NHS treatment
Video report by ITV News Political Correspondent Libby Wiener
NHS trusts will have a legal duty to check whether overseas patients are eligible for non-urgent care and to charge upfront, Health Secretary Jeremy Hunt has announced.
The move means anyone flying to the UK for non-urgent treatment such as a hip operation or cataract removal could now be turned away unless they agree to pay the NHS bill.
Who would be affected?
People needing urgent care will still be treated immediately on the NHS, but can be invoiced - as at present - if it is found they are not to be eligible for free care.
They will also be told upfront that their care is chargeable before treatment begins.
Other possible scenarios where an overseas patient would be charged upfront include where a GP has referred them to hospital to diagnose a condition and payment is agreed before treatment starts.
Under the plans, anyone from outside the European Economic Area (EEA) who is staying in the UK for longer than six months will also not be eligible for free fertility treatment on the NHS.
How will the proposal work?
It will be up to individual NHS trusts to work out whether they take a payment there and then - or allow patients to sign a form to agree to a longer-term payment plan.
Patients will also be able to choose not to have the treatment if they have no means of paying the bill.
How will the scheme be enforced?
The law will change from April this year and will also require hospitals and NHS bodies to identify and flag up a patient's chargeable status so that other parts of the NHS can more easily recoup costs.
Some trusts will check eligibility through asking people to produce two forms of identification - such as a passport and a utility bill with a UK address. It will be up to individual trusts to work out how best to check eligibility.
Peterborough and Stamford Hospitals NHS Foundation Trust is already piloting a scheme where patients have to show two forms of identification - such as a passport or birth certificate and a utility bill - for non-urgent care.
Stephen Graves, chief executive officer at the trust, said: "Since implementing our policy, we have seen an improvement in our hospitals. The funds recouped are invested back into the system to benefit patients and our approach has not been to the detriment of the high quality patient care and patient experience we are able to provide."
What are the Government's objectives?
While it is unclear how many patients come to English hospitals for planned, non-urgent care, the Government hopes that forcing hospitals to have discussions with patients upfront will change a culture where people are invoiced after their care has already begun.
The announcement comes after a swathe of headlines about so-called "health tourists" using the NHS who are unable to pay their medical bills.
One Nigerian mother, Priscilla, who gave birth to quadruplets, two of whom died, now owes the NHS nearly £500,000.
Under the new plans, she would still have received urgent treatment as her life and those of her babies were at risk.
Mr Hunt said: "We have no problem with overseas visitors using our NHS - as long as they make a fair contribution, just as the British taxpayer does.
"So today we are announcing plans to change the law which means those who aren't eligible for free care will be asked to pay upfront for non-urgent treatment.
"We aim to recover up to £500 million a year by the middle of this Parliament - money that can then be reinvested in patient care."
What are the criticisms?
The doctors' union say the plans "lack detail" and warn of "chaos and confusion" as a result of the move.
Dr Mark Porter, Council Chairman of The British Medical Association said: "There is no detail as to how upfront charging will be introduced from scratch in just three months, in an NHS already unable to cope with normal operations.
He added that care needs to be taken to ensure "not to demonise overseas patients" and not to "sow chaos" within the NHS.
The council chairman warned that "Doctors and nurses cannot be expected to arbitrarily decide whether a patient gets treatment or not".
"Ministers should not mislead the public into thinking this will result in a cash windfall for the NHS, but must address the wider funding shortfall in the NHS, which has left it understaffed and struggling to care for its patients", said Dr Porter.
Chief Executive of the Patients Association, Katherine Murphy said it is reasonable for an overseas patient "obviously seeking routine treatment" to be told there is a charge and details of how they will pay taken.
But she said it must not compromise "access to care and the wellbeing of the of the patient".