Migrants must pay more to use NHS, say ministers

Nurse with patients Measures are being taken to help hospitals recover costs more effectively

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Patients from outside the EU are to be charged 150% of the cost of treatment in the NHS in a fresh crackdown on so-called "health tourism".

The move is designed to incentivise NHS Trusts in England to recover the cost of operations from migrants and others.

The UK seeks to reclaim 100% of the cost of treating EU and non-EU nationals where charges are applicable.

But only a fraction of the £460m in chargeable procedures performed every year is currently recovered.

Most foreign migrants and overseas visitors can currently get free NHS care immediately or soon after arrival in the UK but they are expected to repay the cost of most procedures afterwards.

The charges are based on the standard tariff for a range of procedures, ranging from about £1,860 for cataract surgery to about £8,570 for a hip replacement.

'Carrot and stick'

The BBC News Channel's chief political correspondent Norman Smith said many trusts did not bother chasing patients because of the time and cost involved in tracking them down compared with the financial rewards.

From next year, trusts will be able to charge 150% of the normal cost of treatment for non-EU patients who are "non-permanent residents" in the UK.

Under these plans, non-EU patients receiving a £100 procedure could get a bill of up to £150.

Non-UK citizens who are lawfully entitled to reside in the UK and usually live in the country will be entitled to free NHS care as they are now.

But temporary migrants from outside Europe who are in the UK for longer than six months, either to work or study, will have to pay a new surcharge when they submit an application for leave to enter or remain in the UK.

In what Norman Smith said was a "carrot and stick" approach, the NHS will be asked to identify these patients more effectively so costs can be recovered from them.

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Analysis

By Adam Brimelow, Health correspondent

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So how will the NHS recoup five hundred million pounds a year?

First, for patients with a European Health Insurance Card (EHIC) trusts will be re-imbursed one-and-a-quarter times the cost of treatment, if they pass details on to the Department of Health, so it can then pursue payment from the appropriate European government.

Patients from outside Europe will be charged one-and-a-half times the cost - to be paid for directly. Trusts that fail to do this could be fined.

There will also be a £200 annual health levy for temporary migrants who stay more than six months.

The government says this is about ensuring a fair deal for British taxpayers.

But some doctors are worried it may deter people who need treatment from coming forward to get it.

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The new measures - which also include a tightening of the rules on eligibility for free NHS prescriptions, optical vouchers and subsidised NHS dental treatment - are expected to come into force by next spring

'Better resourced'

Mr Hunt said the principle that the NHS was free at the point of delivery for residents, including the provision of urgent care, would not be "undermined".

But he said treating non-UK residents cost the NHS an estimated £2bn a year and the plans could save the health service £500m a year by 2018.

"We have no problem with international visitors using the NHS as long as they pay for it - just as British families do through their taxes," he said.

"These plans will help recoup up to £500m a year, making sure the NHS is better resourced and more sustainable at a time when doctors and nurses on the front line are working very hard."

While NHS Trusts charge non-EU patients directly, the government pays hospitals for procedures on EU patients, with the money being recovered from other EU member states.

'Question mark'

From next year, the government will pay trusts 125% of the cost of treatment for EU patients, up from 100% at the moment to encourage hospitals to submit more relevant data.

The government is also trying to make it easier for hospitals to identify patients who should pay for services while not burdening staff with extra paperwork.

As part of simplifying the registration process, trials are due to start in some A&E departments this summer to explore how details can be taken from patients with an European Health Insurance Card when they register.

The crackdown follows plans already unveiled to charge migrants a £200 "NHS" levy when they apply for a visa.

Dr Mark Porter, chairman of council at the British Medical Association, warned: "Without more detail, there are question marks over whether or not these proposals will be workable and if the NHS has the infrastructure and resources necessary to administrate a cost-effective charging system.

"Plans to fine hospitals who fail to recoup costs would see them punished twice over, to the detriment of other services."

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