Public health fears over healthcare charging

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Health secretary Jeremy Hunt has announced plans to force non-EU immigrants and visitors to the UK to pay for medical treatment. Mr Hunt is also expected to announce a consultation on charging a levy on students or foreign workers who spend more than a year, in order to cover their healthcare needs.

Critics of the plans say they open up the prospect of foreigners with infectious diseases not seeking treatment.

The Secretary of State for Health said: “We need to ensure that those residing or visiting the UK are contributing to the system in the same way as British taxpayers, and ensure we do as much as possible to target illegal migration.
“We have been clear that we are a national health service not an international health service and I am determined to wipe out abuse in the system.

“The NHS is a national treasure and we need to work with the entire health system to develop plans and make sure it is sustainable for years to come.”

Condemning the proposals, Deborah Jack, who is chief executive of the National AIDS Trust (NAT) said that the initiatives could risk the lives of foreigners who contract with HIV and threaten the health of Britons with whom they come into contact.

Ms Jack said: “The proposals, if enforced, would undermine years of work to encourage marginalised at-risk groups to access HIV testing and treatment.

“By limiting access to primary care for some migrants living in England we would cut off the only place many of them will get an HIV diagnosis – short of presenting at A&E many years after they were infected, once they are very seriously ill.

“We are calling on the Government not to limit universal primary care access to migrants living in England. If they go ahead they risk putting lives at risk and accelerating the spread of HIV in the general population.”

Interviewed on Radio 4 on Wednesday, Mr Hunt said: “There will be an exception for all public health grounds whether it is TB or HIV (..) We want to consult on making sure that we do not do anything that will put public health at risk.”

The health secretary confirmed that the consultation would only last six weeks but denied that it was being rushed.

“We want to get this right,” he said. “We have one of the most open health system for visitors in the world. One of the issues is that it is so easy to get an NHS number and that means you have a passport to the whole system.”

Doctors’ representatives are wary the medical profession being expected to become a “form of immigration control”.

Clare Gerada of the Royal College of General Practitioners said: “At the moment we are fairly accessible and I think it is important to keep it that way. I don’t think we should be turning the GP surgery into a border agency. I think we should be making sure that people who do feel that they are ill can come and access us because we certainly don’t want people who have got TB or HIV or any other infectious disease, or in fact anybody that believes themselves to be ill, to be frightened of seeing a GP for fear of being charged.
“It is a very rushed consultation. Whatever happens we need to make sure that what comes out the other end is sensible, proportionate and fair and doesn’t cost us all much more money and put us at much more risk than the current situation which is one that, even at the worst estimates, is a tiny proportion of NHS costs.

“We probably owe that sort of money to overseas health services in a sort of quid pro quo arrangement anyway.”
The proposals are part of a raft of government changes to immigration law aimed at cutting down on abuse of British services. A levy of £1,000 has been mooted for visitors issued with a 5-year study or work visa but negotiations are still going on within the coalition that could see this running into thousands of pounds.

Non-EU short-term visitors will be required to pay to see a GP or for emergency treatment but the health secretary was keen to point out on BBC Breakfast that no-one would be turned away.

Citing the fact that other countries manage healthcare for visitors along similar lines, Mr Hunt said: “We don’t want any doctors or any hospitals ever to turn people away who need help in an emergency.

“We want to make sure we have a non-bureaucratic system in place so that where someone should be paying for their care, we actually do charge them and we do collect the money later.

Visitors from within the EU will not have to pay upfront — but Mr Hunt will promise a new system to make sure the NHS claims the cash back from their countries.

At present, short-term migrants coming to Britain to work or study with more than six months on their visas are likely to qualify for free hospital care as soon as they arrive. Ministers are exploring whether making private health insurance compulsory might be a viable alternative.

Former Liberal Democrat minister, Sarah Teather, sharply criticised the plan saying that it would put off talented people who wanted to work in Britain and contribute to the economy: “I heard that Britain is supposed to be open for business. This sounds like Britain is closed.”

The levy idea is also likely to obstruct universities, already hampered by changes to student visa regulations, in their campaigns to attract overseas students.

Labour’s shadow health minister Liz Kendall MP said: “In its three years in power the Government has a poor record on announcing policies that sound good but prove to be completely unworkable.

“We will have many questions to ask about the details when they are published but the key tests for their proposals are: can they be properly enforced and will they save more money than they cost to put in place?

“The public and NHS staff must be confident that any new measures are about getting taxpayers a better deal and ensuring fairness, not playing politics with our NHS.”