Forum Topic

Should Non Europeans have to pay to see the GP

http://www.bbc.co.uk/iplayer/episode/b03fczr7/The_One_Show_30_10_2013/last night on the one show, they were talking about the introduction of £200 for non Europeans or those not permanent residents of the UK to pay in order to see a doctor.The NHS is not a free for all international. Every week, 60 new people join the surgery which causes a lot of pressure for overworked doctors.So do you think this policy will work? Is it too time consuming? Do doctors have the manpower in order to check eligibility for every single person?

Asha Smith ● 4708d37 Comments

I think it's a no-brainer tbh and easy to manage. To see a GP is it not correct that you must register with a surgery ? If so, at point of registration, you must prove your UK resident status (passport and birth cert) and that deems whether you're NHS or you get the credit card out. I'm sure there are reasons why this has not been done, but they'll surely be bureaucratic junk. Unless I'm missing a bigger picture, surely this is win-win in easing the strain on the health purses and would control immigration too ? Oh, and benefits claimants also ?

Bud Richards ● 4707d

Health tourists would absolutely love to get treatment on the NHS for £200 - when you think it costs £3,000 for ONE NIGHT in a HDU ward and that is just for the bed. Treatment and extras NOT included, so they would therefore be fully entitled to treatment costing the NHS thousands of pounds all for a one off payment of £200.I call that a bargain and it certainly will NOT save the NHS. Unless something drastic is done I think that some time in the future we will ALL have to pay to be treated on the NHS.

Jean F Fernandez ● 4707d

A really ill-considered move.The £200 proposed payment is only going to be levied on those staying over six months. hardly a deterrent to come to the UK for an operation or short-medium term treatment.This is a 'popularist' move to appease those who witness health tourism on a daily basis by a government which has lost any control of the NHS budgets.A better move would be to take an impress of a credit card or evidence of a current health insurance policy from all who have no right to free treatment and charge the full 'private patient' rate for any treatment or medications received.

Nigel Brooks ● 4707d

I think it will be a failure because if a sick person who is not entitled to NHS comes to the hospital, it is very unlikely that a doctor will turn him/her away because of ethics and compassion.If you were a doctor and a person was having a heart attack, you would rush to help them and then ask for papers later.

Asha Smith ● 4707d

Emergency care is somewhat different than simply choosing to come to the UK and derive benefit from something to which you have never contributed.That said, the cost of such emergency care should be recovered and rigorously so, using debt recovery factoring companies as is common in the USA.

Nigel Brooks ● 4707d

This is what happens already, a friend who worked for 9 years in a large hospital witnessed health tourists on a daily basis who were offered treatment - no questions asked.They did chase up a few but the amount of money recovered was a small percentage of what it would have been if those not entitled to receive treatment on the NHS paid up in the first place.

Jean F Fernandez ● 4707d

A&E should be free to all but all else chargeable against your NI history, private ins. or by cash.

Keith Iddon ● 4707d

I think there should not be a payment to consult a GP. The treatment should be free of charge for everyone, all, each, tout le monde! That's what the National Health Service was created - free for ALL at the point of use!Long live the NHS!

Gerry Tan ● 4707d

Gerry, the NHS can no longer afford to be there for non UK residents, that was never what it was meant to do.There was even a sign on the wall in a little hut somewhere in Africa which advised locals what to do on arrival in the UK. This sign was actually seen by a person who worked in the NHS so it must have come as quite a shock, or on the other hand, maybe not!It was not named the INTERNATIONAL Health Service, however generous we would like to be there must be a limit as to what the NHS can afford.Paying off 2 individuals with £1million each and then inviting them back into the NHS to work once again is yet another reason the NHS is in such dire straits.What I think I would charge a small fee for (and I think my GP would agree) is for those who make an appointment but don't even bother to turn up or cancel the appointment! How many times have I heard the GP calling out names of the patients but it was obvious that they were not in the waiting room. If they had the decency to cancel then surely it would allow another patient to see the Doctor?After all Dentists will charge for a no show!

Jean F Fernandez ● 4707d

Jean, if someone(anyone!) develops a sudden excruciating pain and needs an immediate appendicectomy, do we expect that person to pay(assuming they haven't the money)?  Our NHS is the envy of the world - free for ALL, irrespactive of status, creed or colour.

Gerry Tan ● 4707d

No Gerry that would be an emergency and the person would be admitted via A&E. Some people who have long standing medical probs. come here for 'free' treatment when in fact it is at great cost that it is provided. It is also not what the NHS was designed to provide.If I go to another country I make sure I have medical insurance, all I am asking is that people who come here have the same. Is that unreasonable, or am I missing something?

Keith Iddon ● 4707d

Absolutely Keith! People visiting the UK should take out health insurance, after all we have to do this when travelling abroad!

Jean F Fernandez ● 4707d

My husband's nephew on a recent visit to London was ill during the night, he was staying in a West End hotel. He contacted Reception who called in a Doctor.This call out cost him £250, but fortunately he was covered by medical insurance so could claim the money back, but he paid up front for his treatment. This was just for an upset tummy by the way, nothing life threatening!

Jean F Fernandez ● 4707d

Gerry, why do you think they are selling off the land and closing down hospitals? The NHS needs more MONEY!By the way, I am replying in short bursts today because this stupid antiquated forum keeps showing an error message and I have been unable to post my comments.

Jean F Fernandez ● 4707d

Gerry you wrote"Our NHS is the envy of the world - free for ALL, irrespective of status, creed or colour."Absolutely right, as long as those receiving treatment have contributed to the system treating them. If they have not, then they pay, NO exceptions.

Nigel Brooks ● 4707d

It can't be free for all Gerry unless you accept that to make this affordable would mean compromising on basic care for everyone.One salient fact in this debate that proves there is a problem to be solved - 2/3 of all people in England who are now receiving treatment for HIV were born outside of the country and in the most recent data, around one third of new diagnoses were made for people who had been in the country less than 12 months - reflecting that some patients arrive here with the main intention of seeking treatment (which is of course completely understandable from a human / compassion perspective).The difficulty however arises because society’s healthcare needs will always outstrip our ability to fund them – as can be seen by the proposed £75K additional co-payment towards care costs. The difficulty for clinicians and NHS managers is that have to make difficult choices to balance the needs of an ageing population and patients who in some cases have only come here to get treatments unavailable in their home countries. In the case of HIV, each new diagnoses represents a minimum additional £300K lifetime treatment cost over the £2,000 per year typical capitated budget for an average NHS patient and quite often a lot more than that when other related specialty care is provided. In most other diseases, the NHS makes no attempt to collect the data that would quantify the size of the problem - but a cursory review of areas like scheduled maternity services i.e. not emergency cases, does suggest a significant number of patients are very recently arrivals to the UK.

Chris Martin ● 4707d

I wonder if those who would like us to provide for all the needs of every visitor to this country, however casual a visitor they may be, would be willing to stump up a lot more money in taxes to pay for it? Perhaps a tax on home ownership or on owning a second or third home, or an extra tax on savings above a certain amount or a means tested old age pension where the 'wealthy' don't receive it on the grounds that as they are older they will need more health care and thus that money would go toward that? I believe in the NHS and want to save it too but we have to get real about what and who it is for.

Keith Iddon ● 4706d

'People visiting the UK should take out health insurance, after all we have to do this when travelling abroad!'Well, not necessarily. We are entitled to health care when travelling in the EU, in the same way that locals are. This is a reciprocal arrangement and perfectly reasonable, IMO.

Susan Kelly ● 4706d

Have you ever tried to get treatment for  apre-existing condition in Spain or Italy for example Susan?

Keith Iddon ● 4706d

It's called "scapegoating".Politicians and newspapers are lying to you about the impact of so called "health tourism", dog whistle politics it's called. And of course, without immigration our health system wouldn't be able to operate anyway, for anyone.http://fullfact.org/articles/health_tourism_factsheet_cost-29253http://www.independent.co.uk/life-style/health-and-families/health-news/the-truth-about-health-tourism-twice-as-many-foreign--visitors-pay-to-use-nhs-as-exploit-free-healthcare-in-britain-8902520.html

Paul James ● 4706d

...and for those with access to twitter a nice picture that sums up the lengths papers like the Sun will go to lie to it's readership, this is a tiny apology for a totally inaccurate front page headline:https://twitter.com/GoodallGiles/status/395912299606593537/photo/1

Paul James ● 4706d

Yes..and they have removed the word 'gullible' fro the dictionary.

Keith Iddon ● 4706d

I should add that if you present people with facts it can often entrench their views.http://www.boston.com/bostonglobe/ideas/articles/2010/07/11/how_facts_backfire/

Paul James ● 4706d

The hoary old chestnut that the nhs would not operate without immigrants is fine in so much that no-one, including me, has a problem with someone who comes to this country legally and contributes via working/taxes/ ni etc.My wife is an immigrant who works and contributes.The Independent had a survey some years ago where they canvassed the supermarkets and sewage management companies to see what their estimates were for the number of people in the UK population because the cencus is next to useless.They estimated 77 million.

Keith Iddon ● 4706d

If the government does nothing to protect the NHS then we shall all suffer because the current situation cannot go on forever.There have indeed been so many reports of people being refused hospital treatment in Spain and other European destinations. Travellers are often asked for money up front BEFORE any treatment is offered. How can this be fair?

Jean F Fernandez ● 4706d

>If the government does nothing to protect the NHS then we shall all suffer because the current situation cannot go on forever.The government has conceded it currently spends MORE money trying to stop "health tourism" than is spent by the NHS on it.Please read above for a definition of what "health tourism" is.It's a piffling amount (0.3% of the total NHS budget), not worth worrying about.There are much bigger issues with what this current government is doing to the NHS, the health tourism thing is a distraction cos immigrants are an easy target, you must watch what governments that use scapegoating like this are doing with their other hand.

Paul James ● 4706d

For people working in hospitals are more aware of the truth of the matter.One chap came from USA for treatment on the NHS, spent many weeks in an HDU unit FREE OF CHARGE, meanwhile his visitor came back from the cafe at the hospital moaning about being charged a paltry sum of 16p for a packed of sauce!The dear old NHS and the system attracts health tourists and it is surely high time that visitors are required to have insurance before they arrive at the hospital door.

Jean F Fernandez ● 4706d

>The dear old NHS and the system attracts health tourists and it is surely high time that visitors are required to have insurance before they arrive at the hospital door.You've read nothing I posted above about he scale of "health tourism"?For reference, here's the current guidance about who should and who should not pay, but again, chasing up non payers is a waste of money as admitted by the government itself.https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/254530/ovs_visitors_guidance_oct13a.pdf

Paul James ● 4706d

From the scale of the problem I would think that we should all have been paying more for years.The goal posts keep moving though.  It is not that long ago that women were not allowed to work once they married and did not have to pay the same stamp as their husbands.Now it appears that just about everybody has to work for even longer - presumably the idea is that fewer people actually live to collect a pension.  I wonder how many more sick people that will be creating - people too anxious to go to their GP when they should have done?  It will probably just move the problem from one budget to another.  Only you'll only be hearing about the savings made in the one budget and not the increase made to the other.It is the inability of political parties to bite the bullet that has caused a lot of the problems that we have now.

Philippa Bond ● 4706d

As ever the contrarian 'bleeding heart liberal'.The truth is non-one knows how many 'unentitled' people the NHS treat because no one accurately measures the cost. How then you can 'accurately' quote "0.3%" therefore is rubbish.One only has to ask those who work in the NHS (try it you might get some more accurate data) how many they treat who they believe are not entitled to free treatment.The problem is that woolly minded, human rights quoting, numbskulls have, for years, prevented the accurate recording of data (see Commons questions and the Hansard transcripts from Tuesday to validate).EU nationals are entitled to free treatment under the reciprocal arrangements we have which entitle us to free care. Non-EU nationals should and must pay. if that means questioning people as they attempt to register for free treatment (acute emergencies aside) then sobeit. if that means turning away those who have neither insurance nor the means to pay then sobeit. I am sure that an arrangement can be made for those who have genuinely sought and been granted asylum in the UK. Let's send the message out loud and clear we are not a free ride for those who have not contributed.

Nigel Brooks ● 4706d

I don't really beleve statistics pumped out by the government, in fact I now find it very difficult to believe anything we are told  by any government.Statistics can easily be rigged, that's ths problem. As mentioned perhaps it is better to ask those who are actually working within the NHS on the frontline to get a more accurate picture.

Jean F Fernandez ● 4706d

>Non-EU nationals should and must payNot necessarily.There are quite a lot of exceptions to this in that document I posted up the page, including countries we have reciprocal agreements with (Aus and NZ for a start).I'm sorry for bring official government statistics to the debate, but compare these to the lies spread by politicians and newspapers regarding the scale of this.Again, all I'm saying is when governments point the finger at such an emotive subject and make it look much worse than it actually is (along with the "useful idiots" in the media  that join along in chorus), make sure you watch what it's doing with it's other hands.

Paul James ● 4706d

'Have you ever tried to get treatment for a pre-existing condition in Spain or Italy for example Susan?'No, happily I have never yet been taken ill on holiday.

Susan Kelly ● 4706d

Absolutely, one must always be wary of politicians pandering to a popularist (for some) agenda.Gone, in the main, are the days of public service and altruism in politics and most politicians are now simply self-serving seeking only to preserve their 'status' and privilege.Incidentally, the reciprocal arrangement with Australia will only be provided on production of your Reciprocal health card (a version of the EHIC) or your British passport, neither of which would be available to 'other' non-EU nationals visiting the UK.

Nigel Brooks ● 4706d

As Paul mentioned Australia I took a look at the Medicare (Australian 'NHS') website.Only 'crisis care' is available without ID and even this is subsequently billed and recovered if no proof of entitlement can be provided. There are arrangements in place for those granted asylum but that's about it.No proof of free entitlement/no reciprocal arrangement = no free treatment or, indeed, no treatment at all.

Nigel Brooks ● 4706d

I have mates living in Aus. There is no reciprocal arrangement. You have to have ins. or medi-care and it is not cheap.

Keith Iddon ● 4706d

There is no reciprocal arrangement if you are resident only on a visitor's visa Keith and, I agree, it isn't cheap.

Nigel Brooks ● 4706d