BMA vote not to charge "health tourists"

[IrmaFayLear]

Quite cross about this.

Different of course if someone has a heart attack/car accident, but to turn up specifically to access expensive maternity/cancer etc treatment is not only unacceptable but unsustainable.

Particularly annoyed because the pil's dementia care which they had to self-fund ran into many hundreds of thousands (at a humdrum establishment, too).

It sticks in one's craw to be told constantly that the NHS is crumbling but that an extra couple of billion per year is ok for health tourists.

Can you give a reliable source of the annual cost of these sick or unhealthy foreigners to the nhs

It's not about what it costs in real terms, it's about the principle of it.

If I go to the docs here in Germany, they'll ask for my German insurance card. If I don't have one (because I live or work abroad), they make me pay. It's only normal. Even as a native German, I couldn't move abroad and come back to use the system for free when it suits me. It should only be normal not to do that as it's unsustainable and unfair to those who do pay into the system (whether they are UK citizens or not).

I've lived abroad in the EU and had to pay and then get reimbursed or pay part.

Will the BMA members donate some of their pay to help towards this?

The last BMA article I can find on this is August 2017 - and it’s an opinion not legislative. Each trust will make its own decisions. Have you got a more up to date link?

Nursing care is free, no one has to pay for that, other care however is not free if a person has means to pay for it.

OP, perhaps you should read up on some reasoning behind this decision. Making "health tourists" pay will also mean that everyone who does not have proper documentation will also need to pay. This includes refugees, undocumented migrants, victims of human trafficking and modern slavery, very possibly some of the Windrush generation members - both adults and children. Do you want to live in a country where a trafficked woman who falls pregnant is denied medical care? Should she be turned away from a hospital while in labour? Should her baby, if it falls ill, be denied treatment? Perhaps instead of creating policies that will ultimately punish the poor and the already vulnerable we should look at other problems that we have - massive tax avoidance by corporations, for starters.

When will people in the less rich parts of society stop fighting others who are similarly or more vulnerable for the crumbs and instead look up at where the wealth actually resides? Wake up!

@PissedOffProf - well said

And a related point - the NHS employs thousands and thousands of doctors and nurses who were trained outside the UK. The UK and the UK taxpayers did not pay a penny for their very extensive and expensive training in many-many cases. If you are going to justify charging foreign patients for medical care by citing financial fairness, perhaps you should also reimburse the countries where our overseas-trained medical staff comes from for their expenses.

MyOpinionIsValid, thank you!

I agree that poaching staff from abroad because of lack of investment on training and retention is a disgrace.

The idea that the UK health service should never ask for payment as a matter of course is just a nonsense though. If I hadn't been asked to pay I wouldn't have volunteered either.

The BMA don't make NHS policy.

Just because something is done in Germany or other continental European countries does not mean it is the right thing to do. There are plenty of concerns raised about the German and other EU countries' approach to health care for non-citizens (e.g. www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30245-4/fulltext).

I'm pretty sure the administration costs of checking eligibility for treatment, itemised billing, chasing non-payers in different countries would be pretty high, if not higher than the cost of the treatment.

However, given that the current WM government is busy breaking up the NHS I wouldn't worry about it - soon everyone will need to pay.

I completely support this. As PissedOff says, it would protect the vulnerable.

Of all our spending priorities, health care has got to be near/at the top

I agree with what PissedOff says in relation to those people who come 'under the radar'.

However, one person who really got my back up was a woman who was on the ward when my mum had a heart operation about 5 years ago. The woman in the opposite bed became quite friendly with my mum. When she was discharged my mum said to me that she hoped 'Jane' would have a good flight home. I asked her what she meant. Mum said 'Jane' had told her that she'd moved to Florida 25 years ago (she was in her 60's), had been diagnosed with a heart condition that needed an operation. Her insurance didn't cover it in full so she'd flown over to stay with her son in England, gone to A&E with her symptoms and had been given a bed and the operation. She hadn't mentioned that she resided in the USA, the hospital hadn't checked that the GP she gave (which was her son's GP) was her GP and she had an operation on the UK tax payer. her view was that she'd paid in for the twenty odd years she'd worked as an adult in the UK so she was entitled to the help. She planned to stay with her son for a month or so then would be flying back to the USA! Pissed me off no end as they were bed shuffling at the time because the NHS was hard pressed as usual.

And yes, I did report her. If it all boiled down to how much you'd paid in over the years, all the people who needed help because they were vulnerable would be going without. The NHS is for people living in the UK and intending to live in the UK. If they're coming just for the operation without paying then flying back to another country, they pay.

Agreed, it's not just the vulnerable. Someone I know is a tax exile but pays his dm's gas bill here in order to maintain a presence. He admits this is in order to access NHS treatment should he need it.

Btw, the BMA have just voted on this at their conference in Belfast, so it is their latest position and not from an article two years ago.

I don't know. I feel uncomfortable with the thought of denying anyone health care, but equally I realise money for the NHS doesn't grown on trees! (esp under a Tory government)

But as with benefit fraud, it's probably the case that the amount of money 'wasted' is far outweighed by tax evasion/general corporate greed, etc.

It may even be the case that hospitals are funded depending on the number of operations carried out, so these few extra ones could actually be helping individual hospitals? That's just a guess though

I have a lot of GPs in my social circle and they all believe that not only should all NHS services be free at the point of need, but that they should be free to anyone who needs them. Anyone.
They all labour the point about refugees etc and the cost of collecting fees from people who are not eligible, but that's a smokescreen for the fact that they believe the NHs is the world's health service. Underlying this of course is the real hard line, which is that ANY charging for ANY care (not insurance letters and so on), is the thin end of the wedge that opens up for some sort of payment system.
I understand their rationale, but it's political.

LondonJax, with respect, but your story is exactly what I mean when I say that poor people are fighting over scraps instead of fighting for justice and security for everyone.

Could you provide a link please? This is not at all my experience of accessing NHS care. We are not British, we don’t live in the UK and we pay to access NHS care for my DD’s rare bone disease.

It's not about what it costs in real terms, it's about the principle of it.

But of course you have to think about what it costs in real terms. If it ends up costing more than is recouped to charge people for medical care, then the NHS both ends up worse off financially and deprives vulnerable people of care, which is a scenario I'm not willing to tolerate for the sake of "the principle of it". We live in the real world; I'd rather some people who don't "deserve" it get their care for free than punish a much wider range of people just so I had the satisfaction of sticking it to the CFs.

We live abroad, and always make use of the NHS when we come back to the UK on holiday. I think there should be something to prevent us from doing it.

I can't believe that people (GPs) can truly believe that it is a fair system that allows anyone from wherever in the world (including "rich" countries) to access any care whatever the timeframe and cost without any contribution.

My FIL lives in an EU country with a not-that-good health service. He always comes back to the UK to use the NHS. I see why he does but he should be banned. I think France’s system is better, you pay at source and get a rebate.
Anecdotally I read about an American man who dropped his elderly dementia suffering father at a hospital and high tailed it back to the US as he didn’t have health insurance there but it might well have been in the Daily Mail.

Thing is, I think the GP representatives who voted in favour of this probably know an awful lot more about the ins and outs than we do. Presumably they'd not approve of something that would bring the NHS to its knees.

I'd like to have been there for the debate

But you can’t just come from abroad and use the NHS. When we sign into hospital, the automated system asks for a UK address and a UK GP, it asks you to confirm you have been resident in the UK for the last six months (I think, I may be wrong on the time scale as it does not apply to us).

British subjects who are resident abroad are not entitled to NHS treatment (other than anything covered by the EHIC) and won’t get it if they register with their foreign address.

The French system doesn’t cover foreigners either. If you are resident in France there are various routes for claiming a Carte Vitale (e.g. paying tax through your salary, or as self-employed), buying you are not entitled to one you’re conditions of residency is that you take out private medical insurance. If you are a foreigner who need emergency medical treatment you will get it and the hospital will try to access hardship funds to help you pay, but otherwise you won’t be treated.