Passport checks considered for pregnant NHS patients

[LurkingHusband]

www.bbc.co.uk/news/health-37621239

Pregnant patients could have to prove they are eligible for free NHS treatment by showing ID such as a valid passport, under plans being considered by one London hospital.
St George's says the checks would help tackle health tourism and would only be for non-urgent patients - emergency cases would get automatic care.
^It says such a move is in line with what guidelines recommend.
But critics say the checks could be potentially dangerous.^
St George's says it has a duty to use resources wisely, as well as provide care and treatment to patients requiring the hospital's services. The hospital has a high number of patients from overseas who are not eligible for NHS treatment.
The government said a pilot was a good idea and it would be keen to see the results.

(contd)

It is possible to precis the story as "The only thing worse than a foreigner, is a poor foreigner".

For many procedures you have to preregister. So hip replacements or heart transplant patients could easily be checked months ahead of time.
Dr's are expected to do a certain amount of pro bono (free charitable) work, occasionally providing care for people without coverage can count towards this.
In Canada your medical care ID number is on your drivers license so most people are reviewed for eligibility regularly.

This is nothing new. In the 90s I worked for a while in a hospital which is very near Gatwick. They had a huge problem with health tourism, and the Ethics committee was constantly debating how much treatment to give people who would fly in from all over the world, often seriously ill or dying, and expecting treatment. They would give emergency treatment, but often people were just too ill to discharge and they would end up billing them, bills which were hardly ever paid. It was a massive financial and ethical problem. So this is not a new thing at all.

I mentioned the registration thing because someone asked up thread.

I wonder how this would work with refugees and asylum seekers.

The way they do it here in Finland is that everyone who is legally resident gets a personal health insurance card with an ID number on it, every time you go to the doctor you have to show that card, that's how they know you are entitled to care. The UK needs to do something like that, its simple but effective.

Glasto is right. My friend was a paramedic at Heathrow and patients used to arrive on the same flights every week. They would have a "cardiac arrest" in the passport queue and then an ambulance was called. Her rule of thumb was that under 40's would generally have a lazarus-like recovery after 10 minutes and then hoof out the back of the ambulance when it stopped at lights, over 40's were generally not having a heart attack either but often had health problems severe enough to require immediate hospital treatment.

It's long overdue really, considering London hospitals are some of the most over-stretched in the country. It shouldn't just be maternity/ante natal patients they target though.

The way they do it here in Finland is that everyone who is legally resident gets a personal health insurance card with an ID number on it, every time you go to the doctor you have to show that card, that's how they know you are entitled to care. The UK needs to do something like that, its simple but effective

Where I live it's an ID card. If you are a national or you are here legally as a worker, or you own a property, you get the ID card. Nationals have free treatment. Foreigners pay - at point of contact at the hospital. Employers have to provide health insurance for their employees. Sadly, many workers get shipped home as soon as they're able to go. It's awful. Then there are foreign workers who are here illegally. Their plight is terrible.

"because the ones most likely to be affected are the babies of women who are illegally in the UK. They aren't health tourists and risking the lives of newborns seems a strange way to go about tackling health tourism"

I think people will tolerate a few newborn deaths if it means savings for the NHS. Especially if we're talking about the babies of forriners.

Yep, this thread of presumably mostly mothers suggests a much higher tolerance for risking newborns' lives in the name of cost saving from foreigners than I would have expected.

I'm a patient at St George's. So was the person I grew up with who died in revolting circumstances thanks to lack of medical time and money. The NHS admitted the death was 'avoidable'.

For every health tourist the NHS sees, the risk of another medical killing goes up. By quite a lot. A bitter pill for us liberals to take, but the facts can't be dodged.

Health tourism kills people.

Can you imagine the howls if the government introduced a mandatory card or ID check for NHS treatment?

No, no. What people want is for people who look or sound "foreign" to be asked. Not for British people to be inconvenienced by having to prove their entitled. Just those obvious Johnny Foreigners.

So, Daily Mail sadfaces a plenty when an 80 year old turns up for their GP appointment but doesn't have their card, or little Lucy turns up for a vaccination but her mother forgot her card, or Boris breaks his leg falling down drunk but on attendance at A&E he's forgotten his card...

How much will these mandatory cards cost (current NHS cards are a piece of paper so we couldn't use the existing ones)? How much will the extra administration of checking and recording these checks cost? How much will keeping the system up to date cost?

"Today, in the UK, you are treated first and asked later, if you are asked at all."

I just worry about what impact this news will have on impoverished pregnant women in the UK.

I think we'll be seeing more of these women not accessing antenatal care, and giving birth alone, for fear of being chased for huge sums of money they have no prospect of finding.

I became pregnant with my third child shortly after returning to the Uk after living abroad for a few years. I had to provide evidence that we were staying permanently including details of the home we were buying at the time, had to shown UK passports etc. This was back in 2002.

So, Daily Mail sad faces a plenty when an 80 year old turns up for their GP appointment but doesn't have their card, or little Lucy turns up for a vaccination but her mother forgot her card, or Boris breaks his leg falling down drunk but on attendance at A&E he's forgotten his card...

Let's stop with the little violins, please.
If Boris falls down drunk and gets treated he can take up the matter with his insurance,
If poor little Lucy's mum forgets the card then Lucy will get her vacs later and her mum will put the card in her wallet or with her mobile and won't forget it again.

Now, if I were to turn up at the library and have forgotten my card I won't get books out. If I go on the train they won't let me travel without a card or a ticket.

Why would an impoverished woman avoid prenatal care? No one's that stupid to think that if they are going to be made to pay if they are resident in the UK and entitled to health care.

For genuine case sod asylum seekers there can be charities who people are welcome to pay into.

I'm tired of hearing that the HNS is free, it's not, we all pay for it, but then again if something is free it's not OK to abuse it.

People would soon get used to carrying a card around at all times, people are using to carrying credit/debit cards, another card should be no trouble. Driving licenses can have the ID number added (OH uses his driver license to prove entitlement rather than his health insurance card)

I forgot DD's card when I went to pick up her prescription the other day, couldn't get it, fair enough that's my fault for forgetting it, its not the end of the world.

Sorry, don't know where that sod came in.

It was meant to be of.

"For genuine case sod asylum seekers"

Yes - sod the newborn babies of asylum seekers, and those not entitled to NHS care.

There WILL be women who don't get antenatal care because of a fear of being chased by debt collectors. There WILL be women not entitled to NHS care who will now choose to give birth alone rather than risk being saddled with an enormous debt.

IMO the state has a duty of care towards these babies, just as it would if they were born.

I did say it was typo.

Clearly it has to be of.

But do stay on your soap box if you wish.

"So should the NHS continue to treat everyone without cost ?"

Babies and children who are not here through choice? Yes, of course. Anything else is unthinkable.

That are not treating the babies. They are treating pregnant women who come here to exploit the system.

St Georges are clear this is about health tourists.

"They are treating pregnant women who come here to exploit the system."

They have their babies with them.

The babies are here and they are vulnerable.

No, they are pregnant. They don't have the babies yet.

This is about women who pay a flight ticket to come here and have their babies here, they can have then home, and they do have the funds to come here and fly back later, so they are not destitute.

Genuine cases, yes, that's different, and I can see how a woman being illegally here might be reluctant to access care, but I don't think the cases targeted by SGH are genuine cases of people in need.

"They don't have the babies yet."

So the wellbeing of these babies needn't be considered?