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".

"This is about women who pay a flight ticket to come here and have their babies here"

In part, yes.

It will also affect many others who are here for reasons other than health tourism.

Everyone will still be treated regardless of entitlement but some people will get a bill afterwards. No one is suggesting we provide no care to these women and children. HCPs in this country use the hypocratic(sp) oath as the criteria for treatment not ability to pay and that will continue.

The card thing is a bit of a red herring .... the 80 yo and little Lucy are presumably registered with their GP - and would have had to provide proof that were eligible to register -so they wouldn't need to show their card every visit (wasn't there some fraud in Birmingham a few years ago where the practice manager was fraudulently registering foreign patients -health tourists - then they were referred to a hospital for eg cancer treatment, considered eligible because they were registered with a GP...
Of course someone could turn up pretending to be an existing patient to get treatment but to get round that you would need photo ID that would need to be updated every so often... but that would take quite a bit of organising and money and I don't think is necessary.
The 'imposter' would have to be a similar age, ethnicity etc as the 'real' patient who would be taking a serious risk as if they became ill 'their' previous medical history could be taken into account...
Your GP could check you were still eligible every 5yrs or something. (Ours check our contact details etc every so often -they could check at the same time)
A&E is different but unless you were unconscious - when emergency treatment was required anyway -you could provide your address or similar and they could check you are on the electoral roll at the address in question...
I think this is targeting organised health tourist gangs ...who are exploiting the system - the odd case of a prescription for antibiotics getting through is very different than months of expensive hospital treatment.

I know someone who is a UK citizen (holder of passport) but her children aren't and she was billed when one of them got sick in the UK on a visit. I also have a relative that is receiving ongoing care and has to show their ID/passport for scans, at a London hospital although judging by this thread, it's not entirely clear they could be refused, perhaps they are being tracked on the system. Some attempts are being made to try to recover costs/see who is eligible.

eligibility for treatment, its quite simple and nobody avoids care because they mistakenly thing they will get a bill. I'm in Oz, if you are a citizen or on a permanent visa you are entitled to Medicare, otherwise you need to take out private health insurance. The sad thing is, while it would be lovely if the UK could say they will pay for all the health care for anyone that turns up looking for treatment, there isn't even enough money to pay for everyone in the UK, never mind the world. Its unfortunate, but limits have to be set, and I for one am bloody glad I don't have to sit on a medical ethics board and make those decisions.

I don't know what happened to the start of my sentence. It should have read 'Other countries check on eligibility for treatment...

I'm in total agreement with it. The clue is in the name:- National Health
Service,NOT International Health Service.

The thing is, the NHS has to make decisions every day about who to treat and where their limited pot of money should be spent. I remember learning about QALYs (Quality Adjusted Life-Years) where quality and quantity of life is calculated to a number in order to prioritise where the money is spent, decisions are made that there is no point spending lots of money on grandma because she is over 80 for example. The pot isn't limitless, hard decisions must be made.

Maybe I am missing the point here, but since when did a passport determine the right to NHS treatment? We are all British passport holders but live abroad, and on recent visits have paid for services that UK residents receive free.

Mistigri, it doesn't.

I suspect the DM have used the word 'passport' instead of 'documentation proving the holder is entitled resident and entitled to treatment.'

Those saying this is xenophobic don't seem to realise that this means plenty of non Brits will rightly be entitled to treatment as they work and reside in the uk and plenty of British passport holders (like me) won't.

misti it doesn't.
I have a european passport and am as entitled to nhs services as my british passport neighbour.

Pink, you are entitled to health services here because you are resident here, not only because you have an EU passport.

What hospitals check is residency, utility bills and so on to prove you are indeed living here. Not all and not in every case, though.

Residency not passport is the test. Not payment of NI either - I paid NI whilst a non-resident through choice but it's not the basis for entitlement.

No idea how they can check this without ID cards really... Utility bills seem like a good option but all ours are in DH's name!

A&E treatment actually isn't chargeable for anyone. You'd only pay if you needed follow up care or an admission. We get a lot of people in a&e who aren't registered with a doctor because they don't want to pay for treatment. We do also get cases of fraud where one patient pretends to be someone else for treatment. It's always a nightmare trying to unravel and fix the case notes when that is discovered.
The recoup of funds from ineligible patients is a bit of a mess. I would like to see a cost benefit analysis to look at the cost of staffing and managing this process properly vs. The money that could be recouped if we had proper processes in place.

SGH only have a loss of almost £5 million, no amount of staffing will come even close to that.

And that's just one London hospital.

Utility bills prove nothing either - plenty of tenants still have some utility bills in the landlord's name (regardless of whether that is officially allowed) meaning that if that landlord is resident overseas they'd still be able to "prove" residency if utility bills were enough, and on the other hand plenty of people who have never left the UK even for so much as a holiday aren't on any utility bills (adult children living with parents as well as plenty of couples who have all bills in one name).

Passports are irrelevant as others have said.

The UK population is hugely resistant to ID cards or compulsory registering of residence though, and apparently now only popularity politics matter, so however popular stopping forriners using the NHS might be there is actually no consistent, practical, enforceable way to check entitlement at point of use.

Therefore handily forriners can always be blamed for breaking the NHS - so actually shouting and blustering about health tourism but not being able to do anything about it is a win win situation for a popularist right wing government who survive by scapegoating certain unpopular groups on behalf of "the people" ...

Its the norm in other countries from my experience.
Countries just don't have the spare money lying around to let anyone have free treatment I am afraid.

US - nothing done without checks and payment, usually before anything gets done at all. Sister had all this for a non emergency appointment but something that needed sorting as soon as. Had to pay upfront and claim back from insurance.

Spain - I needed treatment in Majorca last year. I had to prove who I was, insurance and how I was going to pay before I was let into the waiting room. I had consultation, X-ray, cast, etc and then paid on exit (having previously had CC swiped) and had to claim back when home. Could have gone to the state hospital and not had to pay, using EHIC, but that was a very long drive from where we were and a much linger wait, and I was in a lot of pain.

pikachu I think part if your job is to use resources wisely. I am presuming you don't waste dressings or take stuff home to distribute to others.

It's the same as people in a supermarket. Would you sit there as a supermarket employee and not watch out for shoplifters? We should all be alert to the possibility of fraud, and take steps to rectify.

I know I do. I find expat after expat. I pass their details on. They will never know it was me.

The airlines aren't meant to allow pregnant women to fly after a certain time so this also needs addressing.

It doesn't have to be an ID card either. Here in Australia you apply for a Medicare card, I assume if you are born here they just send it to you, but as immigrants we had to apply for it by showing our Passports and visas. Its just a card with our names on it, no photos. We show it every time we go to the doc. If you can't get a Medicare card then you need to have private cover. It's all pretty straightforward.

I also agree with it, but have to ask - what will be the limit?

I have family that were born here, buggered off to whatever country and return to the UK to give birth. How will they be treated? As a UK citizen (who doesn't pay tax) or as foreigner.

(Not trying to flame, but genuinely curious as I have been abroad for a few years and while I plan to have my children abroad, am treated as a foreigner in some situations and as a UK citizens in others)

You need to be resident in the country without leaving for six months to be able to claim nhs treatment.

the rules are not difficult. Live here - get treated free regardless of passport. Don't live here - pay for all except emergencies regardless of passport.

childbirth is not an emergency, you get 9 months warning.

The hard bit is enforcing it. As several recent cases have proved, other countries enforce it. It goes; visitor? Need treatment? Produce payment or strong evidence of ability to pay, or NO treatment. Yes, even if you are going to die or be permanently disabled without treatment.

And the medevac plane will also not take off without payment.

Haven't RTFT, but not everyone is covered, even if you live here. Non U.K/EEA nationals are only given free care if they have indefinite leave to remain (ie. spousal/student visas don't count), with the exception of Australian and New Zealand citizens.