Making a fair contribution – the UK Government response to the consultation on the extension of charging overseas visitors and migrants using the National Health Service (NHS) in England – has detailed the steps the government is planning to take to limit extent to which the NHS pays for care given to foreign visitors who are not entitled to receive it. In the foreword to the report, Health Secretary Jeremy Hunt notes that in the last three years, the NHS has trebled the income from overseas visitors and migrants, from £89 million to £289 million. He continued: “We will ensure that for the first time it becomes a legal obligation to pay up front and in full for any non-urgent treatment on the NHS. We also plan to put an end to overseas visitors from outside the European Economic Area (EEA) benefitting from free prescriptions.” He also made reference to Brexit, but with no definite answers for patients hoping for clarity: “As we prepare to exit the European Union we will also have to consider the best deal for British people living and travelling in EU countries and any reciprocal healthcare arrangements we might put in place for EU nationals visiting the UK. This work is out of scope of this consultation. Until we leave the EU, the current rules apply and we expect the NHS to maximise the identification of these patients and collect the necessary information to enable cost recovery.”
The first stage of the plan will introduce financial incentives for trusts to improve the rate at which they recover costs from visitors from EAA countries with European Health Insurance Cards. It will also introduce a risk-sharing arrangement for trusts to seek charges at a higher rate (150 per cent of the cost of care) from visitors from outside the EEA while having the assurance that commissioners will pay 75 per cent of these costs should the visitor fail to pay.
The report went on to explain the situation for tourists and expats: “Information about the charging rules and how they apply to overseas visitors or migrants looking to settle in England are available on [the] NHS Choices [website] but we know this information is not sought out on this website before visitors travel to the UK. We will therefore work with the Foreign and Commonwealth Office to communicate to overseas visitors coming to the UK the fact that NHS treatment is not usually free of charge and that they should therefore travel with insurance to avoid charges and potential impacts on future visa applications. We will also work with the FCO to make sure that British expatriates are provided with information about their entitlement to free healthcare or whether they will need to pay.”
ITIJ spoke to Kimberly Loudon about the situation for international visitors who have travel insurance, and how these proposed changes will affect them and their insurance providers: “In terms of travel insurance this would be up to the individual Trusts to have conversations with patients about payment options as well as individual insurance company policies. In some cases patients can provide proof of travel insurance and the Trust can bill the insurance company directly. Depending on the cost of care, and the arrangements/policies of individual insurance companies, Trusts may take a payment from the patient up front and then the patient is reimbursed by the travel insurance company.” She concluded: “Essentially the Government’s policy is that Trusts should identify and charge up front, but it is up to individual Trusts how they do this.”