Government's migrant charging proposals could damage the NHS

The government’s proposals for an extended charging system for migrants and short term visitors attempting to access healthcare in UK are impractical, inefficient, and uneconomic and could cause unintended damage to NHS services, according to the BMA.

Responding to the government’s recent consultations on migrant and short term visitor access to the NHS, the BMA has outlined serious concerns about these proposals:

• There is no evidence that the income derived from charging short term visitors or migrants would be sufficient to cover the significant cost of the increased bureaucracy necessary to administer the system.
• It is difficult to see how extending charging to general practice could be implemented without ensuring every patient was checked by their GP practice when they register, resulting in inconvenience for all patients and an increased administrative burden on already over stretched GP services.
• There is no explanation of what documentation patients will need to use to prove they have permanent residency. There is no obligation for UK residents to hold a passport and the documentation some practices currently require, such as utility bills, would not prove permanent resident status.
• Forcing non-European Economic Area (EEA) migrants, and any dependents, to make a contribution to their healthcare costs could reduce the likelihood of highly skilled migrants coming to work in the UK.
• If migrants and short term visitors are deterred from seeing a GP, it may become more difficult for the NHS to identify communicable diseases such as TB. This could increase public health risks for the wider population and result in increased stress on NHS services.
• The BMA agrees with the government that care should not be denied to patients who require immediate treatment, but the current proposals do raise ethical concerns. For example, charging could deter patients from seeking emergency care and could make them reluctant to bring their children to a GP practice or emergency care department.

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