Crackdown
announced on
‘health tourism’

24 July 2014

In an effort to improve systems for identifying and charging overseas visitors and migrants who use the NHS, an NHS Visitor and Migrant Cost Recovery Programme is set to be rolled out over the next two years.

The objective of the programme is to recover £500m annually by improving identification and recovery from chargeable patients and from health surcharge income. This target, which represents a significant improvement on the £73m recovered in 2012/13, will be invested back into the NHS.

Health Surcharge

Amongst the proposals to be implemented, a new immigration health surcharge will be introduced to the existing UK visa application process. This tariff will be paid by most non-EEA temporary migrants when they apply for leave to enter or remain in the UK. With a few limited exemptions, the charge is expected to be £150 per year for students and £200 per year for others and will be paid upfront for the duration of the visa.

By way of example, a Tier 2 worker seeking permission to undertake a 5 year assignment in the UK should expect to pay £1000 in order to gain access to NHS services for the duration of his or her stay in the same way as a person who is ordinarily resident in the UK.

This surcharge will not apply to non-EEA visitors (here for less than 6 months), who instead can expect to pay 150% of the cost of any treatment they receive whilst in the UK. By increasing the charge to 150% of the NHS standard tariff for non-EEA patients, the government hopes to encourage and support identification and charging of non-EEA patients.

EEA Nationals

With a view to increasing the level of cost recovery from reciprocal healthcare agreements with other EU member states, the government also plans to encourage hospitals to collect the necessary demographic and administrative information for EEA patients by paying NHS trusts 125% of the cost of treatment for EU patients.

Current cost recovery through these mechanisms is low because the NHS struggles to identify patients holding European Health Insurance Cards (EHIC) or other European forms. A pilot in a number of A&E settings around the country is therefore planned to assess the feasibility of collecting EHIC information as part of the registration process when patients arrive.

Radical Change

If the NHS is to receive a fair contribution for the cost of the healthcare it provides to non-UK residents, then a seismic shift in the NHS approach to charging overseas visitors and migrants will be needed.

Hospital staff will not take kindly to embracing the duties of an Immigration Officer or being burdened with extra paperwork. So simplifying the process to make it easier for hospitals to identify foreign patients is crucial.

The new measures – which include a tightening of the rules on eligibility for free NHS prescriptions, optical vouchers and subsidised NHS dental treatment – are expected to come into force by next spring. We await further details from the government as to how the programme will be fully implemented.

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