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GPs concerned at NHS charges for migrants

RCGP and BMA say charges might mean extra paperwork for GPs

Mark Gould

Thursday, 02 January 2014

New plans announced by the Government to extend NHS charging for visitors and migrants from April this year could potentially lead to confusion among patients and more red tape for GPs, the BMA and the Royal College of General Practitioners (RCGP) have warned.

While both organisations say they are encouraging that the Government has taken on board some of their concerns about the impact on public health, they remain concerned at how these proposals will require doctors and GPs to spend more time on paperwork at a time when the health service is under increased pressure. The RCGP has also raised concerns that GPs will be "pressed into acting as an arm of the Border Agency".

Dr Mark Porter, Chair of BMA Council said the proposals could create unintended drawbacks for the NHS and patients. "They are likely to create a complex patchwork of charging and access entitlements where some services remain free, such as GP appointments, while others will be chargeable, including A&E visits and other services provided via many GP practices, such as physiotherapy.

“Not only will this arrangement cause confusion amongst patients, it will also require GPs and hospital doctors to spend more time on the paperwork and bureaucracy needed to regulate these charges.

This could mean the system of administering the new charging system will end up actually costing more to run than it collects in revenue. There remains a real risk that some migrants and short term visitors who desperately need care could be discouraged from approaching the NHS if they cannot pay the proposed charges. There is particular confusion over access entitlements to emergency care services, given the proposals to introduce charging for A&E visits yet say no patient will be turned away if they need care."

RCGP spokesperson, Dr Helen Stokes-Lampard, who is a GP in Birmingham, said the college was pleased that access to a GP will remain free at the point of need. "However, we still need reassurances that GPs are not going to be pressed into acting as an arm of the Border Agency and we remain unconvinced that the proposals will work across the NHS.

"There is no detail in today's announcement about how the new system for recording and monitoring foreign nationals will operate - or who will run it.

"GPs will face the dilemma and extra responsibility of what to do once they have consulted with patients in need of care. The ramifications of this could be very serious for patients who are in desperate need of assistance, and it must not be left to GPs to have to decide who is entitled to free NHS care and who is not. We are also concerned about the practicalities of charging for A&E services, and the extra burden that this would impose on busy A&E departments. While the NHS must not be abused and health tourism needs to be stopped, it is important to keep the problem in perspective."

She also wanted reassurances that the extra administrative responsibility will not fall to frontline NHS staff and take them away from their most important job of providing care to patients.

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