Lord Howe told the BBC that patients will be able to go to a doctor in general practice and to appointments with a nurse for free. Anyone taken to accident and emergency for genuine emergency treatment, such as those who have had a heart attack, will continue to be treated without having to show eligibility to free healthcare.
Lord Howe said that he expected the changes to save the UK's National Health Service about £500m a year. He said that it was 'A national health service, not an international health service'. Currently, the NHS treats people free if they are deemed to be 'ordinarily resident' in the UK.
People to be charged
This includes people from outside the European Economic Area who
- Have been living in the UK for at least 12 months when they begin treatment
- Have permanent resident status, even if they have been in the UK for less than a year
- Have come to the UK to work, either as an employee or in a self-employed capacity
- Normally work in the UK but are currently working abroad, for less than five years
- Have applied for asylum in the UK
The full details of the scheme will be announced in March 2014 but it seems that the following groups of people will be required to pay for most treatment on the NHS
- Foreign workers in the UK, such as those with Tier 2 (General) and Tier 2 (Intra Company Transfer) visas
- Tourists
- Business visitors
- UK citizens who live and work abroad (It is not clear if this will apply to all such workers or whether some will be exempt from the requirement to pay)
Varied reactions to proposals
Reactions to the proposals among medical professionals varied. Dr Laurence Buckman, a former chairman of the General Practitioners Committee, told the BBC that GPs were not opposed to charging foreign nationals for treatment but said that doctors needed clarity on who should be charged and when. He added that doctors did not want to act as border guards or tax collectors.
Dr Mark Porter, Chairman of the British Medical Association Council said that the proposals 'could create unintended drawbacks for the NHS and patients.
He continued, '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'.
Wrong to deter people from visiting their doctor
Dr Chaand Nagpaul, leader of the BMA's GP committee, said 'We cannot have a situation where any patient with a serious health need is deterred from visiting a GP, especially if their condition raises a potential public health risk'.
Writing in the Journal of Medical Ethics Bog on the British Medical Journal website, Iain Brassington wrote 'The planned NHS budget for the 2012/13 financial year is £108.897bn, in the context of which, £500m really isn't that much'.
Government accused of 'grandstanding'
The UK's opposition Labour Party has accused the Coalition government of 'grandstanding' meaning that it is attempting to gain headlines for being 'tough on immigration' without addressing any underlying issues.
Labour shadow health minister Lord Hunt said 'Labour is in favour of improving the recovery of costs from people with no entitlement to NHS treatment…Rather than more grand-standing, the government needs to deliver practical, thought-through changes to make that happen'.
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