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Proposals to show passports for NHS treatment 'go too far'

Published 22/11/2016

Some NHS trusts are trialling asking patients to bring ID before getting some elements of care.
Some NHS trusts are trialling asking patients to bring ID before getting some elements of care.

Proposals to make patients in England show their passports to get NHS care go "too far", leading doctors have said.

The comments from the British Medical Association (BMA) come as it emerged that health officials are examining whether patients should have to show identification to get some elements of NHS care.

Labour said it would oppose the proposition, adding that NHS staff are "not border guards".

On Monday, a senior official said t he Department of Health is looking into some methods that are already being employed across some parts of the NHS to claw back money from foreign NHS users.

Chris Wormald, permanent secretary at the Department of Health - which is responsible for the NHS in England, told the Public Accounts Committee (PAC) that the NHS has got a "lot further to go" when it comes to reclaiming money from foreign visitors.

Mr Wormald admitted that there were challenges in the identification of people who should be charged for elements of NHS care.

Some trusts are trialling asking patients to bring ID before getting treatment, he said.

And the Department of Health was looking into whether more trusts should go down a similar route, he told MPs.

Commenting on the news, Dr Mark Porter, chairman of BMA council, said: "Ensuring eligibility for NHS services is always important, but these proposals go much too far and it is unlikely they could ever be turned into a serious policy that would be accepted by patients and the public, that is, showing your passport before undergoing treatment."

Labour's shadow home secretary Diane Abbott added: " Our public sector staff are not border guards.

"The real problem here is government cuts. Instead, we are invited to believe that foreigners are a significant problem in the NHS, without much evidence.

"We should be clear what this policy would mean. Either we would all have to carry two pieces of ID to get treatment, or those who are believed to sound or look foreign will be profiled in order to receive treatment.

"Labour will oppose this policy, and would reverse it if implemented by this Tory government."

PAC chairwoman Meg Hillier also expressed concern about British residents that do not have photo ID and those who would struggle to find a utility bill.

There are different rules for charging visitors from the European Economic Area (EEA) and Switzerland and from those outside the EEA.

Visitors from the EEA are usually covered by agreements under which their home country pays for treatment.

But there are big differences between the amount of money other European countries claim from the UK and how much the UK pays out, the Committee heard.

The Committee drew on official figures released earlier this year which show that in 2014/15 £674 million was charged to the UK government for the care of British citizens in EEA countries.

But the amount charged for the care of EEA nationals in British hospitals was just £49 million.

Mr Wormald said the figure was "hugely driven" by the number of UK pensioners who live abroad.

There are 62 Spanish pensioners living in the UK compared to 70,000 British retirees living in Spain, said Mr Wormald.

But in 2014/15, Poland charged the government £4.3 million for the medical care of British patients, while the UK charged the Polish Government £1.5 million for the treatment of Polish people in the UK, the Committee was told.

Yesterday, Mr Wormald told MPs that the Department of Health had an "awful lot more to do before we could hand on heart say we are doing our duty to the taxpayer in this area".

He said officials were looking at a range of measures to encourage the identification of people who should be paying for NHS care, including whether all patients should have to show ID.

He added: "We are looking... at whether trusts should do more on upfront identification.

"The general question - are we looking at whether trusts should proactively ask people to prove identity? Yes, we are looking at that.

"There are individual trusts like Peterborough who are doing that, who are reporting that it makes a big difference and there you are saying 'please come with two forms of identity, your passport and your address' and they use that to check whether people are eligible or not.

"Now it is obviously quite a controversial thing to do to say to the entire population you now have to prove identity."

But Ms Hillier said the process could be "humiliating" for some patients.

"I have constituents who have no photo IDs," she said.

"Because they have never travelled they have no passport, they have no driver's licence because they have never driven, they still live at home because they can't afford to move out so they've never had a utility bill in their name.

"(They are) perfectly entitled to health care - British born, British resident - how are you going to make sure that people have access easily to the National Health Service without having to go through a very humiliating and impossible to meet set of demands?"

Mr Wormald replied: "This is why we are going very slowly on some of these questions and individual trusts are trying these out."

Labour's shadow health secretary Jon Ashworth added: "It's testament to the desperate squeeze on our NHS finances that we have civil servants publicly talking about patients being forced to show not one but two forms of identification before they are treated.

"The NHS is supposed to be free at the point of need, not free at the point of ID'd.

"This story - which Jeremy Hunt's team regularly spin - shows the Tories are desperately trying to distract attention from their broken promises on funding for the NHS and social care."

A Downing Street spokesman said that requesting patients' passports was a practice being tried in some NHS trusts, and would be considered as part of a consultation exercise currently under way.

"You would expect the health service to require patients to provide credible evidence of their eligibility for free treatment on the NHS," said the spokesman.

"It is only right that if they are not found to be eligible, the cost of their healthcare should be recouped.

"It's worth stressing that no-one is going to have emergency healthcare denied while their proof of eligibility is established.

"If an NHS professional believes healthcare is urgently needed by a patient, they will of course receive it. If it then transpires that person wasn't entitled to free healthcare, we would look to recoup that money."

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