Letter to Mr Hunt, the Health Secretary

 

Dear Jeremy,

           I was pleased to read in the Sunday press that you are working on the issue of access to free health services in the UK by visitors. I have raised this matter as have  other MPs for some time, and think we need to ensure we are running a National Health Service, not a World Health Service.

          The rule we want and thought we had is simple. Any UK citizen is entitled to free provision of  both GP and hospital services. Any foreign visitor should have to pay, by holding insurance or having sufficient money to pay for treatments needed. Anyone involved in an accident or needing emergency treatment would of course be looked after without first querying their ability to pay, but for all non urgent treatments patients from 0verseas will be asked to provide insurance or a credit card or other means of payment before any consultation or  treatment is offered.

         British citizens do not wish to be asked each time they go to a GP or hospital to show their ID or other credentials. The hospitals and doctors wish to devote their time to offering medical advice and treatment, not to policing a fee system. The best way to do so this is to ensure our current NHS system works as intended.

          Everyone going to see a hospital consultant or seeking non emergency treatment in a hospital should be referred by his or her GP. Anyone seeking GP help should go to the practice where they are registered. Thus the policing of payment should be ensured through checking that anyone wanting to see a GP first has to register with a GP  practice. When you register with a GP you should show your birth certificate or passport or some other document which establishes your entitlement to free treatment. Otherwise if you are not a UK citizen you set up the payment system when you first register.

          People attending accident and emergency, when able to answer sensible enquiries about their status, should have to tell the hospital the name and address of their registered GP. Those who are not UK citizens should be asked for payment in most cases, and visitors to the UK should be advised to hold health insurance. EU visitors would need their EU health  card.  The UK should not deny life saving emergency treatment for lack of the means to pay or lack of clarity over future  payment.

          People coming from the rest of the EU have use of the health card system. GP practices and hospitals must insist on proper recording of all EU  card cases – who should not be able to register with a GP without establishing their health  Card status, so the UK can receive the money back it is owed.

 

Yours sincerely

 

John Redwood

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61 Comments

  1. colliemum
    Posted July 1, 2013 at 6:02 am | Permalink

    This is a much-needed step in the right direction, and I hope it bears fruit. Sadly, I cannot see these proposals becoming more than that because I cannot see anybody policing these proposals. Certainly doctors and nurses won’t. Also, it would seem that administrators are incapable of chasing up payments even from EU patients. There’s a long way to go towards eradicating the abuse of the NHS by those who haven’t contributed.

  2. lifelogic
    Posted July 1, 2013 at 6:05 am | Permalink

    All seems fairly simple to me to organise, why on earth has this not been done for the past three years, and even before that under Labour? A shame we cannot charge EU visitors too, until after we have left the EU when the government are finally forced into asking the people. How is Cameron getting on, can he at least tell us what powers we are to get back? He seems to have gone very quiet on the issue, I suppose he is dealing with something more vital like the gender neutral royal succession, the £10K pay increase for MP’s or the absurd HS2 ? Will the £10K pay increase result in an average pension pot increase of something like £150,000? An increase of perhaps 5 times the average total pension pot in the private sector. Still we are all in it together as they say.

    Meanwhile I see Obama had been to visit Robben Island for some photo opportunities (at least he did not see Mandela), might he not have spent his time rather better visiting Guantanamo Bay, so he could see how best to start to keep his election promises?

    Reply There is a charging system for EU visitors using the NHS levied on their governments, and a reciprocal one for Uk visitors to the rest of the EU which the Uk government pays.

    • lifelogic
      Posted July 1, 2013 at 8:10 am | Permalink

      Of course they should really charge all who can afford to pay and cut taxes to compensate.

      • A different Simon
        Posted July 1, 2013 at 7:36 pm | Permalink

        For something like severe health problems the national insurance model is far better .

      • Bazman
        Posted July 1, 2013 at 7:38 pm | Permalink

        How many could afford a heart attack or cancer in Britain no matter how large the tax cut? Get real.

        • lifelogic
          Posted July 2, 2013 at 5:48 pm | Permalink

          All those who can afford a new car, kitchen, house, boat, school fees so quite a few. Even more can afford insurance they are paying for it anyway already through taxes.

          • Bazman
            Posted July 3, 2013 at 5:48 pm | Permalink

            A heart attack is going to be a bit more pricey than a boat or a car, because you are not going to be able to work when you are having it unlike the car it will have to be paid for out of no wages. Maybe we should all save up for a heart attack? As for insurance its called NI and tax additional insurance is avalible. What you mean is the very rich should be allowed to opt out and less tax. We live in a democracy and the rich benefit more from this democracy including the health service. (etc)

  3. Jerry
    Posted July 1, 2013 at 6:15 am | Permalink

    Everyone going to see a hospital consultant or seeking non emergency treatment in a hospital should be referred by his or her GP. Anyone seeking GP help should go to the practice where they are registered. [..//..] People attending accident and emergency, when able to answer sensible enquiries about their status, should have to tell the hospital the name and address of their registered GP.

    Some years ago because of a house move, same town but different area, I unwittingly did not have a properly registered GP for five years although I was still technically registered with my old GP and honestly thought that practice was still my official practice. This only came to light when I eventually needed a (non urgent) medical consultation, when at which point “my GP” refused to see me and I had to go off and register with the correct GP surgery! Had your suggested system been in place, had I gone to or been admitted to A&E, had I given my current address and my (assumed) registered GP the two would not have tallied with the NHS system, I might well have been have been taken to be trying to “pull fast one” and diddle the system…

    Oh and I can already see cases were great offence gets taken when a UK national, born here and who pays UK taxes etc, is assumed by over worked and perhaps harassed A&E staff to be ‘Non British’ simply because of their racial origins.

    I do not object to your suggestion John, I just fear that a lot more work will be needed to make the system work for the UK citizen, for example what ever happened to the suggestion that people should be able to register with a GP of their choosing and not only the one within the catchment area they live, what about those who for what ever reason do not have a registered GP, what about British citizens who live abroad but currently have every right to use the NHS as if they are resident in the UK, how would they be affected, would they need to make sure that they are still registered with the correct GP to were ever they are staying whilst in the UK, would they have to carry their UK Passports, would they be bared due to being non-doms?

  4. frank salmon
    Posted July 1, 2013 at 6:21 am | Permalink

    The NHS has always been sloppy on this. There must be a time whereby the cost of implementing a scheme such as that above, is less then the cost of supplying free treatment to health tourists. A Guardianista journalist on Shy TV last night claimed that only £24 million was being wasted in this way and it pointless making the effort. She even claimed that the Polish imigrants eschew the NHS and return home or go for private care because it is not good enough for them. I thought these days of Labour propaganda were over, but we still get it – even on Sky TV. If the abuse is put at £24 million it may be because our inefficient, self serving NHS don’t even collect the data properly. I know if I worked for the NHS I’d think twice before reporting such abuse for fear of ending up in some sort of hate crime tribunal – or I might be tempted to accept payment in return for keeping quiet on the issue.

    • lifelogic
      Posted July 1, 2013 at 8:09 am | Permalink

      The NHS do not have a clue how much they are wasting in this way, just as they do not have a clue how much is being wasted all over the place in the NHS. They simply do not have the systems in place to find out.

      • Jerry
        Posted July 1, 2013 at 6:26 pm | Permalink

        @Lifelogic: “The NHS do not have a clue how much they are wasting

        Those who should be finding this sort of thing out simply do not want to start finding waste, because when they do they will very soon discover that the worst waste comes not from heath tourism, cosmetic surgery (tattoo removals or bust enlargements) and the like but due to their own jobs within the out of control pyramid building that is the modern management of the NHS.

        • lifelogic
          Posted July 2, 2013 at 5:44 pm | Permalink

          Indeed, if the NHS ever produced a report showing how many £billions was being wasted they would, I assume, be told to destroy it before it became public.

      • Bazman
        Posted July 1, 2013 at 7:53 pm | Permalink

        Which no doubt would be ‘absurd’ and ‘pointless’ data collection if they did. Blaming foreigners and the poor for the collapse of the banking system will not wash. Taking a few quid of the least able to afford it for having a spare room they cannot give up whilst talking about fairness as tax cuts for the rich are given will also not go unnoticed. This is there reason for a Tory white wash in 2015, not IHT threshold of less than a million or squeezing of the offshore headquarters that is known as The City.

    • Roy Grainger
      Posted July 1, 2013 at 9:19 am | Permalink

      Actually I know a Turkish immigrant who did exactly that – she had a fairly serious condition and all she got from the NHS was series of far-distant appointments and shoddy service so she went back to Turkey and got (free) the treatment she needed to a high standard in a timely manner.

      I think part of the problem is that if something is “free” it is perceived to have no (monetary) value (this is a commonplace psychological truism in many situations), so as at the point of delivery the NHS is doling out “free” treatment to everyone they don’t really distinguish between those who are entitled and not entitled.

      • Iain Gill
        Posted July 1, 2013 at 10:50 am | Permalink

        I know a few French students who gave up on the wait for an operation on the NHS and went back to France and had it done during the holiday and came back. Meanwhile their British equivalents went on waiting.

      • uanime5
        Posted July 1, 2013 at 1:12 pm | Permalink

        If free treatment causes people to perceive it as having no (monetary) value then why isn’t Turkey having the same problem if people can get their treatment for free.

        • Bazman
          Posted July 1, 2013 at 7:45 pm | Permalink

          There is some truth in this by the number of individuals involved in attacks on NHS staff. You can see this fear in some of the NHS staffs faces if you have a powerful appearance and a small child who is ill at that moment and no doubt from their experiences on the Saturday night shifts. Free and no respect for this. Council house attitude.

          • Roy Grainger
            Posted July 2, 2013 at 8:37 am | Permalink

            My point was that the NHS care PROVIDERS may be inclined to perceive the care as having no (monetary) value but it could be true for the care receivers too. It is such a well-known psychological topic I’m surprised anyone is arguing the toss over it, there is a wealth of research out there from marketing and other fields to prove it. Just as a little example it is why the word “complimentary” rather than “free” is used when handing out free tickets to events – when they are called the former they are perceived to have more “value” and people are more likely to turn up.

        • lifelogic
          Posted July 1, 2013 at 9:10 pm | Permalink

          They are.

      • Jerry
        Posted July 1, 2013 at 6:29 pm | Permalink

        @Roy Grainger: Sorry but your two paragraphs appear to be conflict with each other, and as such your point -if there is one- seems very mysterious to say the least!

        • Roy Grainger
          Posted July 2, 2013 at 8:27 am | Permalink

          My two paragraphs don’t conflict at all. The first is a simple factual counter-example to someone who said they didn’t believe some immigrants returned to their home country for treatment. It is just provided for information.

          My second paragraph addresses the issue of why the NHS care providers are apparently so lax about getting payment for treatment. Let me give you a simplified example that you might understand better. Say as part of a marketing exercise by a high-class burger company I’m employed to hand out free burgers at Waterloo Station. I’m specifically told that the target market they want to attract is commuters who pass through the station every day so that is who I should hand them out to. While I’m there a school party of French schoolchildren on a day-trip to UK come past and ask for a free burger and I hand them one each – now I know I shouldn’t but there is no real impact on me one way or the other. To me they are just “free”, I hand them out to everyone, everyone is happy, no-one is negatively impacted from my perspective.

          In answer to the separate question “Why doesn’t Turkey have this problem”, my answer (as it often is in this forum) is how do you know they don’t ? What do they do in Germany, France, Sweden about this problem ? No-one here has a clue – we just try to re-invent a solution in a vacuum.

  5. alan jutson
    Posted July 1, 2013 at 6:53 am | Permalink

    Seems logical that those who pay, THE UK TAXPAYERS, should be treated without cost.
    Those who are visiting, should have insurance to cover any illness.

    Not difficult to seperate those who are visiting, as they would not be registered with a local Doctors practice, who could check out the Status of anyone who wanted to register at the time of their application.

    Simple method of making sure visitors pay, take away their passport on admission to hospital, which is only to be returned when full payment made for all treatment received.

    Anyone who has been unfortunate to require treatment abroad (outside of the UK) will know you cannot access services for free in such places, even if we have reciprical arrangements in place, checks are made and in many cases money exchanges hands to be reclaimed later.

    How many years will it take to sort this one out ?

    • Iain Gill
      Posted July 1, 2013 at 8:29 am | Permalink

      2 problems:
      – many work visa holders are here paying tax but getting signficant discounts on the amount of tax brits have to pay, and many of their family come here already seriously ill. so they do not contribute as much as brits and they are disproportionate drains on the NHS. so while they are UK taxpayers they should not in my view be getting free treatment.
      – I have been treated in Belgium and Italy and got much better care than the NHS for free no question of paying, I have no problem with Belgian and Italian citizens getting free care here.

      • A different Simon
        Posted July 1, 2013 at 2:33 pm | Permalink

        I do .

        What is wrong with having to have health insurance to gain access or where health insurance cannot be obtained a special visa ?

        Make the carriers be they airline , tunnel or boat verify the insurance is genuine and make them underwrite the cost if it isn’t .

        Perhaps to reduce admin costs allow an excess of £500 – £1,000 treatment borne by the host nation or cross-charged back to their country of origin before an insurance claim has to be made .

        • nina Andreeva
          Posted July 1, 2013 at 8:25 pm | Permalink

          To get into the trauma room of one of the Kaiser Permanente hospitals in San Francisco, I had to hand over a passport, my travel insurance policy and a credit card. I cannot see how it would be so hard for the NHS to demand the same to stop the tax payer being ripped off.

          Nothing wrong with Polish dentistry either, the surgeries are just as modern as what you would find in the UK, the dentists can usually speak English and they only charge a fraction of what their British counter parts do as well. Prof Karol Sikora (the cancer czar) also says you have a better chance of surviving cancer in Poland too. though with a name like that he may be biased.

          • A different Simon
            Posted July 2, 2013 at 10:01 pm | Permalink

            Nina ,

            I’m advocating not even allowing people into the country unless they have comprehensive travel insurance or a special visa .

            People like myself with serious pre-existing conditions would have to get a visa to approve travel with travel insurance exclusions .

            There is no need to trap everyone , just the vast majority .

            Medic’s should not have to argue with accountants when presented by someone on a trolley . That is too far downstream .

      • alan jutson
        Posted July 1, 2013 at 9:52 pm | Permalink

        Iain

        Do not see the problems you do.

        People, Visa or no Visa are either paying National Insurance contributions or they are not.

        Just because the rate may vary (by Government decree) does not alter the situation.

        The stupid thing is allowing rates to be different, for diffent groups of people, if that is indeed the case.
        If this is the case, then resolve this issue as a matter of urgency.

        Confiscating a passport seems a logical and simple method to hold people to account, if they are not registered with a GP.

        The onus should always be on people (who turn up at A&E) to prove that they are in the system in the first place by at the very least knowing their Doctors Practice name and address, after all a Hospital would almost certainly need/require access your medical records from this source as a help to best treatment !

    • Bob
      Posted July 1, 2013 at 9:20 am | Permalink

      @AJ
      “…take away their passport on admission to hospital”

      Problem is Alan, if they don’t pay then we’ll be stuck with them because they can’t leave. They’ll hang around forever demanding ongoing treatment, housing benefits, sickness benefits, child benefits, mobility allowances, education for their kids etc.

      As for the suggestion that the NHS will become an extension of the border agency, if the hospital or GP’s admin people cannot cope with checking basic credentials of their customers then they are already very similar to the borders agency (i.e. not fit for purpose).

      While the subject is under discussion, the issue of persistent abuse NHS resources by drunks, junkies and people with broken fingernails or dog poo on their shoe should also be addressed; I would suggest adopting a system similar to the French whereby you settle your account with the hospital and then recover 70% from the government healthcare service.

      “The French health care system is generally recognised as offering the best, or one of the best, services of public health care in the world. Above all, it is a system that works, provides universal cover, and is a system that is strongly defended by virtually everyone in France.
      The health care system in France is made up of a fully-integrated network of public hospitals, private hospitals, doctors and other medical service providers. It is a universal service providing health care for every citizen, irrespective of wealth, age or social status.

      Funding of health care in France.
      The French health care system is funded in part by obligatory health contributions levied on all salaries, and paid by employers, employees and the self employed; in part by central government funding; and in part by users who have to pay a small fraction of the cost of most acts of health care that they receive.”

  6. Mick Anderson
    Posted July 1, 2013 at 6:58 am | Permalink

    The UK should not deny life saving emergency treatment for lack of the means to pay or lack of clarity over future payment

    A noble thought but one that can be abused. All you need is someone threatening suicide if they don’t have a free tattoo removal, and it’ll be classed as an non-chargeable emergency because of the perceived mental health issue….

  7. Martin
    Posted July 1, 2013 at 7:00 am | Permalink

    What is a Green Card? EHIC cards are purple.

  8. zorro
    Posted July 1, 2013 at 7:24 am | Permalink

    John, all eminently sensible and reasonable……Unfortunately, the system is not sensible as being a UK citizen or taxpayer has diddly squat to do entitlement to treatment. See the following link……http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Healthcare/Entitlementsandcharges/OverseasVisitors/Browsable/DH_074374

    ‘What about British Nationals? I have paid taxes in the past.

    Nationality or past or present payments of UK taxes and National Insurance contributions are not taken into consideration when establishing residence. The only thing relevant is whether you ordinarily live in the UK.’……..That says it all about our ‘National Health Service’

    zorro

    • rose
      Posted July 1, 2013 at 10:28 am | Permalink

      “That says it all about our ‘National Health Service’” – and about our nation.

    • Mark
      Posted July 1, 2013 at 10:48 am | Permalink

      That seems to be regardless of whether you are even entitled to live in the UK – so illegal immigrants would qualify.

      It seems a more logical criterion would be having indefinite leave to remain, or citizenship. The exclusion of British citizens who are resident abroad is an interesting issue of itself, as these number several millions, ranging from the retired to those working elsewhere.

      ILR is not granted until someone has been here for a year, so it offers an opportunity to filter out those who might come here for medical treatment. Of course, time was when we had health controls at our borders – although these were mainly concerned with enduring that vistors had the required innoculations.

  9. formula57
    Posted July 1, 2013 at 8:04 am | Permalink

    Let us hope Mr Hunt is rather more polite and responsive than the Energy Minister ( @ http://johnredwoodsdiary.com/2013/03/27/letter-to-the-energy-minister/ ) whose failure to respond to your 27 March letter continues, yes?

    Perhaps it would be more polite though if you stopped bothering the Government? Maybe it is not interested?

  10. Iain Gill
    Posted July 1, 2013 at 8:14 am | Permalink

    It doesn’t work like this currently, and you are being too simplistic and you know it.

    For one British Citizens who have been abroad for a few years are not immediately entitled to free NHS on their return, this is a mistake and should be changed. My brother for instance has been in Australia for a number of years (doing his best to help UK exports) and would not be entitled to free NHS if he came back, which is madness as it penalises those who help this country the most.

    Also of course currently there are wide numbers of people entitled to free NHS who are not British citizens, those here on work visas, student visas, visiting priests, those who have already gained indefinite leave to remain, or are on marriage visas, prisoners, children, and their families, and so on and so on (there are many exemptions) are all entitled to free NHS regardless of whether their home country provides equivalent healthcare to Brits when there. This is too expansive a list I agree and it should be cut right back.

    There are other issues with your words, for one a British birth certificate and being born here does not entitle you to British citizenship so showing your birth certificate when registering with a GP will not help. (I agree babies born to couples here on work or student visas should not be getting British citizenship, otherwise its just another massive migration route, and encourages the wrong behaviours).

    Any foreign national marrying a Brit cannot gain British citizenship till about 7 years after they marry, during which time many will have children – do you really want these spouses to be living here without entitlement to NHS? No healthcare during pregnancy etc? Don’t be silly?

    Your reliance on the magic GP ignores that many of us have rubbish GP’s, we need to be able to referred from one consultant to another, or from the Diabetes Nurse to the eye consultant and so on, the GP in the middle is just a delaying factor. Also many of us routinely form part of the mobile workforce and work far far away from our supposed home address for most of the year, If I am working in Newcastle for months why do I need to see my home GP in Penzance to get referred? It’s a nonsense. The NHS already fails to deal with these issues, reinforcing it more is silly.

    You also fail to deal with the fact in many areas there is no real private provision, the only provision in the UK currently is from the NHS. So for instance do we really want to prevent foreign diabetic students from coming here to study? They will need insulin throughout their stay and the only place they are going to be able to get it will be the NHS in most parts of this country. Is getting an insulin prescription a “non urgent treatment” in your definition? Because without it the patient will be dead in short order.

    You ignore the fact that “indefinite leave to remain” is just that full entitlement to be here and get benefits etc, there are many active members of British society who have been here decades working and contributing who are on foreign passports with indefinite leave. For all intents and purposes in the UK currently ILR is pretty much regarded as the passport to life here not British citizenship. Do you really want to change that? Have you thought through the consequences?

    So while being in passionate agreement that far too many people get free NHS I don’t agree with your simplistic words.

    For me I would give free NHS to anyone who is
    1 A British Citizen, or here with Indefinite Leave to Remain, or Married to a British Citizen
    2 A child, especially new born as they are in no position to be looking after themselves
    3 A prisoner
    4 From a country which gives equivalent care to a British citizen in equivalent circumstances
    5 People already here and seriously ill before you enact this change

    Else I would be asking the foreign national to pay full commercial cost of their medical insurance before granting their visa. And in the case of some basically uninsurable conditions such as pre-existing conditions I would expect the NHS to charge a fair premium for looking after them during their stay (so for instance I would expect it to be affordable for a foreign diabetic student to be able to come here and study).

    I would stop giving free NHS to folk here on work visas, student visas, their spouse and children, and so on. But I would be making sure their insurance was in place before granting their visa to come here not refusing treatment after entry whenever possible.

  11. AVI
    Posted July 1, 2013 at 8:25 am | Permalink

    Broadly good things.
    However, I query the concept of asking an A&E visitor for the name and address of their local GP: I don’t have a clue of the name or address of mine, and would have to look up the practice – even then I wouldn’t be certain where I was registered. Like many people, I simply haven’t needed to visit for years.

  12. David Cee
    Posted July 1, 2013 at 8:25 am | Permalink

    John, that is as clear as it possibly could be. Sadly, I doubt that ministers and civil servants have the ability to implement this: it is far too straightforward!

  13. margaret brandreth-j
    Posted July 1, 2013 at 8:27 am | Permalink

    Good , but not enough . Dual citizenship means that patients can move from country to country , travel to the UK when treatment is needed and use the NHS as a free service. Many Brits have been buying hip operations etc abroad to jump the queue, but queue jumping is free here!

  14. Peter Davies
    Posted July 1, 2013 at 8:48 am | Permalink

    This sounds too much like common sense for politicians and their civil servants to comprehend.

    Surely with the (England) NHS GP Commissioning structure this should fall into line in England by default – the onus being on the GP Practice to ensure that they register UK citizens.

    Something for people in the health service industry to add weight to.

  15. StrongholdBarricades
    Posted July 1, 2013 at 9:15 am | Permalink

    Interesting idea to make GP’s who operate from tax efficient companies (practices) to police the collection of non payment of taxes.
    Better idea would be to make them actually accountable for non-payment

  16. English Pensioner
    Posted July 1, 2013 at 9:24 am | Permalink

    When we went to Australia my wife needed her routine blood test when we arrived in Sydney. There are reciprocal arrangements with Australia for visitors for up to three months, so we went to the local hospital where they checked her passport and the date of entry before carrying out the test. Without proof that we were British visitors, she would have had to pay, there was a large sign in reception to the effect that you had to prove your eligibility for treatment or pay upfront.
    Incidentally, she only had to wait about 15 minutes for the test, not hours, and they phoned the results through to our hotel later in the evening at an agreed time. Now that is real service, something that our NHS should aspire to.

  17. DrJohnGalan
    Posted July 1, 2013 at 10:02 am | Permalink

    I have retired to France, but return to the UK for a few days each month. Despite being a British subject and having paid a not inconsiderable sum in UK taxes over my working life, I have no entitlement to UK health care. Having jumped through the bureaucratic hoops I now have a European Health Card. However, I do not really feel the need of it for UK trips as, at the moment, there is no process to make those who should pay actually pay.

    I see nothing wrong with having rules, albeit, acknowledging the irony of an eastern European immigrant living in the UK, having paid nothing into the system, being entitled, whereas I am not.

    I think the idea of having to be referred by a GP with whom one is registered is a good one that could be implemented quite easily. However, I will not hold my breath: the whole culture of the NHS being free at the point of delivery is so ingrained that it will either take a complete overhaul or many years for that culture to disappear. In the meantime it will remain a World Health Service to the detriment of all UK taxpayers who have to fund it.

  18. rose
    Posted July 1, 2013 at 10:25 am | Permalink

    And about time too!

    Did you see the Guardianista fine diner Zoe Williams denying there was a problem last night? Trying to make out this was petty and nasty?

  19. zorro
    Posted July 1, 2013 at 10:34 am | Permalink

    http://m.bbc.co.uk/news/uk-politics-23122628

    Let’s see if Cameron can persuade MPs from extracting the Michael…..a test of his persuasion and negotiation skills to prepare for the EU

    zorro

  20. Pleb
    Posted July 1, 2013 at 10:51 am | Permalink

    In Kavos, Greece, if you go to A&E they charge you 50 euros, health card or not. Its a fixed fee for all.

  21. Malcolm Edward
    Posted July 1, 2013 at 11:56 am | Permalink

    Sounds a very sensible idea to me. Unfortunately sensible ideas have a poor record of being considered and enacted by government decision makers.
    I am sorry that being a sensible ideas man keeps you are on the back benches.

  22. Peter van Leeuwen
    Posted July 1, 2013 at 12:15 pm | Permalink

    I wonder if the many British visitors we’ve had over the years ever carried a European health insurance card like I do, at least they were surprised when I produced one, when needing something myself in Britain. We’ve never experienced any trouble for British visitors needing medical treatment here in the Netherlands and I doubt whether doctors here would even bother to chase up payments, unless of course it would be something major, requiring visiting a hospital.

  23. IndependentEngland
    Posted July 1, 2013 at 12:25 pm | Permalink

    I thought Jeremy Hunt was only responsible for the English NHS so why all this talk of the UK? Surely the Scottish Welsh and N.Irish Health Ministers are responsible for regulations in their respective nations?

  24. Lindsay McDougall
    Posted July 1, 2013 at 12:41 pm | Permalink

    This is good sense but enforcement is urgent, since its term is limited. By 2020, people will have fallen out of love with NHS. Any organisation that routinely covers up culpable deaths in its hospitals is beyond the point of no return. The NHS’s supposed virtue, that treatment is free at the point of consumption, is in fact its greatest vice. In the absence of any form of tax rebate for people who pay for private health care, the NHS is effectively a nasty Stalinist monopoly, run for the benefit of its staff.

    People who smoke too much, booze too much, eat too much and don’t exercise enough, should not expect other people to pay for their folly. What about the chronic sick and the elderly? Let GP groups and hospitals set up charitable trusts with good tax breaks. Then politicians can stay out of health care.

  25. Dexter
    Posted July 1, 2013 at 1:08 pm | Permalink

    As a retired GP it is my experience that a good proportion of overseas visitors and people with questionable residency status are seen as “temporary residents ” ,which gives NHS treatment for 3 months and is easily renewable. Therefore they do not need to fully “register”. GPs are very reluctant to query residency status for fears of accusations of “discrimination”.
    Practices are put under severe pressure by language schools ,hotels etc to see overseas patients on the NHS and threaten complaints etc if they do not do so. Why risk your career and the hassle?
    Another problem is overseas patients “dumped” in the UK when they get long term medical problems. I have seen this with chronic psychiatric problems, quadriplegia and HIV etc. They are usually patients from Africa , who come from all racial groups in countries such as Ghana, Zimbabwe, Kenya etc.
    I have even seen individuals seek “free” IVF treatment from developed countries.
    The other phenomenon I saw was bringing “granny” over for medical treatment for expensive conditions. I have seen this in patients from Iran, Somalia, Somaliland, and the Asian Subcontinent .It is very difficult confronting patients families about their relatives immigration status when they are in the consulting room. Doctors have to live and work in communities and are generally motivated to help individuals.
    Whenever I rang what was the PCT in my days, to query patient’s status and eligibility for NHS treatment ,no one was interested as they knew this whole area was a quagmire and a potential career “killer”.

  26. uanime5
    Posted July 1, 2013 at 1:19 pm | Permalink

    Maybe the UK should introduce a health card as well as this would make it easier to determine who could receive treatment in the UK.

    Before someone points out that an immigrant could use someone else’s health card I’d like to point out that there’s nothing stopping an immigrant using someone else’s GP information.

  27. Vanessa
    Posted July 1, 2013 at 1:21 pm | Permalink

    The NHS is a waste of time and money if you are not feeling well. I cannot get an appointment with my GP for TWO WEEKS. This is because there are so many “Europeans” (and muslims) with huge families all waiting in the “waiting” room that the doctors cannot see us. It is time it is broken up and hospitals etc. are put in the control of doctors and nurses. The levels of beaurocracy which swallow HUGE amounts of money with no good consequence must go. I have paid for this crap service for sixty odd years and I am not the one getting service, but those who have paid NOTHING now get priority.

    • uanime5
      Posted July 2, 2013 at 12:58 pm | Permalink

      Under the Conservatives’ NHS plans hospital budgets are effectively under the control of GPs (well the private companies the GP consortia hire to manage the budget).

  28. Leslie Singleton
    Posted July 1, 2013 at 4:42 pm | Permalink

    I am in favour of making non-nationals pay but I suggest do not underestimate what would need to be done at Receptions at GP Surgeries where at least a proportion of emergencies go. Receptionists already suffer grief from people who expect to be treated immediately or on time and don’t have the wit to realise that occasionally a Doctor is held up by patients with an urgent severe need or maybe the presenters do have an urgent need themselves. Are Receptions to be changed so that there is a Doctor always there to assess people demanding treatment and perhaps in pain? Also, it is one more thing for the Receptionists to have to worry about if they have to take money on deciding that a prospective patient has to pay. And there is the potential language problem in some areas. By no means a complete piece of cake.

  29. Bazman
    Posted July 1, 2013 at 7:36 pm | Permalink

    Maybe you could write a similar letter to George Osborne asking him what he intends to do about large companies and private individuals using out infrastructure and education system without paying adequate tolls for these services? Which would make the NHS bill shortfall look like small change. I won’t hold my breath..

  30. Bazman
    Posted July 1, 2013 at 7:59 pm | Permalink

    Like the chasing of absent fathers which ended up costing more than it raised. Would it be right to do this in the NHS or in any other area? Interesting to note that any taxation which produces a similar outcome produces screams of blue murder from the right and areas which clampdowns of tax avoidance produces revenue rightfully collected to spend on the state infrastructure produces silence. Ram it.

  31. JimF
    Posted July 1, 2013 at 8:39 pm | Permalink

    We control cars and car drivers better than we control human health and the NHS.

    If we don’t have a valid tax disc and insurance and drive, we are fined. Yet we can receive free healthcare by paying neither tax nor insurance.
    If our car doesn’t carry a valid MOT then our insurance becomes invalid. Yet we can continue to live without any health checks and receive free NHS treatment.

    • Vanessa
      Posted July 3, 2013 at 4:57 pm | Permalink

      Jim – You seem to forget that we who are born in this country pay a huge amount of tax for the National Health Service – it was called NI (National Insurance). It was meant to go to fund the NHS.

      It has cost all of us an enormous amount of money over our lifetime and you are proposing we pay twice for it now so the “world” can use it for free.

      It is certainly not free, this is a misunderstanding; it is only free at the point of need.

  32. Pleb
    Posted July 2, 2013 at 1:04 am | Permalink

    Another comment not published?

  33. Janice Mathew
    Posted July 3, 2013 at 6:52 am | Permalink

    At long last something is being done about immigrants paying for their health care, however this should be for all people from other parts of the world not just from people from countries in the EU. Members of the EU have not paid into the health system like ordinary British people have, we have thousands and going to get thousands more people entering Great Britain form EC countries, they should also be made to pay for health treatment.
    Yours sincerely

  34. sm
    Posted July 3, 2013 at 11:41 am | Permalink

    If the NHS managers were incentivised and or penalized the collection of data when foreign nationals are treated might happen.

    For example they could be mandatorily re-imbursed by the dept for overseas aid where the spend is identified correctly and managers/GP’s penalized when the data is not collected. The relevant deductions could be made against each countries aid budget or netted off the EU contribution.

    The data collected could then be used to direct efforts, to reduce the problem at source. Both countries may then have an incentive to co-operate and seek better solutions and use of the local aid budget perhaps even co-funding a locally ran NHS hospital in the relevant country.

  • About John Redwood


    John Redwood won a free place at Kent College, Canterbury, and graduated from Magdalen College Oxford. He is a Distinguished fellow of All Souls, Oxford. A businessman by background, he has set up an investment management business, was both executive and non executive chairman of a quoted industrial PLC, and chaired a manufacturing company with factories in Birmingham, Chicago, India and China. He is the MP for Wokingham, first elected in 1987.

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