Doctors have called charging foreign patients for medical treatment on the NHS “racist” at an annual conference run by the British Medical Association in Belfast earlier this week. In total, 500 delegates at the conference were in support of withdrawing charges for foreign patients or tourists.
Currently, if an individual has a life-threatening condition, they will not be not be denied treatment to stabilise them, though if a patient’s condition is not an emergency, treatment can be postponed until funds for charges can be produced. If the charges cannot be met, the appropriate treatment will be denied.
EU citizens can still qualify for free treatment on the NHS, if they hold a European Health Insurance Card (EHIC) or have evidence of being a UK resident for at least six months.
Dr Jackie Applebee, who headed the motion at the BMA conference, stated, “Determining eligibility for free NHS care will inevitably lead to racial profiling…if the sheep are to be separated from the goats, both must be classified. What began as an attempt to keep the health service for ourselves would end by being a nuisance to everybody.”
She added that charging is “not only harmful for those who are charged” and holds “public health implications for us all and introducing charging for some makes it easier to extend charging to the rest of us.”
Dr Omar Risk highlighted the ethical dilemma of charging foreign patients to use NHS services by asserting doctors are not “border guards” and that to do so would be to engage in a “fundamentally racist endeavour.”
Opposition to Free NHS Services for Foreign Patients
Nonetheless, some doctors opposed the motion, due to the current pressure on the NHS from staff shortages and a lack of funding in specific sectors.
Our feature on the NHS Crisis highlighted how last year alone in 2018, over a half a million patients were forced to find a new GP following the closure of an estimated 140 surgeries. Furthermore, with a drop of 444 fully qualified, permanent GPs in 2018 and a disproportionate number of GPs working beyond the safe age limit, can we afford to drop charges for foreign patients– a vital form of funding for the NHS?
A 2013 study published by PLOS One examined 28 hospitals, of which 18 were able to provide sufficient data on the income generated through non-UK resident patients and private non-UK resident patients. The findings illustrated a combined income from private patients of £195 million across a period of 12 months between 2010-2011 – in fact 25 percent of the total private income for these 18 hospitals was acquired through medical tourism. But a more recent study in 2018 showed that of 8,900 checks on NHS ‘health tourists’, just 50 were found to be liable to pay.
Tory MPs voiced disagreement over the proposal to scrap charges for foreign patients – Conservative MP Andrew Percy going so far as to suggest those delegates in favour of motion should pay for the treatment of foreign patients themselves. He emphasised services should be reserved exclusively for those residing permanently in the UK and contributing towards the NHS via taxes.
Another Conservative MP, Phillip Hollobone, declared the BMA to be “completely out of touch with public opinion.” Mr. Hollobone attempted to debunk the notion of charges to foreign patients being racist, stressing, “Every pound spent treating health tourists is a pound not spend on British citizens.”
Are We the Bigger Spenders?
Contrary to popular reports of the UK being one of the largest importers of patients, we Brits are in actual fact one of the biggest net exporters of medical tourism. PLOS One’s study also demonstrated that in 2010, an estimated 63,000 UK citizens took the decision to travel abroad for treatment, while 52,000 overseas patients sought treatment in the UK.
If medical tourism does play a significant role in NHS income, perhaps the BMA’s opposition to charging on whatever grounds is short-sighted. It could be argued that with increasing staff shortages and closure of GP practices due to under-resourcing, it is imperative now more than ever to retain medical charges for foreign patients as a vital part of maintaining NHS funding. If the shift to free medical charges for foreign patients is installed, as MP Andrew Percy commented, should the doctors who agreed with the motion have a stake in footing the bill to the NHS?