Government rules require Health Service to charge destitute people

nhsA QARN member writes: A destitute asylum seekers came into our project today with an invoice from a hospital for outpatient attendances with a letter that says “the above account will be referred to our debt collecting agency if payment is not made within the next seven days. This is because of new government guidance issued sometime this year:

Guidance on implementing the overseas visitor hospital charging regulations 2015

Although ‘GPs have discretion to accept any person, including overseas visitors, to be either fully registered as a measure of an NHS patient, or as a temporary resident if they are to be in an area for between 24 hours and three months. No registration application can be refused on the grounds of race, gender, class, age, religion, sexual orientation, appearance, diversity or medical condition. In reality, this means that the practice’s discretion to refuse a patient is limited. There is no minimum period that a person needs to have been in the UK before a GP can register them. Furthermore, GPs have a duty to provide free of charge treatment which they consider to be immediately necessary or emergency, regardless of whether that person is an overseas visitor or registered with that practice.’

However  these Hospital Charging Regulations  now  place a legal obligation on NHS trusts, NHS foundation trusts and Local Authorities in the exercise of public health functions in England, to establish whether a person is an overseas visitor to whom charges apply, or whether they are exempt from charges. When charges apply, a relevant NHS body must make and recover charges from the person liable to pay for the NHS services provided to the overseas visitor. This would seem to apply even to destitute asylum seekers, even though those trying to recover the money are aware that there is little or no chance to recover the charges and in fact, they are likely to incur additional administrative and legal costs.