Upfront charges for overseas visitors using NHS services have come into force, despite doctors being unclear how the new regime will work.
From today trusts in England will be required to determine whether patients are eligible to free, non-urgent forms of care, and ensure that charges are applied to international patients who do not qualify.
BMA council chair Chaand Nagpaul said it was vital that patients in urgent need of care weren’t deterred from seeking treatment.
He added that many trusts and doctors were uncertain as to implications of the new requirements, and warned against placing further demands on already hard-pressed frontline medical staff.
He said: ‘It is important that those accessing NHS services are eligible to do so, especially at a time when the NHS is under intense pressure and struggling to cope with patient demand.
‘However, the current charging proposals lack clarity around how and when overseas patients should be charged which does run the risk of causing confusion and an additional administrative burden within NHS trusts.
‘It is vital that patients do not face bureaucratic or financial obstacles that prevent acutely sick and vulnerable individuals from seeking necessary treatment. This would be morally unacceptable and could end up costing the NHS more money due to lack of timely treatment.’
Updates to Department of Health guidance published this month states that employers are responsible for ensuring staffed are appropriately trained in understanding and implementing upfront charging.
It says: ‘It is the clinician’s role to provide appropriate healthcare for their patients and to make decisions on their treatment based on their clinical needs … clinicians will at times, however, be required to make a decision on whether treatment is urgent or immediately necessary for those patients identified as not eligible for NHS funded care.
‘This action is critical in ensuring that only those patients who are eligible receive free care. At a time of increased financial challenge for the NHS, every organisation needs to ensure they’re meeting their legal obligation and maximising the cost recovery potential.’
Plans to introduce upfront charges for overseas patients seeking non-urgent medical treatment has been a long-standing aim of the Government as a means of recovering much-needed funds for the health service.
The BMA has pointed out, however, that even if the full projection of £500m were recovered, this sum would equate to only 0.3 per cent of the NHS budget, and would fail to sufficiently address current funding deficits.
Meanwhile, an impact assessment published in July this year ruled that implementing the changes would incur an estimated £40m in costs over a 10-year period.
The assessment adds that while the majority of this charge will result from increased administrative work related to the recording and billing of patients, it insists that ‘no new burden will be placed on clinical staff’.
The association has also expressed concerns about how the charging system might influence patient behaviour, effectively dissuading some patients from seeking out care.
Earlier this month the BMA's public health committee warned that applying charges to overseas patients was one of a number of factors that could potentially undermine wider public health initiatives, such as the elimination of contagious disease.
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