GP leaders have declared their continued opposition to being required to levy charges on overseas visitors – as NHS hospitals in England introduced an up-front charging system.

Many NHS managers and senior doctors have expressed concern about the rules, which require NHS staff to establish patient residency and levy charges before admission to hospital.

A published list of prices shows how non-European patients will face an extra levy. A patient from a country such as Norway, which is in the European Economic Area but not the EU, would be charged £10,000 for spinal surgery. Patents from outside Europe would be charged £15,000 for the same procedure.

The list suggests a price of £3,188 for a cardiology procedure but does not indicate a price for cardiac surgery.

Under the rules, patients seeking admission could be asked 32 questions to establish residency and may also have to produce a range of documents.

The British Medical Association said it was surprised that rules had been issued without consultation.

Chair Dr Chaand Nagpaul said: “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.”

The Royal College of GPs said it would continue to resist the application of rules to GP surgeries.

Chair Professor Helen Stokes-Lampard said: “We recognise that the NHS must not be abused and measures need to be taken to tackle health tourism – but it should not be the role of doctors or other healthcare professionals to police this.

“Whilst the charges being introduced will not be applicable to general practice services, we have concerns about the unintended consequences of increasing demand on GPs and our teams from patients who are unable to get free treatment in secondary care.”

Health Minister Lord O’Shaughnessy said: “We have no problem with overseas visitors using our NHS as long as they make a fair financial contribution, just as the British taxpayer does.

“The new regulations simply require NHS bodies to make enquiries about, and then charge, those who aren’t entitled to free NHS care. All the money raised goes back into funding and improving care for NHS patients.”