By Robert Campbell

“Health Tourism costs the NHS in the region of £200 million pounds or 0.3% of the NHS budget each year.”

The NHS’ rules about accepting and seeing patients, no matter what their place of origin or permanent residence, have become more relaxed over the years. In fact, NHS service providers don’t usually think to check a patient’s credentials. But should we be doing this?

Health tourists

Nowadays there are many NHS users who are not UK residents; they have simply arrived in this country to obtain healthcare. It is a well-known fact that some expectant mothers who are foreign nationals come to this country to give birth. Membership of the EU has made such events even more common. Without wanting to be discriminatory in any way, we must look at the cost of this to the NHS, as it is said to be £200 million per year.

Examples of proof of identity

Two forms of identity?

Nowadays, you may be asked to prove your residency and offer a variety of forms of proof of entitlement to NHS treatment. Thirty years ago many people had a NHS medical card. Then if a patient’s credentials were in doubt, the medical card could be used to obtain GP care, particularly by patients residing here temporarily.  But sadly an FP4 medical card is no longer automatically issued. Yet the NHS number, which has changed its format several times, contained on it has become more and more central to patient record-keeping in the NHS.

How many UK residents hold a passport?

“Of the 56.1 million usually resident population of England and Wales in 2011, 76% (42.5million) held a UK passport, and 7.4% (4.2 million) held a foreign passport only (of which 372,000 were Irish passports). There were 17% (9.5 million) who stated they did not hold a passport.” (the Office of National Statistics)

The suggestion that patients present their passports when attending for hospital treatment and care has met with a damning reaction from the BMA as there is no guarantee that all UK residents will have one. Also, passports have a long lifespan and the address might not be accurate, let alone proof of a continuing residency in the UK.

NHS smart cards et al

It’s not that easy to provide a second form of identity. If you’re not the owner or bill payer in a household, you may find it difficult to provide your own evidence of residency. A young worker living at home with parents may only have a mobile telephone invoice but of course mobile phone bills are not accepted as evidence.

How many people are employed in the NHS?

“The NHS in England is the biggest part of the system by far, catering to a population of 54.3 million and employing around 1.2 million people. Of those, the clinically qualified staff include 150,273 doctors, 40,584 general practitioners (GPs), 314,966 nurses and health visitors, 18,862 ambulance staff, and 111,127 hospital and community health service (HCHS) medical and dental staff.” (NHS Choices)

For NHS staff, who are holders of an NHS smart card you could argue that you have already provided sufficient evidence to entitle you to NHS treatment. But the idea of providing evidence of identity, whatever form it takes, is still flawed. I could mention the European Health Card issued in the UK for UK residents to travel in Europe and obtain treatments. I could mention the various identity cards that people carry to prove employment. The list is endless. But of course a form of identity is only correct at the time it is issued. So maybe the ‘powers that be’ need to think again. Perhaps we need to reintroduce, at great cost, the medical card or a national identity card with a photo? Or should we just simply write off the expense of health tourists?

Whatever the answer, as long as your address and NHS number can be traced and an NHS number found, you should receive NHS care.