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How the Spectator blew the whistle on the International Health Service

3 July 2013

At Prime Minister’s Questions today, backbencher Philip Lee ambushed David Cameron on the subject of health tourism. He asked:

‘As a doctor who once had to listen incredulously to a patient explain, via a translator, that she only discovered she was nine months’ pregnant on arrival at terminal 3 at Heathrow, I was pleased to hear the statement from the Secretary of State for Health today on health tourism. Does the Prime Minister agree that although the savings are modest, the principle matters? The health service should be national, not international.’

The Prime Minister replied:

‘My hon. Friend makes a very important point. This is a national health service, not an international health service. British families pay about £5,000 a year in taxes for our NHS. It is right to ensure that those people who do not have a right to use our NHS are properly charged for it. We have made this announcement, and I hoped that there would be all-party support for it, but Labour’s public health Minister has condemned it as “xenophobic”, so I assume that Labour will oppose this sensible change that working people in this country will roundly support.’

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In describing an ‘international health service’, both speakers were echoing J. Meirion Thomas’ Spectator piece in February in which the consultant surgeon spoke of his frustration with the number of patients who, in spite of being ineligible for free care, fell through the net anyhow. Shortly afterwards, the government started making noises about cracking down on health tourism, and this week ministers launched a public consultation on charging migrants £200 a year for using the NHS. In February, the Spectator called health tourism the ‘next NHS scandal’. As ever, this magazine was ahead of Number 10.

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Show comments
  • Ron Todd

    NHS is a non commercial organisation. However money is moved around internally in the end it all comes from the taxpayer. Public sector managers are often of a liberal/left inclination and likely to care more for the well being of foreigners that for the well being financial or medical of white native British.

    I would be very surprised if Cameron or even a future Tory PM if we ever get such a thing will greatly reduce health tourism without a total restructuring of the NHS.

    • HookesLaw

      Huge assumptions all round.
      Managers will follow whatever rules are set
      UK citizens do not pay for health treatment in the EU

  • GnosticBrian

    If Cameron wants to get the BMA on board he should allow Doctors to charge non-EU citizens at the point of delivery and to keep half of the money involved. We would hear no more complaints.

    • Alexsandr

      no need. GP’s are paid per patient on their books and extra for treating patients not registered. If they cant prove their patients are entitled, then they don’t get paid. Same for hospitals.

      • GnosticBrian

        But the capitation amount is relatively modest. Make the charge for non-EU patients, say, £200 per GP visit plus all medicines etc at a 100% mark up and allow GPs to keep half. The non-EU patient would have to pay (cash or card) the GP practice; the GP passes on half to the NHS. A nice earner for GPs and a disincentive for health tourists.

        • Alexsandr

          and the NHS should reclaim treatment costs from other EU countries for treatment of their nationals, as I believe is allowed by the rules. Seems the NHS hasnt been bothering. But the foreigners have been claiming from the NHS

  • Magnolia

    Commenters can also reinforce the message.
    Since we are blowing our own trumpets, I mentioned this topic in a comment back on June 16th.
    Perhaps a minion read moi?
    Lots and lots of Russian sounding names on gynae biopsies.
    I wonder just how much of below the line life is really understood or even noticed by those ‘above’ us.

  • telemachus

    So Speccie will be responsible for all the abuse and personal safety fears now to be experienced by doctor’s receptionists
    These columns now need to ensure that smug Hunt does not let this happen

    • Alexsandr

      doctors and their staff are paid for by the state. If they cant prove their patients are entitled then they dont get paid. Lets see how much free work they will end up doing.

      • telemachus

        What about their duty to treat
        You do not seem to care about the poor
        And now you decry the sick

        • Alexsandr

          No, they can treat the sick. And the sick pay. Same as we do through our taxes. Only foreign sick have to pay cash or have insurance, Remember, emergency treatment is still to be provided free of charge.

        • David B

          If you fall ill in a forign country you will have to pay or provide proof of insurances. Why should we be different.

        • rubyduck

          “What about their duty to treat”

          It’s their duty to treat. It’s not my duty to pay for it.

          • telemachus

            Buy the structure to make them pay in our free health service
            Do not subject hard pressed GP staff to abuse as smug Hunt seems to want

  • Dogsnob

    So, despite the ‘crackdown’, migrants will be charged just £200 to avail themselves of potentially thousands of pounds worth of UK taxpayers funding.

    Still makes the plane ticket to Heathrow look like a good buy for anyone, anywhere who suddenly finds they need prolonged treatment.

    It remains – as I have said way before the Spectator blanket throwers – the International Health Service.

  • HookesLaw

    I am sure the Spectator is an up to the minute publication but it hardly takes much searching to show that the Daily Mail (to name just one) was banging on about health tourism in 2012, if not before.
    (the article wheels out the old pregnant mother story again. They are popular in this context)

    Any road up, there hardly seems much evidence of the Spectator driving govt policy.
    I think for the moment I will keep the pound in my pocket.

  • colliemum

    Didn’t airlines refuse to carry ladies in their last trimester of pregnancy? what happened to that? or is it nowadays discriminatory to refuse those ladies, even if they might give birth right in the plane, during the flight?
    Puzzled ….

  • Ray Veysey

    Valid insurance to be shown and verified to the border control or no entry. Insurance to be valid for duration of visit or no entry, Valid address for duration of visit or no entry, All these laws to be clearly promulgated to passengers before boarding aircraft to UK, if not airline not allowed to land. Aircraft carrying non compliant passengers impounded. Airline operators always responsible for their passengers compliance with laws at point of entry to any country, but from our point of view especially the UK.

    • Martin Adamson

      Not even that. Make the airlines responsible for verifying the possession of certificates at check-in. If the passenger lands at Heathrow without the certificates, then straight back to port of embarkation at the airline’s expense. Airlines which are persistent non-compliers lose landing slots. When I used to travel to Singapore in the 1970s and 1980s, you were not allowed on the plane if you did not have a certificate showing recent immunisation against a range of diseases.

    • Dan Grover

      How can you make someone that plans to live in the UK show valid insurance for “indefinite” periods of time?

      • Ray Veysey

        They will arrive with somewhere to go and a job in place, and therefore a visa, assuming it is a normal UK paye type job they will then, I assume join the system.

        • Dan Grover

          But they won’t have insurance! Won’t they be turned away?

          • Tim Reed

            If they don’t meet the requirments they shouldn’t be allowed here in the first place. It shouldn’t be left to the NHS to turn them away, that should be the job of whatever immigration services we have left.

            • Dan Grover

              We were talking about at the airport, Tim.

              • Tim Reed

                My mistake, Dan.

          • Ray Veysey

            I don’t know the fine details Dan, but I am assuming that if they have a visa sponsored by an employer then this should cover Insurance as well, as part of any contract they have. It does strike me that anyone who is coming here to work with a sponsored visa will be fit for work.

            • Dan Grover

              True enough!

      • itdoesntaddup

        An answer is that anyone who is coming here intending to secure indefinite leave to remain is supposed to live without recourse to public funds for their first year pending approval. Therefore a year’s insurance would be required up front. Once ILR is granted (presumably because they or their sponsor is paying taxes) they can have full NHS support as part of the deal. Those on assignments without ILR would have to show insurance as part of their UK tax return.

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