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Proof of ID may be needed for NHS care, says health chief Proof of ID may be needed for NHS care, says health chief
(about 2 hours later)
Patients could have to show proof of identity to get some NHS care, the senior civil servant at the Department of Health has said. Patients could have to show two forms of identification to get some NHS care, the senior civil servant at the Department of Health has said.
Chris Wormald told a Commons committee it was a controversial move but already happened in some NHS trusts.Chris Wormald told a Commons committee it was a controversial move but already happened in some NHS trusts.
The NHS has "a lot further to go" in reclaiming money for treating foreign visitors, he said.The NHS has "a lot further to go" in reclaiming money for treating foreign visitors, he said.
Committee chairwoman Meg Hillier raised concerns that some British residents might not have passports or other ID.Committee chairwoman Meg Hillier raised concerns that some British residents might not have passports or other ID.
Head of the BMA council Dr Mark Porter said the discussions were a distraction given that health tourism was "such a small problem" for the NHS.
NHS Trusts in England are legally obliged to check whether patients are eligible for free non-emergency NHS treatment and to recover any costs from overseas patients.
But this does not always happen.
The National Audit Office report estimates that only half of debts were recovered from patients from outside the European Economic Area (EEA) and only 58% of hospital doctors know that some people are chargeable for NHS healthcare.
Estimates from 2015-16 suggest £500m should have been charged to foreign patients - but only £289m was collected.
St George's Hospital in Tooting, south London, is currently running a pilot scheme to test new proof of ID processes to recoup costs from pregnant overseas patients.
'Big difference''Big difference'
Mr Wormald, permanent secretary at the Department of Health, which is responsible for the NHS in England, told the Public Accounts Committee: "We have some trusts that are looking at asking for two forms of ID before treatment.Mr Wormald, permanent secretary at the Department of Health, which is responsible for the NHS in England, told the Public Accounts Committee: "We have some trusts that are looking at asking for two forms of ID before treatment.
"Now that is obviously quite a controversial thing to do but... those are the kinds of things we want to look at."Now that is obviously quite a controversial thing to do but... those are the kinds of things we want to look at.
"We don't have evaluated results of those yet, but what those trusts are reporting is that does lead to an increase in identification.""We don't have evaluated results of those yet, but what those trusts are reporting is that does lead to an increase in identification."
He added: "There are individual trusts like Peterborough who are doing that, who are reporting that it makes a big difference and there you are saying 'Please come with two forms of identity, your passport and your address' and they use that to check whether people are eligible or not.He added: "There are individual trusts like Peterborough who are doing that, who are reporting that it makes a big difference and there you are saying 'Please come with two forms of identity, your passport and your address' and they use that to check whether people are eligible or not.
"Now it is obviously quite a controversial thing to do to say to the entire population 'You now have to prove identity'.""Now it is obviously quite a controversial thing to do to say to the entire population 'You now have to prove identity'."
Ms Hillier said she had constituents who had no photo ID. But Ms Hillier said she had constituents who had no photo ID.
She said: "Because they have never travelled they have no passport; they have no driver's licence because they have never driven, they still live at home because they can't afford to move out so they've never had a utility bill in their name.She said: "Because they have never travelled they have no passport; they have no driver's licence because they have never driven, they still live at home because they can't afford to move out so they've never had a utility bill in their name.
"Perfectly entitled to health care, British born, British resident; how are you going to make sure that people have access easily to the National Health Service without having to go through a very humiliating and impossible to meet set of demands?""Perfectly entitled to health care, British born, British resident; how are you going to make sure that people have access easily to the National Health Service without having to go through a very humiliating and impossible to meet set of demands?"
Mr Wormald responded: "This is why we are going very slowly on some of these questions and individual trusts are trying these out."Mr Wormald responded: "This is why we are going very slowly on some of these questions and individual trusts are trying these out."
Visitors from the European Economic Area (the EU plus Iceland, Liechtenstein and Norway) are usually covered by agreements under which their home country pays for treatment. Dr Porter told BBC Radio 4's Today programme: "Why are we discussing this today? We've got an Autumn Statement tomorrow, we've got an NHS with a deficit approaching 100 times [the cost to the NHS of health tourism] opening up over the course of this Parliament because of the funding decisions taken about how to address resources in the NHS.
But the committee heard that according to official figures released earlier this year, in 2014-15 £674 million was charged to the UK government for the care of British citizens abroad, but the amount charged for the care of EEA nationals in British hospitals was only £49m. "This is little other than a pin prick on the top of the actual problems facing the NHS."
Last month the Department of Health said: "NHS Trusts and Foundation Trusts in England are legally obliged to check whether patients are eligible for non-emergency NHS treatment free at the point of use, and recover costs from the overseas patients who are not normally resident in the UK where charges apply." A Department of Health spokesman said: "The NHS is a national - not an international - health service and we are determined to stamp out abuse of the system to ensure it remains free at the point of need in this country.
St George's Hospital in Tooting, South London, is currently running a pilot scheme to test new processes to recoup costs from pregnant overseas patients. "We consulted earlier this year on extending the charging of migrants and visitors using the NHS. We will set out further steps in due course."
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