Foreigners may be barred from seeking free NHS help

Patients with foreign accents may be vetted before receiving free NHS treatment as part of a Government clampdown on "health tourism", it was announced yesterday.

Failed asylum-seekers and foreign business travellers are among those who will no longer be able to receive free treatment in a bid to stem a flood of abuses of the system. Patients may also be requested to produce documentation - ranging from passports to council tax paybooks - to ensure that they are eligible for free health care.

John Hutton, a Health minister, unveiled the proposals as part of a clampdown on "abuses" of the health system, which the Government says cost an estimated £200m every year.

Opposition leaders and medical professionals raised fears that vulnerable people would be denied vital treatment and questioned the implementation of such a policy.

The changes, which will come into force in April, will close loopholes that have previously enabled overseas visitors with no substantive link to the UK to have treatment on the NHS. Under the rules, heavily pregnant women who have relatives permanently residing in the UK will be prevented from arriving in the country to give birth.

Failed asylum-seekers and others who have no legal right to be in the country will not be able to receive free treatment for illnesses that arise after their legal status has been determined. Others who lose their right to free medical care include business travellers and their families who fall ill or are injured during their stay.

While the proposals aim to reduce the number of people who illegally seek free medical care, Mr Hutton stressed that any life-saving treatment would not be delayed if there were doubts over their eligibility.

"The NHS is there to provide free treatment for those who live here, not those who don't," he said. "It is a national health service, not an international service. Irrespective of the financial scale of abuse, it is important we establish a closer link between free use of the NHS and residency in the UK.

"NHS staff have told us what abuses are occurring and what rule changes they would like made. We have listened to them and we are making those changes so that the NHS is no longer taken for a ride."

Gill Morgan, chief executive of the NHS Confederation, welcomed the measures and said the burden from health tourism was "quite significant" in some areas. "The issue here is tightening up the rules for more discretionary treatment, care which people have a choice about where and when it is provided," she told BBC Radio 4's The World At One programme.

Mr Hutton emphasised that the burden of responsibility in making sure people qualified for treatment should lie with NHS managers as opposed to doctors and nurses.

Medical organisations expressed concern about the implications of the enforcement of the proposals and the effects on medical staff. Dr Edwin Borman, chairman of the British Medical Association's international committee, said doctors wanted to work with the Government to minimise fraud within the NHS.

"As a fundamental principle we support the introduction of appropriate measures to stop the deliberate abuse of NHS resources," Dr Borman said. "However, it is not the role of doctors to be the agents of the state in policing eligibility for healthcare. We are particularly concerned about the health of failed asylum-seekers awaiting deportation.

"These people have no access to money and it would be totally unjustifiable to leave them suffering from chronic illnesses ... It is essential that doctors do not become involved in determining the immigration status of patients to assess eligibility for healthcare."

The proposals were also likely to raise serious "ethical dilemmas" among medical staff, said Tim Yeo, the Conservatives health spokesman. "Any attempt to address the problem of health tourism must involve three things," he said.

"Firstly, they must consult with family doctors about how to prevent people not entitled to free NHS treatment from registering as patients. Secondly, they must consult with immigration authorities screening potential immigrants and asylum-seekers for HIV/Aids and TB. Thirdly, awareness must be raised abroad that not everyone who comes to Britain is automatically entitled to free treatment for non-emergency conditions."