Department of Health and Social Care
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News Release issued by the Government News Network on 20 July 2009

- Department of Health and Home Office publish joint review findings-

A joint Department of Health and Home Office review group has published its findings on a review into access to the NHS by foreign nationals, Health Minister Ann Keen announced today.

The review, launched in 2007, set out to examine the rules on charging non-UK residents for access to NHS services in England. The government has concluded that there should not be any significant change for either primary or secondary care.

The government has now agreed on a number of proposals, which will be consulted on in the autumn:

Asylum seekers whose claim has been refused but who are being supported because there are recognised barriers to their return home should be exempt from charges;Unaccompanied children, including those in local authority care, should be exempt from charges;UK residents may be absent from the country for up to six months in a year before being considered for charges for NHS hospital treatment;Working with the UK Border Agency to recover money owed to the NHS and exploring options to amend the Immigration Rules so that visitors will normally be refused permission to enter or remain in the United Kingdom if they have significant debts to the NHS; andInvestigating the longer-term feasibility of introducing health insurance requirements for visitors.

Health Minister, Ann Keen said:

“These changes will support a clearer and fairer system of access to free NHS services that will maintain the confidence of the public and prevent inappropriate access while maintaining our commitment to human rights.

“These measures strike the right balance between controlled access, the protection and promotion of wider public health, and ensuring that the healthcare needs of the most vulnerable groups are protected.

“We remain firmly committed to the requirement that immediately necessary or other urgent treatment should never be denied or delayed from those that require it.”

The proposed changes will be put to public consultation in the autumn. The Department of Health and the Home Office will undertake separate consultations on their respective areas of responsibility, which will be linked and coordinated. Subject to the outcome of the consultation, changes will take effect as soon as possible in 2010.


1. The main recommendations from the joint review are as follows:

i. To maintain the position that immediately necessary and urgent medical treatment should never be withheld, treatment in Accident & Emergency departments remains free, and no charge is made for treatment for specified infectious diseases;

ii. To maintain General Practitioner (GP) discretion to determine registration to access free NHS primary medical care services along with the established principle that GPs may charge non-residents as private patients;

iii. To maintain the system of charging non-residents for secondary care services, including for most failed asylum seekers, but to introduce a new exemption from NHS charges for unaccompanied asylum seeking minors, including those in local authority care, and those failed asylum seekers who are in receipt of UK Border Agency support (Section 4 or 95) on the grounds they have children or face recognised barriers to return to their home countries;

iv. To introduce a new exemption from NHS charges for unaccompanied minors, including asylum seeking minors, and those in local authority care, but to hold parents liable for NHS charges incurred by dependent minors;

v. To amend the period of absence for current residents that is disregarded for the purpose of determining continued eligibility for free NHS hospital treatment in England from 3 to 6 months;

vi. To maintain the existing position that maternity treatment for non-residents is chargeable under the regulations, notwithstanding the requirement never to deny or delay such treatment pending payment;

vii. To commission additional research on the current policy to charge for HIV treatment beyond the initial diagnosis and counselling;

viii. To take joint action between the NHS in England and UK Border Agency to recover NHS debts from those foreign nationals who refuse to pay for treatment. We will create a single point of contact within the NHS in England to supply the UK Border Agency with data on persons subject to immigration control who have significant un-discharged debts to the NHS; and

ix. To consult further on the feasibility and merits of introducing a mandatory health insurance requirement for certain non-residents at a future date.

2. A full public consultation document will be launched in the autumn.

For media enquiries only call the Department of Health press office on tel: 020 7210 5221

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