Eligibility of non-residents for NHS treatment: Eligibility for HIV treatment needs special consideration

doi:10.1136/bmj.329.7467.684-a

BMJ 2004;329:684 (18 September), doi:10.1136/bmj.329.7467.684-a

Letter

Eligibility of non-residents for NHS treatment

Eligibility for HIV treatment needs special consideration

The first 150 words of the full text of this article appear below.

EDITOR—We agree with Pollard and Savulescu that the newguidelines directed towards recovering costs for HIV from overseasvisitors are not only unethical but also could lead to an escalationof new cases in the United Kingdom by failing to treat highlyinfectious cases with advanced immunosuppression.¹

In this hospital most new HIV cases present with low CD4 cellcounts and medical complications that usually require urgenttreatment. These patients invariably have minimal financialresources. Pre-test HIV discussion with these people at highrisk includes treatment issues and the likelihood that highlyactive antiretroviral treatment (HAART) will be recommended,if not immediately then in the near future. If the guidelinesare to be implemented this discussion will have to include theinformation that the government will seek to recover medicalcosts from patients who may be extremely ill with conditionscausing respiratory distress, such as Pneumocystis carinii pneumonia. . . [Full text of this article]

Nigel O'Farrell, consultant physician

Nigel.O'Farrell@eht.nhs.uk

Stephen Ash, consultant physician, Paul Fox, consultant physician, William Lynn, consultant physician

Pasteur Suite, Ealing Hospital, London UB1 3HW

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Relevant Article

Eligibility of overseas visitors and people of uncertain residential status for NHS treatment: Andrew J Pollard and Julian Savulescu
BMJ 2004 329: 346-349. [Extract] [Full Text] [PDF]