Overseas visitors and free NHS care

BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g1323 (Published 03 February 2014) Cite this as: BMJ 2014;348:g1323
  1. Julian Sheather, deputy head of ethics,
  2. Martin Davies, senior ethics adviser
  1. 1Ethics Department, BMA, London WC1H 9JP, UK
  1. JSheather{at}bma.org.uk

Doctors are providers of healthcare, not immigration officers

In December 2013, the Department of Health published its latest plans to reform access to the NHS by overseas visitors in England.1 Together with the introduction of a health surcharge for temporary migrants from the non-European Economic Area (EEA), access to NHS treatment by visitors, working migrants, and undocumented migrants is set to change.

Several drivers are at work—the current system is seen as too complex, too inefficient, and far too easily abused. There are high profile accusations that migrants set out systematically to defraud the NHS.2 The changes are also taking place in an atmosphere of heightened anxiety around immigration. Attitudes are hardening, with calls for ever tighter immigration controls growing louder.

Decisions about entitlement to public goods and services are political and, therefore, ultimately a matter for parliament. The question of what obligations a wealthy state owes to non-citizens, both within and outside its borders, is a challenging and urgent moral one, but not one primarily for health professionals to answer. A raft of practical and administrative problems will need …

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