Passports, Please!

It’s been suggested (again) that patients accessing the NHS should have to produce a passport before being allowed treatment in order to put an end to health tourism at the expense of the British taxpayers who fund the system.

Obviously, there’s a major flaw in this train of thought – the problem with abuse by overseas visitors of the NHS has little to do with them and much to do with the incompetence of the NHS authorities and government. Of course, given that people know the system is flawed, foreigners are encouraged to take advantage, but penalising everyone isn’t the answer. We regularly hear stories of foreign visitors who have accessed NHS services and attempted to pay or provide insurance details only to be fobbed off by the NHS on the grounds that processing, let alone pursuing, payment is more bother than its worth. Likewise, there is little or no action by the government to get payment from foreign governments. Strangely, other countries seem to have no problem requiring British citizens to pay or be insured.

The suggestion is that by requiring everyone to produce a passport, it will be clear who is entitled to free treatment and who must pay. Assuming the NHS can administer such a policy any better than it administers anything else at present. The obvious problem is that a lot of Britons don’t have passports – if you’re poor and have no reason to travel, you don’t need one. Go with this suggestion and a lot of Britons entitled to free treatment, those most in need of it, will be denied any treatment because they won’t be able to prove they’re British (meanwhile, the hardcore of fraudsters will doubtless use false passports to abuse the system).

“Buy a passport, then,” proponents will say. Because poor people have the money to spend on something they don’t otherwise need to prove they are entitled to something they’re already entitled to? “Well, let’s introduce identity cards.” What a surprise – another attempt to introduce compulsory ID! Just sign away some of your rights and privacy to access the treatment you’ve already paid for… great idea!

NHS cards already exist and could be pressed into service, except they risk becoming the first step towards identity cards.

The sensible option would be to introduce a system that ensures foreigners using the NHS pay for their treatment (well, at least a nominal fee, if not the full costs). It would be possible to require anyone entering the country to pay a bond that would be refundable if they didn’t use the NHS. Everyone using the NHS could have their fingerprint checked against the database of those who have entered the country – Britons wouldn’t be on the system and so would be exempt payment, while foreigners would have the cost docked from their bond. However, although British fingerprints wouldn’t be retained in my approach, there’s a possibility that they could be and I wouldn’t favour it.

Alternatively, they could be required to pay an additional non-refundable visa fee allowing everyone entering the country to access the NHS for free (obviously some people would receive more treatment than the amount, but this would be offset by those who make no use of it).

But, whatever approach we take, it must not compromise the notion of the NHS as free at the point of use nor require Britons to compromise their rights and privacy, nor inconvenience them. Nor must it make it difficult for those visitors to the UK who genuinely need medical treatment to access it when needed.


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