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Access to NHS hospital treatment for overseas visitors

  • Last modified date:
    27 January 2011

Entitlement to free NHS hospital treatment is dependent on being 'ordinarily resident' in the UK, which means, broadly, currently living here on a lawful and settled basis. Entitlement is not linked to nationality or the past or present payment of UK taxes or national insurance contributions.

The NHS is a residency-based healthcare system.  Services are available free of charge to anyone living legally and on a settled basis in the UK. There are also a number of exemption categories:

 

  • People who have lived in the UK for ten continuous years and who are currently working abroad, but have been doing so for five years or less.

 

  • Anyone who is working for a UK-based company, or self-employed people whose principal business is in the UK. 

 

  • Students on a full time course that is at least six months long, or is less than six months but is substantially funded by the UK government. 

 

  • Anyone who receives a UK war disablement pension or a UK war widow’s pension.  UK state pension holders who lived in the UK for ten years or more in the past are also exempt, but not for pre-planned or routine treatment. 

 

The Department has no statistics on the numbers of overseas visitors treated.  NHS Trusts keep their own financial records of overseas patient treatment, including the amounts they have received for treating overseas visitors and the amounts outstanding. The Department does hold centrally data on written off debt and income received in relation to overseas visitors. 

 

Asylum seekers are exempt from hospital treatment charges, but failed asylum seekers are not, except for the completion of a course of treatment underway before their application was turned down.  Free treatment for asylum seekers is an international obligation under the 1951 UN Convention.

 

There are also some services that are free to all patients for public health reasons, such as treatment for many infectious diseases, including pandemic flu.

 

Primary Care

 

Primary medical care contractors (GPs) are self-employed and have contracts with the local Primary Care Trust to provide services for the National Health Service.  Under the terms of those contracts, GPs have a measure of discretion in accepting applications to join their patient lists. However, they cannot turn down an applicant on the grounds of race, gender, social class, age, religion, sexual orientation, appearance, disability or medical condition. Other than that, they can only turn down an application if the Primary Care Trust has agreed that they can close their list to new patients or if they have other reasonable grounds.

 

Charges

 

The NHS is first and foremost for the benefit of people who live in this country. People who are not ordinarily resident here are not automatically entitled to access free NHS hospital treatment.

 

Those people who are not 'ordinarily resident' in the UK (living here lawfully and on a settled basis) are subject to the NHS (Charges to Overseas Visitors) Regulations 1989, as amended, and will have to pay for any hospital treatment they receive unless an exemption from charge applies to them.

 

We have been clear that trusts must act on these regulations and recover any debts incurred.

 

For urgent treatment

 

The NHS is essentially a humanitarian service and it is required to provide all patients with treatment that clinicians consider to be immediately necessary or urgent.  No-one in need of immediate treatment will ever be left to suffer just because they cannot pay.

 

In cases where immediately necessary or urgent treatment is given and the patient is without funds to pay, the hospital should provide only such treatment as is clinically required to stabilise the patient to allow them to return to their own country.

 

Consultation

 

The consultation [Review of access to the NHS by foreign nationals] is still being evaluated and we will respond in due course once this has been completed.

 

Although the NHS budget is protected, the NHS still needs to deliver significant savings and hospitals must take reasonable measures to recover any debts from overseas patients.

 


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