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Access to NHS services for foreign nationals

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kevinkelleher
Guest
Access to NHS services for foreign nationals
Posted on: January 5 2010, 02:50 pm



- 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; and
    * Investigating 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.
Notes to editors

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.

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

 

 

 

 

 
Contacts
 
NDS Enquiries
Phone: For enquiries please contact the above department
ndsenquiries@coi.gsi.gov.uk

http://nds.coi.gov.uk/clientmicrosite/Content/Detail.aspx?ClientId=46&NewsAreaId=2&ReleaseID=404959&SubjectId=36
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Ben Cromarty
Member
Posts: 451
Re: Access to NHS services for foreign nationals
Reply #1 on: January 5 2010, 04:33 pm

So with regard to HIV, the key bit seems to be this...

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

Any idea as to what additional research is needed or might be done to address this?
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Roger Pebody
Member
Posts: 91
Re: Access to NHS services for foreign nationals
Reply #2 on: January 5 2010, 08:40 pm

Please note that the report above dates from last July. It promised that proposals would be put out for consultation in the autumn, but I'm pretty sure this hasn't happened yet.

You might be interested to see the Aidsmap story published at the time: http://www.aidsmap.com/en/news/2D2D8B76-C19F-40F8-A39C-E8C6C38C84A8.asp
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kevinkelleher
Guest
Re: Access to NHS services for foreign nationals
Reply #3 on: January 6 2010, 10:55 am

Dear Rodger,

With regards to your reply, I have contacted the Dept. of Health and have been informed

"I've spoken to colleagues. This consultation hasn't taken place yet. It should be launched early this year, so I would advise you keep an eye out for it. Please feel free to drop me an email if you want anymore information. "

Kevin
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Lisa Power
Member
Posts: 5
Re: Access to NHS services for foreign nationals
Reply #4 on: January 6 2010, 11:14 am

There's been a lot going on about this - NAT, THT and AHPN have all been consulting and gathering evidence, as have BHIVA and BASHH amongst docs. They're still talking about going out to public consultation, which is obviously a problem with the election timeline. We're pushing.

On a related note, I've been invited to go and talk to the Overseas Visitors Payments Officers Group about why THT think they shouldn't be charging people with HIV - if anyone else has something they want me to bear in mind/communicate about their recent practice (apart from "stop it"), email me at THT - lisa.power (at) tht.org.uk.
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kevinkelleher
Guest
Re: Access to NHS services for foreign nationals
Reply #5 on: January 6 2010, 11:48 am

Lisa hi,

This might be of use. http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_100503.pdf
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Lisa Power
Member
Posts: 5
Re: Access to NHS services for foreign nationals
Reply #6 on: January 6 2010, 11:51 am

Thanks - and that gives you some idea of the sort of replies they get from people who don't agree with us. Sometimes it's easy to forget the strength of opposition we face on this and the way they misuse statistics and urban myths to make their points.
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kevinkelleher
Guest
Re: Access to NHS services for foreign nationals
Reply #7 on: January 6 2010, 11:57 am

This was to long to copy and post, though interesting. http://www.publications.parliament.uk/pa/jt200607/jtselect/jtrights/81/8107.htm
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Lisa Power
Member
Posts: 5
Re: Access to NHS services for foreign nationals
Reply #8 on: January 6 2010, 12:15 pm

Yes, and there's also a report (depressing and hilarious in equal parts) from the Health Select Committee in about 2006 where THT, NAT and a bunch of the MPs ran rings round the then Public Health Minister, who made a total hash of her evidence trying to defend the charging system. The Health Select Committee came down squarely on our side, and one of the Labour members subsequently told me privately that he thought it was the worst single appearance by any Minister before a select committee he'd ever seen - people in the room were openly giggling and shaking their heads. The civil servants looked like they were in despair.

Still didn't shift the Government, sadly, but we keep trying.
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kevinkelleher
Guest
The hidden rise of HIV in the UK
Reply #9 on: January 25 2010, 11:48 pm



My research in the west Midlands with postgraduate student Betselot Mulugeta, talking to groups of immigrant men and women from the Ethiopian and Eritrean communities, has revealed serious misconceptions about the nature of the HIV/Aids epidemic in the UK. Lack of information tailored for different migrant groups, alongside lower awareness of HIV/Aids through media coverage as a whole, is a problem with real consequences.

Newly reported cases of HIV in the UK are higher than ever before. Between 1995 and 2006, the rate of HIV infection among black Africans in the west Midlands increased 100-fold, compared to a two-fold increase among white people, a three-fold increase among black Caribbeans and a six-fold increase among other mixed ethnic groups (according to the region's strategic health authority figures).

Taking the Ethiopian and Eritrean population as one example: they are predominantly young and single, tend to live alone and are often sexually active. Their culture and language restrict the information available to them. This group therefore represents a reservoir of HIV infection which is both a concern for the immigrant community itself and the host population. As social networks among the Ethiopian and Eritrean communities in the west Midlands do not condone or tolerate the discussion of sexual issues, external information networks are crucial in raising awareness of the HIV situation in the west Midlands and reducing stigma and discrimination of those who are HIV-positive.

The respondents in our study said they believed the UK was "civilised" and therefore they could not contract HIV/Aids, that the problem had been left behind in Africa. Some commented that they believed all migrants were screened before being allowed entry, and that drugs were available in the UK that would "cure" Aids. Perhaps most tellingly, interviewees said that Aids wasn't talked about in the UK and no information or warnings were provided, so they had assumed there wasn't a problem. Culturally, condoms are a difficult issue. It is considered unacceptable for either partner in a sexual relationship to ask for a condom to be used, because it's thought to suggest the woman is promiscuous or a prostitute, or that there is a lack of trust between them.

One of the main reasons for this lack of appreciation of the HIV risk environment in the west Midlands appears to be a lack of communication and understanding between HIV-related service providers and immigrant communities. In particular there are very few culturally sensitive outreach sexual health promotion programmes aimed at different immigrant groups from high HIV-prevalence source regions in the west Midlands, with hidden groups such as failed asylum seekers and irregular migrants often ignored.

The ruling by the UK court of appeal earlier this year that refused asylum seekers and other "not ordinary UK residents" are not entitled to free NHS treatment and care is creating a reservoir of HIV infection in the UK. It is these marginalised and often hidden groups, who are highly vulnerable to HIV infection due to their socio-economic situation, that are being denied free medical treatment. Denying unrestricted NHS HIV treatment to this group is a serious public health issue which may well fuel the epidemic in the UK.

There is a desperate need to understand the social context of the disease both in terms of the migrants' region of origin as well as in their new UK communities. The British government is yet to address the steep rise in rates of the disease among heterosexuals and a new Aids awareness campaign targeted at those most at risk of spreading it is imperative. It's a campaign they are reluctant to undertake because of the sensitivities around immigration, race and perceptions of neo-colonialism.

Sub-Saharan Africa is home to 67% of global cases of HIV/Aids, but it is dangerous to think of the disease as just an African problem now that we can travel easily between continents. Surely it is time we had another UK national campaign to bring this deadly disease to everybody's attention and to correct the misconceptions both the host and migrant communities have of the HIV/Aids epidemic in the UK.

http://www.guardian.co.uk/commentisfree/2009/dec/22/hiv-aids-black-african-immigrants-uk
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