This article was taken from: https://www.theguardian.com/society/2017/oct/11/ex-nhs-chief-backs-doctors-warning-id-checks-patients
Critics say rules to tackle health tourism could deter sick people from seeking treatment and lead to racial profiling
A former chief executive of the NHS is among 1,000 signatories to a letter to the health secretary, Jeremy Hunt, warning of the risks posed by imposing identification checks and upfront charges for NHS care.
School nurses, abortion services, community-based midwifery and mental health services, as well as specialist services for homeless people and asylum seekers, will be included in the new regime. Doctors say the rules will deter sick people from seeking life-saving treatment, and patients with infectious diseases could pass undetected.
The rules are designed to counter so-called health tourism. However, critics say people who are entitled to NHS care but who do not have ID documents such as passports or driving licences could also be denied treatment.
“We are concerned that these regulations have been laid without evaluation of their impact on health outcomes and health inequalities, without a full and robust assessment of the long-term costs to the NHS, and before the completion and evaluation of pilots on patient identity checks in hospitals,” the letter to Hunt says.
“By denying healthcare to the most vulnerable in our society, these regulations will have negative consequences for us all.”
Sir David Nicholson, who was the chief executive of NHS England from 2011 to 2014, is one of 1,078 signatories of the letter, which was delivered on Monday.
Organisations that have signed include the Royal College of Midwives, the Royal College of Paediatrics and Child Health, Unite and Amnesty International, as well as local services for vulnerable groups such as homeless people and asylum seekers.
More than 430 individual medical professionals, including more than 350 doctors and nurses, have also signed the letter. Last month medics joined hundreds of protesters in a demonstration at St Thomas’s hospital against the plan.
The changes are outlined in secondary legislation that is due to be implemented without debate. Upfront charging is already in place in NHS hospitals, and the ID check pilot scheme is operating at 20 primary trusts. The new law will extend the regime to community interest companies and healthcare charities, which have hitherto been exempt.
There are concerns it will lead to racial profiling, with potentially chargeable patients singled out by the colour of their skin. The only way to check for eligibility without violating equality law is by asking everyone for identification, but to do so would be costly and frustrating for patients and staff.
Critics say health workers will be forced to turn away patients who are not able to prove their eligibility or cannot afford to pay. While some conditions, such as meningitis and tuberculosis, are exempt from charges, doctors have warned patients could stay away.
The changes remain mired in confusion. Some organisations contacted by the Guardian seemed unaware they could be affected. The letter was initiated by four charities – Doctors of the World, Asylum Matters, the National Aids Trust and Freedom From Torture.
Samantha Dorney-Smith, a nursing fellow and part of the London Network of Nurses and Midwives Homelessness Group, said: “We work with homeless people who have chaotic lives and are often coping with years of trauma.
“Many of our patients, including those who are UK nationals, simply don’t have ID documents. If you’re middle class the idea of not having a passport might seem very odd, but many people don’t.
“These kinds of rules simply create layers of difficulty and red tape for medics, while making patients’ lives miserable. There’s already a lot of confusion about exactly which services and situations the new rules apply to.”
The health minister, Lord O’Shaughnessy, said: “The NHS is a cherished national institution that is paid for by British taxpayers. Anyone who thinks it should be giving free treatment to overseas visitors has badly misjudged the public’s views.
“The new regulations simply require NHS bodies to make enquiries about and charge those who aren’t entitled to free NHS care. They will never withhold urgent treatment and certain groups will remain exempt from charging.
“Visitors to Britain are welcome to use our NHS so long as they pay for it. All the money raised goes back into funding and improving care for NHS patients.”