Royal College of Nursing has expressed concerns over government proposals to change rules that entitle migrants in England to free healthcare.
The RCN questioned the “fairness” of a proposed new health levy on migrants, saying many would already be paying tax and national insurance through employment, including significant numbers working for the NHS.
A joint Department of Health England and the Home Office consultation on the proposals closed on 28 August.
In its response to the consultation, the RCN highlighted three main areas of concern.
It questioned the fairness of the proposed new health levy on “temporary migrants”, noting that many would already be making a contribution through working in the UK and paying tax and national insurance.
The college also highlighted specific concerns about public health and the potential impact on vulnerable groups, if people opted not to access healthcare when they needed it due to cost.
In addition, the RCN emphasised the need to ensure that any policy changes are based on “firm evidence”.
It noted that an audit being carried out to gather data on NHS use by visitors and temporary migrants, and the resulting financial burden, was not due to report until after the consultation had closed.
Peter Carter, RCN chief executive and general secretary, described the proposals as “unconvincing”.
“If migrants are discouraged from accessing health services, particularly primary care, because of financial charges this could lead to conditions going undiagnosed, worsening and increasing risk to others,” he said.
He added: “We believe these proposals are based on a very restricted view of what is ‘fair’.
“Many temporary migrants are working in the UK paying tax and national insurance, including significant numbers of migrants contributing to the health service by working and providing excellent care as staff in the NHS, so it would be unfair to impose a health levy on them.”
The consultation represents the government’s proposed solution to the health service’s longstanding weakness in charging foreign nationals who use the NHS and in recovering the cost of treatment from European Economic Area visitors.
The consultation asks who should be charged in future, what services they should be charged for and how to ensure the system is better able to identify patients who should be charged.
The consultation includes plans to make temporary residents from outside of the European Economic Area contribute to the cost of their healthcare with a levy that then enables them to access NHS services when they need them, or through health insurance or other options.
In addition it discusses how the NHS could more effectively claim back reimbursement from the home countries of patients visiting from the European Economic Area, and introduce more practical and easier ways for the NHS to identify whether someone is not eligible for free healthcare.
It also proposes to end free access to primary care for all visitors and tourists.
Are you able to Speak Out Safely? Sign our petition to put pressure on your trust to support an open and transparent NHS.