Royal colleges support suspension of NHS overseas visitor charges pending review

Following the minister of state for health’s written statement about the review of amendments made to the NHS overseas visitor charging regulations in 2017, the RCP has joined other royal colleges in calling for the suspension of NHS overseas visitor charges pending review.

Joining the RCP in calling upon the Department of Health and Social Care (DHSC) to suspend the National Health Service (Charges to Overseas Visitors) Regulations 2015 and the National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2017, pending a full independent review of their impact on individual and public health, are the Royal College of Paediatrics and Child Health (RCPCH), Royal College of Obstetricians and Gynaecologists (RCOG) and the Faculty of Public Health (FPH).

We disagree with the ministerial statement that 'there is no significant evidence that the 2017 amendment regulations have led to overseas visitors being deterred from treatment or that the changes have had an impact on public health'. Recent research from Doctors of the World highlights how one in five of their service users were affected by healthcare charging, and one in three of those were deterred from seeking timely healthcare. A recent report by Maternity Action demonstrated the detrimental effects of charging on mothers and children during and after pregnancy. We are also aware of cases of children having been denied treatment for various life-threatening conditions.

We disagree with the ministerial statement that 'there is no significant evidence that the 2017 amendment regulations have led to overseas visitors being deterred from treatment or that the changes have had an impact on public health'.

Joint royal college statement on current NHS overseas visitor charging regulations

We do not believe that regulations that lead to such situations are appropriate. They are having a direct impact on individual health and have potential implications for wider public health. Early diagnosis and treatment are vital to improve patient outcomes and – in the case of infectious diseases such as tuberculosis and HIV – to protect public health.

Concerns have also been raised about people who have been wrongly charged because they are unable to prove eligibility. The role of doctors in this process has the potential to damage the vital trust between us and our patients, and is likely to lead to poorer patient outcomes and contribute to already low morale in our profession.

Our royal colleges have been supporting our members to understand the regulations and support patients through advice and guidance. However, 1 year on from the 2017 regulations, the regulations themselves remain a concerning barrier to care. We therefore strongly encourage the DHSC to work with the Home Office and suspend the charging regulations, subject to a full review of their impact on individual and public health.