The National Health Service (Charges to Overseas Visitors) Regulations (as amended) states that the NHS will charge and recover payment for treatment provided to visitors, or non-residents (someone who is not considered as settled in the UK).
Hospitals can also use their discretion whether or not to withhold treatment if payment is not made in advance.
GPs must offer treatment to anyone who asks for it, but if a doctor deems further treatment as necessary they can use their discretion to refuse to register people as permanent or temporary patients.
If someone is not entitled to free hospital treatment, then a referral from a GP for treatment does not allow exemption from charges, unless the treatment falls under an exempt category (see below).
WHO IS EXEMPT FROM PAYING FOR NHS MEDICAL TREATMENT?
Regulation 3, Schedule 1 of the NHS regulations 1989 sets out:
– the overseas patients that are exempt from the charges; or
– circumstances when overseas patients are exempt.
Whilst the list below is not exhaustive, ‘circumstantial’exemptions include:
• Treatment at A&E, casualty or ‘walk-in’ centres
• Treatment for incapacitating illnesses, such as food poisoning, diarrhoea, salmonella infections, whooping cough etc (see Schedule 1 of the Regulations for a full list)
• Treatment for a sexually transmitted disease (see HIV below)
• Family planning services
• Services provided for those under the Mental Health Act 1983
• Psychiatric treatment required by a court.
Overseas patients exempted from paying the NHS charges are:
• Permanent residents (those holding indefinite leave to remain / permanent residency)
• Those based in the UK for employment, including self-employment (Tier 2, Tier 5, Tier 1..etc)
• Those that can obtain services due to reciprocal agreements with certain countries
• Those who are part of HM Forces and NATO armed forces
• Long term students (over 6 months leave) or students whose course is substantially funded by the UK government
• Refugees, including applicants for refugee status; but not refugees who have been refused asylum – more information is available on the Department of Health website: asylum seekers and refugees
• Those who have previously had 10 years continuous lawful residence in the UK and who have worked overseas for less than 5 years
• Those who work in another EEA state
• EEA nationals, including refugees of EEA states and their dependants
NHS DEBTS – GROUNDS FOR ENTRY CLEARANCE REFUSAL
Since the 1st November 2011 any unpaid debt to one or more relevant NHS Bodies, with a total value of at least £1,000, is grounds to refuse an application for entry clearance.
UNPAID NHS DEBTS
Entry clearance will normally be refused if the applicant has unpaid NHS charges of £1,000 or more taking into consideration any compelling compassionate circumstances and/or human rights considerations.
Where a refusal application is also linked to a dependant application, any dependent will also fall to be refused.
However if the dependent is responsible for refusal, due to unpaid NHS debts, there is no requirement that the main applicant is also refused.
Where the debt relates to a dependent minor the parents/guardian will be responsible for the debt.
The rule only apply to debts acquired on or after 1 November 2011.
Refusal will be under the Immigration Rules paragraph 320(22) stating the charges owed to the NHS.
There are no additional appeal rights.
Application forms have recently been revised to show these changes.
If in the application form an applicant (not covered by the exemption listed above) states that they have received chargeable NHS treatment and there is no evidence that payment has been made, after taking into consideration any compassionate and human rights considerations, and if the applicant’s statement indicates that the NHS debt is for £1,000 or more, which is confirmed by the appropriate checks, then the Entry Clearance Officer will consider refusing the application under the Immigration Rules para 320(22).
If the debt is for less than £1,000, the application should not be refused under paragraph 320(22).
When an applicant has stated they have received chargeable NHS treatment in their application form, the visa officer will check their system or carry out further check with the help of the UKBA NSH SUPPORT TEAM who will contact the relevant hospital/trust and will feedback any information to post.
For further information, please contact us.