This House of Commons Library briefing paper looks at the rules for charging of overseas visitors for the use of certain NHS services. The paper also explores exemptions from the charging requirements, the development of the policy over time and proposed future changes.Jump to full report >>
The NHS is built on the principle that it provides a comprehensive health service, based on clinical need, not ability to pay. However, regulations impose a charging regime in respect of NHS treatment for persons who are not ordinarily resident in the UK. The charging regime provides for some categories of non-residents to be exempt from charges, and EU regulations and other international agreements provide reciprocal healthcare that benefits visitors from and to participant countries.
The principle that NHS services are free at the point of use, unless charges are explicitly allowed for by statute, applies throughout the UK but decisions about specific charges are devolved and these may differ in the different countries of the UK. This note describes the position in England but links are included relating to other parts of the UK.
This paper provides an overview rather than a detailed account of the rules. The NHS Choices website provide general guidance for overseas visitors about charges for NHS services and, according to their circumstances, where they may be exempt from charges. The main legislative provisions are contained in regulations and the Department of Health has issued Guidance on implementing the overseas visitor hospital charging regulations 2015.
Hospitals, community healthcare services and GPs have a duty to provide free of charge treatment which they consider to be immediately necessary or emergency, regardless of whether that person is an overseas visitor. It should be noted however, that being registered with a GP, or having an NHS number, does not give a person automatic entitlement to access free NHS hospital treatment. GP services are excluded from the overseas visitor charging reuglations.
In December 2015 the UK Department of Health consulted on proposed changes to further extend charging for overseas visitors and migrants who use the NHS, including exploring changes in:
Amendments to the regulations introduced in 2017 included several of these proposed changes, including the addition of community healthcare services and NHS funded healthcare services provided by a non-NHS body to the list of chargeable services. As of 23 October 2017, organisations providing chargeable NHS services are also required to recover an estimate of charges in advance of treatment.
Other proposed changes from the consultation, such as charges for A&E and ambulance services are awaiting further Government decisions.
Commons Briefing papers SN03051
Authors: Alex Bate; Tom Powell