Health Tourism
The 2004 charging regulations were predicated on claims that there was a growing problem with ‘health tourism’. Health tourists are people coming to the UK specifically to access free NHS treatment. There has been little evidence from the government to prove that there is substantial health tourism to the UK. However, the cost of this assumption to vulnerable migrant groups is high.
Is there evidence of substantial health tourism to the UK?
We have almost no information on who makes up these groups and what numbers are involved. We can presume however that they include expatriates returning to the UK for health care in the mistaken belief that they are entitled to do so and family members of settled migrant communities (Hargreaves S, June 2006). There will also be some other people who can afford to make the trip specifically to obtain NHS care.
The Government has not provided any reliable data to show that this is an issue of significance. The following is a quote from evidence given by then Health Minister, Melanie Johnson, to the Health Select Committee:
“It is very difficult to produce figures. Historically, figures have not been collected by the Health Service, over decades—never, basically—about levels of people using the service who are not resident or normally resident in the UK. That is partly because, obviously, some of the people who use those services are genuine tourists—and I am not just talking about HIV/AIDS here; I am talking more generally, because it is quite difficult, again, to make distinctions between this and a number of other things for which people need treatment. It is impossible therefore to disaggregate data as to whether a tourist came over and broke their foot and received treatment through an A&E department or whether somebody came in and received another service as a so-called health tourists]”
(Health Select Committee, February 2005).
In the current consultation document, it is stated that NHS frontline staff regularly reports examples of health tourists to the Department of Health and the UKBA reports cases where visitors arrive with hospital records and appointments—evidence that they are arriving to avail themselves of the NHS. Still , no such evidence has been submitted or made public.
Who does this assumption affect?
Whether intentionally or not, the legislation has had the most profound impact on groups who are not health tourists but are instead the most vulnerable of migrants groups. These include failed asylum seekers, trafficked people, and undocumented migrants. Project London’s first end of year report on this service found that the majority of their patients had lived in the UK for just under three years before seeking treatment and presented with only routine minor complaints (Médecins du Monde, 2007).
Asylum seekers are entitled to full access to free NHS care during the period their asylum claim is being reviewed. If health care was a major consideration in coming to the UK they would seek treatment during this initial period and not wait until after their claim has been refused. Asylum claims even today take time to process and appeals will further extend this period.
Until the Government provides adequate evidence of Health Tourism, refused asylum seekers should continue to have access to NHS healthcare until they can be returned home.
For Further information:
• Medicins du Monde, Project London Annual Report
• The Guardian, The Tourist Trap 14 May 2008
• National AIDS Trust. The Myth of HIV Health Tourism. National AIDS Trust, 2008.
