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• W1978834052 abstract "Following UK Prime Minister David Cameron’s speech on immigration control, on March 25, 2013, stating that the NHS is a National not an International Health Service,1Health tourism: how much does it cost the NHS?.The Guardian. 2013; (accessed July 4, 2013).http://www.guardian.co.uk/politics/reality-check/2013/jul/03/health-tourism-cost-nhs-jeremy-huntGoogle Scholar the Department of Health announced in July a public consultation on health tourism. Proposals mainly relate to the introduction of a flat fee, termed “migrant health levy”, of either £200 or £500 per annum and are built on the idea of migrants—specifically those remaining in the UK for more than 6 months and less than 5 years, and originating from a country outside the European Economic Area (EEA)—making a fair contribution.2Departent of HealthSustaining services, ensuring fairness. A consultation on migrant access and their financial contribution to NHS provision in England.https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/210438/Sustaining_services__ensuring_fairness_consultation_document.pdfGoogle Scholar We recently completed research on UK medical tourism denoting a slightly different phenomenon of people travelling with the express purpose of accessing medical treatment, rather than so-called health tourism presented in current UK media coverage as something where there is not always an intention to pay, or where hospitals do not pursue charges. While the policy consultation addresses how to ensure more migrants pay directly for NHS services, it is silent on key issues of wider patient movement. Data from the UK Office of National Statistics International Passenger Survey (IPS) suggest that more people leave the UK than visit for medical treatment. IPS data indicate that a large proportion of those entering the UK for medical treatment are from within the EEA, British expatriates, or those intending to access treatment privately either in the NHS or in private hospitals, contributing resources to UK health services and the economy more generally.3Hanefeld J, Horsfall D, Lunt N, Smith R. Medical tourism: a cost or benefit to the NHS? PLoS One (in press).Google Scholar The IPS suggests that the proposed policy might target a minority of individuals travelling into the UK to access treatment. There are also no data for how many of the 700 000 temporary migrants getting visas for education and work are doing it primarily (or even for secondary purpose) of getting health services. Where UK residents experience complications as a result of travelling overseas for treatment these are frequently treated by the NHS.4Miyagi K Auberson D Patel AJ Malata CM The unwritten price of cosmetic tourism: an observational study and cost analysis.J Plast Reconstr Aesthet Surg. 2012; 65: 22-28Summary Full Text Full Text PDF PubMed Scopus (53) Google Scholar Such complications raise questions about the responsibility of the UK Government where citizens are known to travel for treatment. Currently no clear advice from the UK Government exists. UK residents paying for treatment abroad for procedures where there is NHS entitlement also represent cost savings for the NHS, and reduce pressure on waiting lists. The success of the proposed policy relies on change to both the hard and soft architecture of the NHS: the systems and rules for seeking and monitoring payments, but also the professional culture. Is this realistic? Clinicians have expressed reluctance to be seen as “border patrol” or to mix clinical practice with concerns over entitlements to services. There are also questions of social justice: the NHS is built on solidarity. Can a comparative system of solidarity be imposed on migrants through a levy? What about outbound UK medical tourists: should they also be asked to make further contributions or perhaps even offered a rebate? None of this is considered by the consultation. The government’s policy risks missing many of the most important issues relating to patient mobility and their effects on the NHS. We declare that we have no conflicts of interest. Health-care access for migrants in EuropeThe Health in Europe Series highlights two crucial issues: health-care access for migrants1 and the effect of austerity measures on health care.2 Full-Text PDF Health-care access for migrants in Europe: the case of SpainThe Spanish Government recently approved (April 20, 2012) the transition from a National Healthcare System (NHS) to an insurance model through a Royal Decree-Law, bypassing the need for parliamentary discussion. Universal health-care access, a right guaranteed by laws supported by a large social and political consensus, was abolished overnight. The consequence was that hundreds of thousands of non-citizen residents lost their right to health care, except for emergency services and maternal health. Full-Text PDF" @default.
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• W1978834052 date "2013-08-01" @default.
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• W1978834052 title "Health tourism and the NHS: facts or fiction?" @default.
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• W1978834052 doi "https://doi.org/10.1016/s0140-6736(13)61675-x" @default.
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