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To treat or not to treat?

29 October 2009 / Adam Hundt
Issue: 7391 / Categories: Features , Human rights , Community care
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What happens when migrants can’t pay for treatment? asks Adam Hundt

The NHS (Charges to Overseas Visitors) Regulations 1989 (SI 1989/306) (the regulations) provide that overseas visitors must be charged for secondary care they receive, unless one of the many exemptions in the regulations applies.

Some types of treatment are exempt from charging, eg for infectious diseases such as TB, or STDs, but not for HIV; some types of patient are exempt from charges, eg refugees or people who have been lawfully resident in the UK for more than 12 months; and some types of nationality are exempt, eg people from countries with a reciprocal agreement with the UK.

Interestingly, both primary and secondary legislation in this area concentrates solely on charging for treatment. No mention is made of withholding treatment but the obvious question, once a charging regime comes into being, is what happens when a patient cannot pay?

The Department of Health issued detailed non-statutory guidance on the implementation of the regulations which addressed this problem to some extent, but made no distinction between an inability to pay

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