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Free GP treatment for asylum seekers

The government gives up on controlling "health tourism" among asylum seeker. 13 October 2008. Ministers had threatened to withdraw the right to free GP treatment from asylum seekers whose claims were rejected, forcing them to pay for care privately or go without in all cases except emergencies.

The Home Office and Department of Health – which was due to publish its decision later this month – are understood to be reconsidering their position after admitting that there was no proof that free primary care was encouraging refugees to come to Britain.
Officials are discussing alternative measures, which could involve targeting those with pre-existing chronic conditions or pregnant women hoping to have a baby on the NHS. The doctors have argued the clamp down on so-called "health toruism" would be unethical and potentially illegal, with some saying they would treat patients regardless of any new rules.

A spokeswoman for the British Medical Association said: ‘Our view was always that there had to be more flexibility for GPs. If you are talking about people who can pay, that is one thing, but asylum seekers are unlikely to have the money.’ She said denying primary care could lead to failed asylum seekers later coming to the NHS with ‘more life-threatening and more expensive’ needs: ‘Diabetes may not be an emergency, but if you don’t get any insulin you will end up in a coma and coming to A&E.’

Official guidelines state that GPs should not register failed asylum seekers, but they have the discretion to accept them if they wish. Many doctors argue that excluding such people would mean that they were failing in their duty to put patient welfare first.
The rules have already been changed so that failed asylum seekers are not entitled to hospital treatment except in emergencies or specific cases, such as treatment for TB.
Failed asylum seekers could include people who are appealing against the decision and those trapped in Britain because their countries of origin are considered too dangerous for them to be deported .

Ministers first proposed denying free primary care from GPs four years ago, driven by concerns about the cost of health tourism.
But a decision has been repeatedly delayed, amid objections from doctors and refugee organisations, who argued that it would be inhumane, could encourage the spread of infectious diseases and would put A&E wards under strain as overseas patients whose conditions had gone untreated developed life-threatening complications.

The Department of Health has refused to publish responses to its consultation, but an analysis by a group of medical students – who used freedom of information laws to track down those who had been consulted – revealed that three quarters of the respondents it traced thought the proposals would break ethical guidelines set by the General Medical Council. More than two thirds believed they risked letting infectious diseases go undiagnosed.

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