Health chief warns patients may need proof of ID to get NHS care

Patients in the UK may have to show two forms of identification to get some NHS care, according to Chris Wormald, the senior civil servant at the Department of Health

Pressure on NHS resources caused by the failure to recoup money for treating foreign visitors to the UK could result in the need for patients to produce two forms of ID to prove they are eligible for free non-emergency NHS treatment.

Chris Wormald, the senior civil servant at the Department of Health, told a House of Commons committee that the NHS has 'a lot further to go' in reclaiming money for treating foreign visitors. Although NHS Trusts in England are legally obliged to check patients' status and recover costs from overseas visitors, this does not always happen.

The government estimates that £2bn a year is spent on treating overseas visitors and has set a target of recovering £500m a year by 2017-18 spent on routine hospital care. However, so far it is behind schedule.

Wormald acknowledged that asking for two forms of ID before treatment was a controversial step, but claimed it was already happening in a number of Trusts. St George's Hospital in south London is currently running a pilot scheme to test new proof-of-ID processes to recoup costs from pregnant overseas patients, for example, and in Peterborough patients are asked to produce a passport and proof of address.

However, Commons committee chairwoman Meg Hillier raised concerns that some British residents, including some of her constituents, might not have passports or other ID. 'Because they have never travelled, they have no passport; they have no driver's licence because they have never driven; they still live at home because they can't afford to move out so they've never had a utility bill in their name,' she said.

She questioned how such people who are British born and resident in the UK and therefore entitled to NHS care can be assured of easy access to healthcare without having to meet a humiliating and impossible set of demands.

Head of the BMA council Dr Mark Porter said the discussions were a distraction given that so-called health tourism was a comparatively small problem for the NHS. The government puts the cost of deliberate health tourism - whereby people come from abroad specifically to get free treatment they are not entitled to – at only about £280m. 'This is little other than a pinprick on the top of the actual problems facing the NHS,' Dr Porter told BBC Radio 4's Today programme.

Meanwhile Tamlyn Thompson, Managing Director at Idscan, questions how the government would make such a process work in practice. 'Each year, the UK receives tens of thousands of individuals seeking heath tourism. With more than 4,000 different identification documents existing in the world today, the challenge will be to ensure these documents are genuine, the individual is who they say they are, and they have the right to treatment,' she pointed out.'

'Health tourism costs the NHS around £1.8 billion each year. As such, it’s critical to ensure the right people receive treatment. With fraud rife across all sectors, this could be another route for those with malicious intent to exploit. Without the right checks and processes in place to ensure verification and compliance, following Mr Wormald’s suggestion could open up the doors more widely to health fraud,' she warned.

Healthcare IT security company Imprivata believes that biometric patient identification could replace passport ID for NHS patients.

'While unidentified health tourism is no doubt an issue, certainly for some NHS Trusts more than others, it is a small percentage of the overall health budget. Having said that, given the financial pressure that the NHS is under, we should look at every possible way to streamline services and to save money,' said Dr Saif Abed, Medical Director EMEA at Imprivata.

'As the NHS is currently set to digitise records, use of biometric technology for patient identification will provide many benefits, including ensuring that patients are entitled to treatment. Once a patient has agreed to have their biometric information, such as a palm vein scan which is easy to administer, to be linked to their medical records, there would be no need for a passport, or indeed any other form of identification.

'As well as combating health tourism, this would also significantly streamline patient admissions, and avoid medical or prescribing errors due to patient misidentification.'

A Department of Health spokesman said: 'The NHS is a national - not an international - health service and we are determined to stamp out abuse of the system to ensure it remains free at the point of need in this country. We consulted earlier this year on extending the charging of migrants and visitors using the NHS. We will set out further steps in due course.'

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