NHS useage by people "off the grid"?

[feder1]

DAK how many customers of the NHS are people that are unknown to the authorities please?

I.e. those with no national insurance, birth certificates, driving licences or any other documentation that proves who they are.

[Lootman]

I am not sure how anyone can know that if they are truly "unknown". But what I do know is that it is possible to walk into a GP's office with no documentation and be seen. I know that because I have done exactly that with a foreign visitor who was not entitled to free NHS care. In theory GP offices are supposed to charge people not entitled to NHS care, but in practice most seem to not be set up to accept money so it ends up being free care to all.

[stevensfo]

DAK how many customers of the NHS are people that are unknown to the authorities please?

I.e. those with no national insurance, birth certificates, driving licences or any other documentation that proves who they are.

It's been like this since the start of the NHS. I vaguely remember as a teenager, reading about 'Rich Arabs' coming for treatment on the NHS c. 1970s.

Since everything is computerised these days, I don't why there's a problem. But apparently there is.

The system is abused every day. The system could be improved quite easily by listening to those nurses and doctors with over 30 years of experience. Sadly, the NHS will just employ more very clever managers to massage the figures.


Steve

[wydffa]

The UK allows people who arrive in the UK to remain. So it is not only humane but also cheaper in the long-run to treat people straight away rather than wait until they are eligible for emergency care or have formal permission to stay.
Of course this maintains the incentive of free treatment in the UK to those people without local access to decent healthcare, particularly for life-threatening or chronic conditions.

[bruncher]

I am not sure how anyone can know that if they are truly "unknown". But what I do know is that it is possible to walk into a GP's office with no documentation and be seen. I know that because I have done exactly that with a foreign visitor who was not entitled to free NHS care. In theory GP offices are supposed to charge people not entitled to NHS care, but in practice most seem to not be set up to accept money so it ends up being free care to all.

I have taken foreign visitors to a small injury clinic provided by a major teaching hospital in London. Treatment provided; no questions asked.

[XFool]

DAK how many customers of the NHS are people that are unknown to the authorities please?

I.e. those with no national insurance, birth certificates, driving licences or any other documentation that proves who they are.

I have no idea. I am never asked for any ID, but I guess the GP has your details and passes it on if there is a referral. Then again, after being bitten by a dog a couple of years ago I was treated directly at the hospital. I can't remember now if I was asked for personal details.

Remember the old 'Medical Card'? I can still recall my old NHS number - which is also at the bottom of my original birth certificate.

[richfool]

Whilst living overseas, I returned to the UK on a visit and injured my head, I went to an A&E Dept of a local hospital, who treated me, but were insistent on me giving my NHS number or the name and address of UK GP. I gave them the name of the GP's practice I had last attended some 5+ years before. (Where I was no longer registered).

Years later, after returning to the UK to live, with my foreign wife and step-daughter, having paid the IHS (NHS) surcharge for them and registering them at the local NHS practice, when I took my step-daughter to see the GP, he mentioned that as she was of foreign nationality (as was he!), he said he should really charge for her. When I pointed out that was not correct, because she was here legally with a visa and I had paid the IHS surcharge, so she was covered, he disagreed and seemed to think that strictly speaking he should have charged, but indicated that he didn't propose to. I saw no point in arguing the point with him, as he wasn't trying to charge; but he was wrong. It demonstrates that many don't know the correct situation and I am sure many do take advantage of the NHS who aren't entitled to.

[Garless]

DAK how many customers of the NHS are people that are unknown to the authorities please?

I.e. those with no national insurance, birth certificates, driving licences or any other documentation that proves who they are.

Just registered my partner, moved in with me during lockdown, with my doctor. Required to produce proof of address and photo ID, the latter accepted even though expired as her dementia made her unfit to drive.

[Steveam]

The Kings Fund have done some analysis of abuse of the NHS by non-entitled people. It’s estimated to be a very tiny proportion of the NHS budget but what I found most interesting is that most of the abuse was by expats returning home for treatment or drugs to which they were no longer entitled. (I have expat friends in Thailand who make an annual trip home to the U.K. and seem to spend half their time seeing the doctor and dentist and at hospitals. All they seem to do is maintain an accommodation address.)

Best wishes,

Steve

[77ss]

DAK how many customers of the NHS are people that are unknown to the authorities please?

I.e. those with no national insurance, birth certificates, driving licences or any other documentation that proves who they are.

I have no idea. I am never asked for any ID, but I guess the GP has your details and passes it on if there is a referral. Then again, after being bitten by a dog a couple of years ago I was treated directly at the hospital. I can't remember now if I was asked for personal details.

Remember the old 'Medical Card'? I can still recall my old NHS number - which is also at the bottom of my original birth certificate.

I too got bitten by dog. In Turkey. Free hospital treatment, no questions asked.

[pochisoldi]

https://www.nhs.uk/using-the-nhs/nhs-se ... n-england/ may be of interest.

It appears that the following are "free" regardless of status:

A&E (if not admitted)
Family planning (not abortion or fertility treatment)
Treatment for infectious diseases (including STIs)
"treatment required for a physical or mental condition caused by torture, female genital mutilation (FGM), domestic violence or sexual violence – this does not apply if you have come to England to seek this treatment"

The web page is quite explicit that a coronavirus test and treatment for coronavirus is free regardless of immigration status (to the point where they won't make immigration checks).

[Lootman]

The Kings Fund have done some analysis of abuse of the NHS by non-entitled people. It’s estimated to be a very tiny proportion of the NHS budget but what I found most interesting is that most of the abuse was by expats returning home for treatment or drugs to which they were no longer entitled. (I have expat friends in Thailand who make an annual trip home to the U.K. and seem to spend half their time seeing the doctor and dentist and at hospitals. All they seem to do is maintain an accommodation address.)

There is no formal process for someone to inform the authorities if one relocates overseas. So if an expat shows up at a doctor he or she will be treated as if he were resident regardless of what the rules theoretically say or if the address on file is out of date.

I suspect the only way the government would know at all that you have left the country is that you would presumably stop paying tax or submitting tax returns. But that is not a trigger for anything else as far as I know.

[AF62]

The Kings Fund have done some analysis of abuse of the NHS by non-entitled people. It’s estimated to be a very tiny proportion of the NHS budget but what I found most interesting is that most of the abuse was by expats returning home for treatment or drugs to which they were no longer entitled. (I have expat friends in Thailand who make an annual trip home to the U.K. and seem to spend half their time seeing the doctor and dentist and at hospitals. All they seem to do is maintain an accommodation address.)

There is no formal process for someone to inform the authorities if one relocates overseas. So if an expat shows up at a doctor he or she will be treated as if he were resident regardless of what the rules theoretically say or if the address on file is out of date.

I suspect the only way the government would know at all that you have left the country is that you would presumably stop paying tax or submitting tax returns. But that is not a trigger for anything else as far as I know.

On the last couple of occasions I have had to have outpatient treatment at the local hospital, everyone in the check in queue was asked whether we were resident in the UK for the last six months (iirc) but it seemed to be an honour check as there was no effort made to see if they were being told the truth.

[vrdiver]

In theory GP offices are supposed to charge people not entitled to NHS care, but in practice most seem to not be set up to accept money so it ends up being free care to all.

I remember this being discussed some time ago and, IIRC, the conclusion was that the cost of implementing and maintaining a system to check for eligibility and process any payments due would consume more time and effort, and therefore money, than is lost through failure to charge.

[tjh290633]

I can still recall my old NHS number - which is also at the bottom of my original birth certificate.

So can I. It was the number on my Identity Card, issued in 1939.

TJH

[XFool]

I can still recall my old NHS number - which is also at the bottom of my original birth certificate.

So can I. It was the number on my Identity Card, issued in 1939.

TJH

Golly!

Does it consist of four letters followed by three numerals?

[tjh290633]

I can still recall my old NHS number - which is also at the bottom of my original birth certificate.

So can I. It was the number on my Identity Card, issued in 1939.

TJH

Golly!

Does it consist of four letters followed by three numerals?

The format was ABCD123/3 as I was the third and youngest person in the household defined by ABCD123.

TJH

[XFool]

So can I. It was the number on my Identity Card, issued in 1939.

TJH

Golly!

Does it consist of four letters followed by three numerals?

The format was ABCD123/3 as I was the third and youngest person in the household defined by ABCD123.

TJH

I was missing a '/4'. But it was post war...

[didds]

.... I saw no point in arguing the point with him, as he wasn't trying to charge; but he was wrong. It demonstrates that many don't know the correct situation and I am sure many do take advantage of the NHS who aren't entitled to.

Which goes to illustrate its not really his job anyway - it's down surely to the practise manager?

didds

[didds]

I spent a few years out of the country in a peripatetic manner between 1987 and 1993... on return I eventually went to join a GP practise in middle 1994 and had to provide the details of my previous GP.

I had absolutely no idea what that was - i was only registered with them for something like 3 months before I left the UK, i'd been to them maybe once, i could vaguely think where they were located physically (mind's eye picture etc) but had no idea the doctors' names or actual address etc. No internet back in those time to look anything up and in the end I used a streetmap to find the likely name of the road or roads ... remarkably my new practise found my records from somewhere. Whether they had still been held unused for something like 6.5 years or been transferred to some central vault i have no idea...