Health tourism is a much-debated hot topic that could come up in your Medical School interview.

What Is Health Tourism?

Health tourism refers to non-UK residents travelling to the UK with the specific intention of using NHS services.

It is estimated that the government spends between £100 and £300 million per year on ‘deliberate’ health tourism. When the cost of treating non-UK residents who didn’t come to the UK specifically to seek treatment (such as holidaymakers and temporary workers) is added, the total spend amounts to around £1.8 billion.

There is a great deal of misunderstanding around health tourism, and the topic often ignites a wider debate about immigration. As the debate gained momentum in the time surrounding Brexit, the government reacted by amending health tourism legislation. 

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Changes To Legislation

In April 2015, the government introduced new regulations requiring non-EEA nationals without personal health insurance to pay 150% of the NHS national tariff for any treatment they receive. A&E and emergency services remain free to all patients. 

As of 2017, foreign patients can be refused non-emergency operations unless they pay for the treatment upfront. In July 2019, the Department of Health reported that these charges had raised a total of £1.3 billion since their introduction.

Opposition To The Changes

The British Medical Association (BMA) has heavily criticised the ‘pay upfront’ rule, likening doctors who must charge foreign nationals at their workplace to border guards. At the BMA’s annual conference in 2019, delegates voted overwhelmingly in favour of scrapping the rule, so the BMA will lobby the Department of Health to overhaul it. 

Deliberate health tourism only accounts for around 0.3% of NHS spending, so there is an argument that government and media focus on health tourism is disproportionate to the impact it actually has, and does not help with the public perception of migrants in the UK. People who are determined enough to travel to the UK in order to seek treatment they cannot afford or access at home are more likely to be acting out of need than greed. 

It can also be argued that charging for NHS services could actually increase health tourism in the long term among people who can afford it. Potential buyers may feel reassured that what they are purchasing is legitimate and that the process they are buying into is legal, which could lead to an influx of health tourists looking for cheaper healthcare than what is available in their domestic, privatised systems. 

In one case since the new ‘pay upfront’ system was introduced, a couple whose baby died following an emergency Caesarean in the UK were not given the body to take with them, because they couldn’t present a valid EHIC (European Health Insurance Card) so were required to pay £10,000 medical fees which they couldn’t afford. In addition to the BMA calling for the system to be abandoned completely, the Royal Colleges of Physicians, Paediatrics and Child Health, Obstetricians and Gynaecologists, and the Faculty of Public Health have written to ministers urging them to suspend the system. The Royal College of Midwives has also expressed that maternity care should be exempt from charges.

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Health Tourism Questions

You could bring up health tourism as a topic if you’re asked depth of interest questions such as ‘What recent changes to healthcare have you read about?’.

Other related questions could be:

  • Do you agree that foreign patients in the UK should have to pay for non-emergency treatment upfront? For this kind of ethics question, you need to discuss the ethical issues and outline both sides of the argument. 
  • Imagine you are a Medical Student on a hospital ward placement. How would you explain to a foreign patient that they need to pay for their non-emergency treatment upfront? Take a look at our empathy questions for similar questions and answers.
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