I’m a foreign national. Do I pay for NHS healthcare?

Immigration lawyers would agree that this is a question posed quite often by most non-EEA national clients.   The common misconception is that lack of access to public funds means that the person cannot access NHS healthcare either. This is not so.

The Department for Health has its own rules for deciding who gets free NHS treatment. The test is about whether the person is ordinarily resident in the UK. The term ‘ordinary residence’ has been described by the government as “living lawfully in the UK for settled purposes, as part of a person’s regular order of life. A person's identifiable purpose and whether that purpose has a sufficient degree of continuity to be properly described as settled are the determining factors.”

There are a number of factors that are taken into account when determining ordinary residence. A person’s legal entitlement to stay here is one factor, but not conclusive unless it is permanent residence. The Department for Health has a very useful, but lengthy, tool guide on the subject, designed to assist medical professionals on the topic. 

Those who do not pass the ordinary residence test, will be classed as "overseas visitors". An overseas visitor may be charged for NHS treatment and services. The assessment will be made by the healthcare provider and the patient informed.

Emergency treatments at an Accident & Emergency or casualty department (including an observation ward) are free for everyone. A residency assessment is not required, so the residency status is irrelevant. If, following the emergency, a patient requires  further in-patient treatment or registration as an outpatient, then an assessment as to their ordinary residence would be made. The charges to be applied are in compliance with Regulation 2(1) of the National Health Service (Charges to Overseas Visitors) (Scotland) Regulations 1989. The regulations include exemptions from charges for certain categories of patient and services.

What about the dentist and General Practitioner? The overseas visitors charging regulations do not permit charging for NHS general medical services other than certain dental and optical services. It is for GP practices to decide whether or not to register an overseas visitor or to treat them privately, taking into account the terms of the National Health Service (General Medical Services Contracts) (Scotland) Regulations 2004 as amended. In practice, most GP surgeries treat patients for free but there are some reported problems with initial registration.

Those who have already paid the Immigration Health Surcharge as part of their leave to enter or remain application will of course have access to the NHS healthcare. The IHS is paid by those who are applying for leave to enter the UK for the purposes of work, study or to join their family for a period of more than 6 months. It applies to fiancé(e) applications but not to those visiting their family members under a general visitor visa. It also applies to leave to remain applications but not applications for indefinite leave to remain. Paying the IHS entitles the visa holder to the same rights as someone who is ordinarily resident: They will be treated for free, except for statutory charges such as for dental treatment and prescriptions in England. 

Further enquiries?

Scotland's national health information service is called NHS Inform. They operate a helpline to provide advice to the public, GP practices and other NHS healthcare providers on overseas visitors’ eligibility to receive NHS healthcare whilst in Scotland. If further advice is required, phone the helpline on 0800 22 44 88 (Open from 8am to 10pm, 7 days a week). 

There are also some FAQs on the topic on the Scottish Government's website

Comment

Amna Ashraf

Amna Ashraf has worked for McGill and Co since 2011 and currently holds post as a solicitor. She has developed considerable experience in family immigration matters and holds a very high success rate owing to her meticulous attention to detail and tenacious approach.