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22 November 2016

Passports to use the NHS? Theresa May is biting off more than she can chew

Although the policy is standard practice across most European nations, it will face heavy opposition in the UK. 

By Stephen Bush

How to fix the mounting crisis in the National Health Service? The National Audit Office has taken the unprecedented step of warning that the NHS is on an unsustainable financing footing and heading towards disaster. 

Labour’s Jon Ashworth thinks he has the answer in today’s Mirror – “there is now a consensus among hospital bosses, clinicians and health experts that the NHS needs more money,” the shadow health secretary writes.

The government has other ideas. The Department of Health’s top mandarin, Chris Wormald, revealed one yesterday to MPs: stemming the cost of treating foreign residents on the public dime – £500m is predicted to be spent on so-called “health tourists” next year – by requiring that patients bring a passport and proof of address with them to access healthcare.

“Show your passport for NHS treatment” is the Guardian‘s splash, “Show your passport to see the doctor” is the Telegraph‘s, “Show your passport if you want hospital treatment” is the Mail‘s. 

There are a couple of problems with the idea. The first is that this proposal would mean everyone would have to get a passport – turning  your passport into a de facto ID card. ID cards were, as you’ll recall, a measure favoured by late-period New Labour, bitterly opposed by the Tories and scrapped by one Theresa May way back in 2010.

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The second is that in terms of the financial pressures on the NHS, £500m is chump change. The amount that we don’t recover – estimated to be anywhere between £220m to £360m – is even more derisory. The health service’s big problem over the last six years has been that for all the money poured into the service, there has been a large hole in the ground called “social care”, which is increasing bed-blocking and other pressures on the service.  You might as well try to fix the problems with the NHS by cutting down on the number of pens doctors and nurses take home at the end of their shifts.

But the third, and perhaps the most important of all, is this: yes, it’s common practice in most countries with free-at-the-point-of-use healthcare systems not to treat anyone who turns up without checking who they are first, with the exception of emergency care. The British model is exceptional worldwide for its open door approach.

But  that the NHS does is a source of pride for many, and not only for leftwingers. There will also be political pushback at the idea of what the right-wing press will call “ordinary” (code for “not brown”) people being turned away because they’ve left a piece of paper at home. For all some people fear the idea of “the undeserving” taking advantage of our NHS, the political bill of having to present a passport to your doctor may prove higher than the government is willing to pay.

This originally appeared in today’s Morning Call, your free daily guide to everything you need to know in politics, from Westminster to the White House and beyond. Subscribe here. 

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