Changes to health services charges for overseas visitors

From 15 January 2007 some overseas visitors who previously had to pay for medical treatment will no longer have to pay. The people affected are:
Missionaries and their spouses, civil partners and children.

Spouses, civil partners and children of
- members of the UK forces
- government staff (crown servants) recruited in the UK
- employees of the British Council recruited in the UK
- employees of the Commonwealth War Graves Commission recruited in the UK
- people employed in projects financed in part b the UK government under arrangements with the government or a public body in some other country or territory.

Apart from the changes for missionaries, most of these provisions are likely to affect family members of British nationals and British residents who are based overseas for their work.

Background

The law says that hospitals must charge for health services to people, whatever their nationality, who are not “ordinarily resident” in the UK or who do not come within a category qualifying for free health treatment. The categories qualifying for free treatment include nationals of countries with which the UK has health agreements.

People living in the UK lawfully and on a settled basis, regardless of nationality and immigration status, although they may not be “ordinarily resident” here, can obtain free primary health care. In addition treatment is free if it is emergency treatment given at a GP surgery, treatment given in the accident and emergency department of hospital (but not emergency treatment given elsewhere in the hospital), treatment given in a walk-in centre providing similar services to those of an accident and emergency department of a hospital and treatment for certain communicable diseases (but excluding HIV/AIDS where it is only the first diagnosis and connected counseling sessions that are charge free).

Anyone, or the spouse or child of anyone, who is a national of a country that has signed the European Social Charter but is not entitled to be provided with services under a bilateral health agreement (currently Turkey and parts of Cyprus) who is genuinely without the means to pay for their treatment is also entitled to some limited free NHS hospital treatment.

Other treatment that remains free is family planning services, compulsory mental health care, and treatment for a range of communicable diseases that might pose a public health risk. Treatment (other than for HIV/AIDS) provided in a sexually transmitted diseases clinics is also free.
There are some surprising exclusions from free health care. These include:

- Dependant children aged 16 to 18 of workers and students (only students here on courses of more than 6 months are exempt from charges, but most students on shorter courses will not be able to bring dependants with them in any event), where those children are not in full-time education. They will not be exempt from charges, although the working parent and spouse will be.
- Children of people in the UK on a work permit but who are temporarily unemployed
- People who are in the UK but whose application for residence here has yet to be approved (this excludes children of people seeking asylum whose applications have yet to be decided, treatment to them is free).
- People whose applications for have failed.