The government may increase the number of foreign nationals who are able to access HIV treatment free of charge in England, the junior health minister Ann Keen announced on Monday.
The government also announced a series of other propositions: that access to primary care services should not be further restricted, that a limited number of refused asylum seekers should be exempt from all charges, and that foreign nationals with large debts to the NHS could be refused permission to remain in the UK or to re-enter the country.
These suggestions have emerged from a joint review by the Department of Health and the Home Office, and were briefly described in a statement to the House of Commons and in a Department of Health press release. Some propositions were described in one document, but not the other. None have been finalised - consultations are likely to take place later in the year. Moreover the propositions relate to England, rather than the whole of the UK.
In the statement to the House of Commons, Ann Keen reiterated the government’s commitment that “immediately necessary and other urgent treatment should never be denied or delayed from those that require it” and confirmed that NHS guidance is being revised to ensure that this is made clear.
Moreover she made the following statement on HIV specifically:
“The Government recognise that clinical evidence on treatment, including their role in prevention, is developing constantly. Moreover, HIV is a major global problem, the control of which creates significant financial as well as human costs. We will therefore undertake further analysis of the latest medical and public health evidence together with consideration of how the current policy on treatment aligns with the Government’s wider international aid strategy for HIV. This analysis will inform a future decision on whether the current treatment policy (that only initial diagnosis and counselling is offered free of charge to non-UK residents or individuals who are not otherwise exempt) should be revised.”
She also announced that she did not plan any change to the current system of access to primary care services for foreign nationals, which is at the discretion of the general practitioner. Over the last two years, there has been concern that the government intended to restrict the access to primary care for irregular migrants and other foreign nationals.
She also proposed that those refused asylum seekers who are receiving ‘section 4 support’ should be able to access all NHS services without charge. Section 4 support is given to individuals who are destitute and whose asylum claim has been refused, but are unable to return to their country (often because of war or instability, or because the individual is ill or pregnant). Some newspapers reported that this change would affect one million individuals; in fact 10,850 people currently receive section 4 support.
The government is also proposing making treatment free-of-charge to all children who are in the country without a parent or guardian.
HIV advocates may be less encouraged by some other suggestions which were not included in the Commons statement, but described in the press release as follows:
- ”working with the UK Border Agency to recover money owed to the NHS and exploring options to amend the Immigration Rules so that visitors will normally be refused permission to enter or remain in the United Kingdom if they have significant debts to the NHS
- ”investigating the longer-term feasibility of introducing health insurance requirements for visitors”.