From August 2017, healthcare charges will be introduced for services provided by all community health organisations in England except GP surgeries. From October 2017, non-NHS providers of NHS care will be required to identify chargeable patients.
Any organisation receiving NHS funding will be legally required to check every patient before they receive a service to see whether they should pay for their care and, in some circumstances, patients will be charged for accessing these services.
The anticipated financial saving for the NHS is small (£200,000 a year), based on little evidence and likely to be overestimated. The cost to community services could be extensive if we take into consideration additional administrative time to check paperwork or the cost of the chaos and confusion that will stop people accessing services.
The Government excludes the diagnosis and treatment of all infectious diseases from NHS charges. Most people on effective treatment for HIV are no longer infectious, meaning they cannot pass the virus on. Impact on willingness to access HIV, hepatitis or TB services even if free means that more people will remain infectious. Where people present to secondary care and are refused treatment because they cannot pay, opportunities will also be lost to diagnose communicable diseases.
NAT recommends that the regulations should be withdrawn, with assessments of the impact of charges and checking paperwork conducted and results made public. The Government should evidence that proposed regulations will not breach the duty to reduce health inequalities under the Health and Social Care Act 2012. Any regulations related to extension of charges should exempt all services that protect public health, are provided by community interest companies or charities, and asylum seekers whose claims have been refused.
Guidance must be issued for hospitals and doctors outlining how to implement regulations in such a way that is not discriminatory or violating of human rights, and must confirm that routine identity document checks should not be carried out in services where NHS charges do not apply, such as infectious diseases services.