/ NHS passport or other checks

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neilh - on 23 Nov 2016

Had to take an 11 year old into a German hospital for A & E once a couple of years ago, which then involved having to go back to " base" and returning with a passport before they started treatment. It woke me up as to why we have not adopted this in the NHS a long time ago. It also really shook up a couple of people with me who were NHS employees.

I now fail to understand why this is not done as a matter of routine.

Whats the answer? ID cards?
6
galpinos on 23 Nov 2016
In reply to neilh:

Because the money saved by stopping "healthcare tourism/fraud" is minimal and not worth the additional hassle?
13
Oceanrower - on 23 Nov 2016
In reply to neilh:

> Had to take an 11 year old into a German hospital for A & E once a couple of years ago, which then involved having to go back to " base" and returning with a passport before they started treatment. It woke me up as to why we have not adopted this in the NHS a long time ago. It also really shook up a couple of people with me who were NHS employees.

> I now fail to understand why this is not done as a matter of routine.

> Whats the answer? ID cards?

Really? You'd rather see an 11 year old kid suffer and wait for treatment. possibly in pain, whilst you went looking for paperwork, rather than health staff got on with it and started treating their patient.

You, Sir, are an imbecile.
32
Neil Williams - on 23 Nov 2016
In reply to Oceanrower:

Agreed. Even the way the US's private system operates, for the ER it's treat first, paperwork/payment later, AIUI.
Bogwalloper - on 23 Nov 2016
In reply to neilh:

Without going into personal details what was wrong with the child?

Wally
Jim C - on 23 Nov 2016
In reply to Neil Williams:

> Agreed. Even the way the US's private system operates, for the ER it's treat first, paperwork/payment later, AIUI.

But do they then hold the patient hostage until they pay up?
Neil Williams - on 23 Nov 2016
In reply to Jim C:
I have no idea how it works beyond that. The point is that any system that leaves someone in pain while they find their passport is an inhumane one.

Personally, I'm in favour of NHS emergency treatment being free to all without exception. There is almost no scope for health tourism there anyway - if you've broken your leg you can hardly fly across Europe to the UK before you have it treated. And I don't want anyone to be in unnecessary pain, whether they are legally in the UK or not.

There's also the oddity about paying for emergency treatment through car insurance in a car accident - I see this as a right costly faff that would be better just handled as a tax on car insurance (or just general taxation, given that most people benefit from the use of motor vehicles in some form), the sum would be tiny.
Post edited at 17:28
2
wbo - on 23 Nov 2016
In reply to Bogwalloper:
? Does it matter?

This was proposed the other day wasn't it, but is already the case in some areas such as around Peterborough
Chris the Tall - on 23 Nov 2016
In reply to neilh:

Just to be clear, no one in the UK gets charged for A & E, regardless of their nationality

What you might get charged for is a follow-up consultation. This happened to my nephew (born in the UK) who dislocated his shoulder at the climbing works.

He was told that there was no charge for A & E
He was told to come back for a check-up 5 days later
That check-up lasted about 2 mins
He was then told (as he was leaving) that he would be charged around £150
marsbar - on 23 Nov 2016
In reply to neilh:

It doesn't seem an efficient use of time to me, just treat the person and be done with it. The admin cost of checking everything involved would probably out weigh the savings, never mind the cruelty of making people wait for treatment.

I took my (American) niece to minor injuries whilst she was visiting, we had to fill in a form, so they do check, but they didn't insist on seeing her passport or anything, and I took the form home to get the details. This seems like a sensible compromise to me.
4
Jim C - on 23 Nov 2016
In reply to Bogwalloper:
> Without going into personal details what was wrong with the child?

> Wally

If someone turns up in an life threatening emergency situation, having been a visitor to this country , and even if there is not a reciprocal medical treatment arrangement with their country, then they should of course be treated immediately , and then they can be given a bill.
( whether they pay it or not is another matter)

That is a bit different to someone knowingly coming into the country, with a pre existing condition,m and then deliberately presenting to the NHS for long term and expensive cancer treatment for example)
I would not expect the NHS to just treat them at the taxpayers expense.
Post edited at 17:51
Jim C - on 23 Nov 2016
In reply to Chris the Tall:
I come from a family of Nurses/ Audiologists/Speech Therapists , and none of them would in my experience recognise this scenario.

Is there more to this perhaps?

Edit add 'would in my experience'
Post edited at 17:59
jimtitt - on 23 Nov 2016
In reply to neilh:

I don´ t think you are being entirely accurate. If the child required emergency treatment then this is commenced immediately in German hospitals, irrespective of any paperwork. Emergency treatment is anyway free. However their idea of an emergency may not be yours and they may send you a bill later.
I took my eldest son (14) to the orthapaedic surgeon yesterday here in Germany for an X-ray and a cast and they didn´ t even want to see his insurance card, the accident occured in school hours so the education authority pay.
neilh - on 23 Nov 2016
In reply to Bogwalloper:

Broken arm
neilh - on 23 Nov 2016
In reply to jimtitt:
Maybe because you were resident and not on holiday?not really a direct comparison
Post edited at 19:01
1
neilh - on 23 Nov 2016
In reply to Oceanrower:

Well throw your comments at the German system !
neilh - on 23 Nov 2016
In reply to Chris the Tall:

That is how I would expect it to work.

Did he pay?
john spence - on 23 Nov 2016
In reply to neilh:

When my brother in law retired as a GP he got work as a locum in a Southampton practice, close to the docks. Every week he had patients presenting with serious health conditions . They often could not speak English and the consultation required an interpreter on a premium rate phone line ( paid for out of practice funds) It soon became apparent that most of the people put down the same address as their residence. He estimates that some patients required treatment costing the NHS £200,000. This was an organised scam that probably continues because people are afraid to raise the issue for fear of being described as racist. He was duty bound to refer them for treatment but when he raised concerns they were ignored. I don't know if passports and utility bills are the answer but this issue needs looking at .
1
jimtitt - on 23 Nov 2016
In reply to neilh:

> Maybe because you were resident and not on holiday?not really a direct comparison

Clearly you´ ve some wierd axe to grind. Emergency treatment is carried out as required without the need for any paperwork, they scrape people off the road and get to work before they see any documention.
You were anyway at fault, you are required to carry means of identification at all times in Germany, even as a tourist.
Indy - on 23 Nov 2016
In reply to galpinos:

> Because the money saved by stopping "healthcare tourism/fraud" is minimal and not worth the additional hassle?

Its estimated at between £120 million and £300 million a year so your right... minimal.
3
Neil Williams - on 23 Nov 2016
In reply to jimtitt:
Actually no you aren't required to carry it, you are just required to possess it. At home is fine, though the Police reserve the right to insist that you interrupt what you were doing to get it if they want to see it.

See: https://en.wikipedia.org/wiki/List_of_national_identity_card_policies_by_country#Countries_with_comp...

Conventionally people do carry them, but then conventionally most adults in the UK who drive carry their driving licence as a de-facto ID card despite this never being required (even if asked for it when driving you can produce it instead at a Police station of your choosing within a specified time period, I think it's 7 days).
Post edited at 19:27
summo on 23 Nov 2016
In reply to marsbar:

Every person is ID'd every visit to any healthcare establishment in Sweden. Takes just seconds via an ID card correlated with people's record and their personal number. A&E you get invoiced later, doctors or specialist you pay up front. If a doctors surgery sees a 100 people in day, that is the equiv of £1500, it more than covers receptionist time.

You get less time wasters, more money into the health service and there is an annual cap for those seriously ill or very low paid.
marsbar - on 23 Nov 2016
In reply to summo:

We don't have ID cards here, so it wouldn't be as straightforward. I'm not suggesting it shouldn't or couldn't be done at GPs and in fact I think I did have to take proof of address when I registered. A and E should treat first and ask questions later.
marsbar - on 23 Nov 2016
In reply to Indy:

A lot of people on this thread can't seem to tell the difference between emergency and non emergency treatment.

I'm not talking about healthcare tourism, I'm talking about people turning up at A and E, when A and E is the correct place to be.
marsbar - on 23 Nov 2016
In reply to john spence:

A GP is different to A and E. I think it's fine to check and deal with people differently at GP surgeries , compared to people in an actual emergency.
marsbar - on 23 Nov 2016
In reply to jimtitt:

"There’s no requirement to carry your passport with you, but the police are currently carrying out more frequent ID checks. If you’re asked to show your passport and you don’t have it with you, the police may escort you to wherever your passport is being kept so that you can show it to them."

From https://www.gov.uk/foreign-travel-advice/germany
Indy - on 23 Nov 2016
In reply to john spence:
> scam that probably continues because people are afraid to raise the issue for fear of being described as racist.

It's exactly the same sort of people that scream racist who complain that the NHS is homophobic for not funding expensive lifestyle drugs due to a limited budget.

Everyone needs to play by the rules.
Post edited at 19:56
2
summo on 23 Nov 2016
In reply to marsbar:

> We don't have ID cards here, so it wouldn't be as straightforward.

No but most people carry driving licence or bank card, perhaps a national insurance card would be the way ahead. A modern version of what they used to send out.

They are many other benefits to having an id card, but I can not see anything changing in the UK. People always look for problems, never solutions.

Jim C - on 23 Nov 2016
In reply to neilh:


> Whats the answer? ID cards?

Or no immediate ( non emergency ) free treatment for those without a National Insurance number I guess would be a starting point.
You give your name address and NI number and then you can get automatic free treatment.
If you can't do that, then you get billed.

Indy - on 23 Nov 2016
In reply to marsbar:

> We don't have ID cards here, so it wouldn't be as straightforward.
People don't have problems showing I.D to claim benefits or open a bank account or get on a plane or 1001 other things.
Big Ger - on 23 Nov 2016
In reply to galpinos:

> Because the money saved by stopping "healthcare tourism/fraud" is minimal and not worth the additional hassle?

What makes you say that?

Deliberate' use of the NHS—use by those who come here specifically to receive free treatment or who come for other reasons but take advantage of the system when they're here—is hard to quantify. It's thought to be very roughly between £110 million and £280 million a year.
'Normal' use of the NHS—by foreign visitors who've ended up being treated while in England—is estimated to cost about £1.8 billion a year.
The majority of these costs aren't currently charged for. Only about £500 million is thought to be recoverable or chargeable at the moment.


https://fullfact.org/health/health-tourists-how-much-do-they-cost-and-who-pays/
john spence - on 23 Nov 2016
In reply to marsbar:
A and E should treat first and ask questions later.
I would agree with that but sadly there seems to be no mechanism in place in many trusts.

baron - on 23 Nov 2016
In reply to Big Ger:
There was some big wig from the BMA on the news yesterday saying it was 'only £200 million'.
He dismissed it as being such a small amount compared to the NHS annual budget which, of course, it is.
However, it's still a huge amount of money. Not his money, nor the government's but our (the taxpayer's) money.
Maybe it's this flippant attitude to taxpayer's money that is part of the NHS's financial problems.
1
Mike Rhodes - on 23 Nov 2016
In reply to Big Ger:

I am at a loss to understand why there is such a reluctance in the UK to charge people who use the NHS when not eligible for free treatment.
The argument that admin staff don't have time is strange, as here in France, the receptionist at the GPs, dentist and hospitals seem to be able to check you in, get your medical file, look at your health card/id/insurance to ensure that you are eligible for free treatment, or otherwise and swipe your credit card if necessary. This does not seem to need extra staff as there is normally only one person involved. If you have a EHRC then they ensure that they claim the costs back.
It's a simple procedure that needs implementing and enforcing in the UK.
Big Ger - on 23 Nov 2016
In reply to Mike Rhodes:

> I am at a loss to understand why there is such a reluctance in the UK to charge people who use the NHS when not eligible for free treatment.

> The argument that admin staff don't have time is strange, as here in France, the receptionist at the GPs, dentist and hospitals seem to be able to check you in, get your medical file, look at your health card/id/insurance to ensure that you are eligible for free treatment, or otherwise and swipe your credit card if necessary. This does not seem to need extra staff as there is normally only one person involved. If you have a EHRC then they ensure that they claim the costs back.

Ditto here.

marsbar - on 23 Nov 2016
In reply to Indy:

Maybe not in your cosy world.
1
marsbar - on 23 Nov 2016
In reply to john spence:

I can only comment on that one experience, I was asked about her. However if I had to take my ID with me every time I go to the doctor that would be a nuisance.
2
summo on 23 Nov 2016
In reply to marsbar:
> I can only comment on that one experience, I was asked about her. However if I had to take my ID with me every time I go to the doctor that would be a nuisance.

people take their ID here every where they go, it is credit card sized so hardly arduous. It is also the driving licence, you need to scan it to collect a parcel in your name from a PO or parcel company, it doubles as recognised photo ID for travel, collect prescriptions etc... it is just such a part of life that people do not even pause to think about.

It is the UK that is in the dark ages, with the take a utility bill or some other bit of paper as proof etc.. any kid can make them on Word in 30 mins.
Post edited at 21:31
SenzuBean - on 23 Nov 2016
In reply to jimtitt:
> I took my eldest son (14) to the orthapaedic surgeon yesterday here in Germany for an X-ray and a cast and they didn£ t even want to see his insurance card, the accident occured in school hours so the education authority pay.

Meanwhile on the other side of town...

"Ah f(&k son, you know we can't afford you to break your arm!. You'll have to go to school tomorrow, excuse yourself to the toilet and then when no-one is looking, pretend to fall down the stairs and start screaming so that you can get to the hospital. Don't worry, daddy has some good painkillers - you won't feel anything" ?
Post edited at 21:52
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Indy - on 23 Nov 2016
In reply to marsbar:

Pray tell, what do you mean kind sir.
Chris the Tall - on 23 Nov 2016
In reply to Jim C:

> I come from a family of Nurses/ Audiologists/Speech Therapists , and none of them would in my experience recognise this scenario.

> Is there more to this perhaps?

No

Though it was an administrator, not a nurse, doctor or receptionist, that appeared as he was leaving the northern general to present him with the bill. And whilst she did admit that he should have been warned about the charge both when he made the appointment, and when he turned up for it, she refused to waive the charge.

And Neil - do you really 'expect' the NHS to trick a foreign citizen into paying a ridiculously inflated charge for a unnecessary check-up ? An hour with a private Physio would have been a third of the cost and a damn sight more useful. And yes, FYI, his parents did indeed pay the bill, though our suggestion had been to refuse, and escalate it if necessary.
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marsbar - on 24 Nov 2016
In reply to Indy:

Don't call me sir.

Some people can't afford a passport. Not everyone drives. It isn't free to have a driving licence. If you live with parents because you can't afford a place of your own, you don't have your name on utility bills. Getting ID can be yet another difficulty for vulnerable people.
2
marsbar - on 24 Nov 2016
In reply to summo:

I agree, but we decided against ID cards here, because we don't want to be like those sensible European types.
2
Big Ger - on 24 Nov 2016
In reply to marsbar:

> Don't call me sir.

> Some people can't afford a passport. Not everyone drives. It isn't free to have a driving licence. If you live with parents because you can't afford a place of your own, you don't have your name on utility bills. Getting ID can be yet another difficulty for vulnerable people.

So, allowances cannot be made for the microscopically small percentage of the population you describe? Should we throw the baby out with the bathwater then?

Isn't this getting into the realms of "reductio ad absurdum"?

2
marsbar - on 24 Nov 2016
In reply to Big Ger:

I'm not saying they can or can't, I was just answering the question. Having an ID card might have been sensible, but we chose not to.
Big Ger - on 24 Nov 2016
In reply to marsbar:

I'm sure some way around the problem of ID could be found for the people you describe though, without having a national ID card system. So that's not really a hindrance to the concept of requiring ID for treatment.
Rob Exile Ward on 24 Nov 2016
In reply to Big Ger:

You really should be a politician. 'I don't know what the solution is, but there must be one because I say so. So let's go ahead with the policy anyway, because when it goes t*ts up I'll be long gone and no one will remember.'

I sat in a meeting the other day when NHS payments were being discussed. 1st item on the agenda: Crapita are currently in meltdown, and can't process paper forms at the moment, let alone introduce computer systems. 2nd item on the agenda? Responding to the govt's Daily Mail fuelled demand to make the system more complicated still by introducing checks to prevent Johnny foreigner claiming free eye tests. Cost? Millions. Savings? About 50p.
1
StuDoig - on 24 Nov 2016
In reply to neilh:

Differentiating between A&E and other services (particularly chronic services) is important I think.

Genuine A&E care immediate should be free to anyone who needs it, regardless of nationality.

Follow ups, subsequent treatments or anything chronic related and I like the EHIC system that you are treated as a national of the country you're in with costs reclaimed from your "home" health service. ID should be required, but shouldn't delay treatment either (a friend recently had an accident in Italy and they were happy to treat him (A&E + followup care the next day) with no proof of ID etc until we went back to our camp and found his passport (he's a US citizen living in a different European country for extra complication).

Personally I've little against a national ID card replacing passports; I'm too boring for the state to care much about, and it'd be convenient to have a single card that counted as ID for all official functions living in my wallet. I'm not keen on compulsory carry, and would like definite limits set on the info it links to though. Plus doubt our government to set it up without a major disaster of some kind!

Cheers,

Stu

hang_about - on 24 Nov 2016
In reply to Neil Williams:

> Agreed. Even the way the US's private system operates, for the ER it's treat first, paperwork/payment later, AIUI.

Only if you are unconscious and in a life threatening condition (even then they will move you to a public hospital asap). You can't get through to the reception desk of a hospital in California without having first shown a credit card or insurance documents (at least for a bike injury where bone was visible through the hole in my elbow).
graeme jackson - on 24 Nov 2016
In reply to Big Ger:

> So, allowances cannot be made for the microscopically small percentage of the population you describe?

Stats quoted on the BBC on Tuesday suggest that less than 70% of the population have a passport and even fewer have a driving licence. I'd say over 30% of the population is not 'microscopically small'.
ads.ukclimbing.com
Big Ger - on 24 Nov 2016
In reply to Rob Exile Ward:

> You really should be a politician. 'I don't know what the solution is, but there must be one because I say so. So let's go ahead with the policy anyway, because when it goes t*ts up I'll be long gone and no one will remember.'

There may be a solution, we won't know until we try finding one. Issuing a NHS ID card for those who find it impossible to get a bill, or a driving license may be one solution.

Isn't it better to look for a solution, rather than to give up because; "someone, somewhere may not be able to get ID"? Or should we take a defeatist attitude to every problem?

Your attitude is rather strange



1
GrahamD - on 24 Nov 2016
In reply to john spence:

> He was duty bound to refer them for treatment but when he raised concerns they were ignored. I don't know if passports and utility bills are the answer but this issue needs looking at .

It may well need looking at but its a criminal investigation that is needed, not a change to the NHS
neilh - on 24 Nov 2016
In reply to Chris the Tall:
Difficult. I have in the past been hit by some high charges for seeing both Spanish and French doctors for quick visits.I have also learnt that visiting a pharmacy in Europe can be a good way of solving issues.

I am always mindful in this situation of what other country's practises are.

Interstingly when I travel abroad both on business and holiday I religously carry with me id ( passport or whatever) ehc card in Europe and medical insurance detailsl ( one of those cards you get). When I send my employees abroad I make sure they understand that they must do the same.

I bet most people do this when they go overseas. Or they quickly change habits after experiencing other countries medical systems.
Post edited at 09:47
GrahamD - on 24 Nov 2016
In reply to Big Ger:


> Isn't it better to look for a solution, rather than to give up because; "someone, somewhere may not be able to get ID"? Or should we take a defeatist attitude to every problem?

First off you need to quantify how much the current 'problem' is costing us and how much we are willing to sppend in order to 'solve' it.
marsbar - on 24 Nov 2016
In reply to Big Ger:

Is it a problem is the first question? There are other more pressing issues right now.
neilh - on 24 Nov 2016
In reply to marsbar:

They are testing it out already in some areas like Peterborough.

The answer I suspect is nobody really knows. There is an old saying " looking after the pennies etc".So these small things can matter when added together.
marsbar - on 24 Nov 2016
In reply to neilh:

I get the feeling this is less about looking after the pennies, and more about foreigners taking our tax money. There are plenty of other places where far more is being wasted. In principle I'm not against the idea, if it is done sensibly. In practice, Crapita are a complete disaster already and it will just be more chaos.
2
summo on 24 Nov 2016
In reply to marsbar:

> Is it a problem is the first question? There are other more pressing issues right now.

UK public sector roughly 5 million workers, there are many thousand just working in and around the MP/Lords themselves, I would hope they can work on more than once issue at a time.

Apart from the NHS an ID can be used to counter a variety of means of fraud, they are a little harder to produce at home than a paper utility bill with your name and address on.


marsbar - on 24 Nov 2016
In reply to summo:

I didn't argue against an ID card. However other people did and now it isn't happening. https://www.gov.uk/identitycards
Neil Williams - on 24 Nov 2016
In reply to Big Ger:

Probably because most of the European systems are insurance based, and as such there needs to be a bill to claim back for each individual piece of treatment.

The NHS is not funded in that way, so a billing infrastructure simply doesn't exist in the same way.
Neil Williams - on 24 Nov 2016
In reply to marsbar:
> I didn't argue against an ID card. However other people did and now it isn't happening. https://www.gov.uk/identitycards

I argued against Labour's expensive, ill-conceived scheme. I'd be in favour of a much simpler one, possibly based around issuing driving licences with no driving entitlement on them, as some US states do for that purpose.

I also oppose compulsory-carry, though I don't oppose a need to prove your identity for some activities e.g. voting, NHS treatment etc, provided a card is available at very low cost (possibly zero cost for those on benefits) for everyone legitimately in the UK, regardless of who they are - including homeless etc.
Post edited at 10:38
Chris the Tall - on 24 Nov 2016
In reply to neilh:

Indeed, live and learn, which is why I was sharing the story on here.

But in this case the lad did specifically ask if he would be charged (remarkable foresight given the pain he must have been in) and was told that A & E was free to all. The £230 he was charged was for a one-minute outpatients consultation.
summo on 24 Nov 2016
In reply to marsbar:

> I didn't argue against an ID card. However other people did and now it isn't happening. https://www.gov.uk/identitycards

UK stepping or staying back in time. The world is going electronic, perhaps the UK will skip the whole scannable biometric ID card bit and just have the chip under the skin in 20 years time instead.
neilh - on 24 Nov 2016
In reply to Chris the Tall:

Probably about the going global rate for these things.Unless in the USA

summo on 24 Nov 2016
In reply to Neil Williams:


> I also oppose compulsory-carry, though I don't oppose a need to prove your identity for some activities e.g. voting, NHS treatment etc, provided a card is available at very low cost (possibly zero cost for those on benefits) for everyone legitimately in the UK, regardless of who they are - including homeless etc.

About £35 for a card valid for 5 years here. Folk need them here if they go in person to the benefits, tax, job centre office etc... too. They link in with the same computer bank ID system, where you can sign in with the same banking log to government websites to do tax returns etc.. less passwords and log ins to remember. They also tie in with national data base so if you buy things in a shop then 14 or 28 days invoicing is quite common, or for an instant credit check as everyone's earnings and tax payments are public. With a well run system, the security it can bring to a whole hosts of things is only limited by your imagination.
Neil Williams - on 24 Nov 2016
In reply to marsbar:

> I agree, but we decided against ID cards here, because we don't want to be like those sensible European types.

ITYM "because Blairite Labour wanted to turn it, like most other things, into a data collection and surveillance operation".

Mind you May is hardly better at that...
Neil Williams - on 24 Nov 2016
In reply to summo:
Agreed, Blair ruined it.

But I think £35 is too much. That's £140 for a family of four - for some, that'll mean no or very basic food that month.

Either means-test the cost, or just put it on general taxation with a nominal fee (maybe £5 or so) to stop people treating them like they have no value and losing them all the time.

I'd also go for 10 year validity - it works for driving licences and passports, the latter being the gold standard for a secure identity document that is valid in and of itself rather than off the back of a database record.
Post edited at 10:49
summo on 24 Nov 2016
In reply to Neil Williams:
> But I think £35 is too much. That's £140 for a family of four - for some, that'll mean no or very basic food that month.

unless kids start to drive at 16 ( tractor car or moped) then they don't need them. If they can afford to drive then the car cost would imply they have funds.

£140 would probably only feed you for a week here! Besides even if you have 4 ID cards in a family, that's an average cost of £2.30 per month, hardly ground breaking. I don't mind the cost, I see the benefits in terms of better financial security, less fraud etc... Perhaps rather than say it's the governments job, their responsibility etc... everyone should take a bit of responsibility and help fund aspects of society that benefit themselves and others.

I suspect that the £35 cost is a nominal fee and doesn't reflect the actually cost of checks, staff time etc...

I think the 5 year bit is to cut fraudulent production, everyone is re-photoed, height measured, details confirmed in person etc.. plus the design changes to the card.
Post edited at 10:58
1
pass and peak - on 24 Nov 2016
In reply to summo:
The world is going electronic, perhaps the UK will skip the whole scannable biometric ID card bit and just have the chip under the skin in 20 years time instead.

Don't need chip, they have the retina scan, they have mine and I'm fairly certain they have yours, along with a large portion of the people on here. Anyway slight side track, I carry my UHIC in my wallet along with driving licence just in case I get asked, but would be rather surprised and annoyed if it was at admissions for A and E.
Neil Williams - on 24 Nov 2016
In reply to summo:

> unless kids start to drive at 16 ( tractor car or moped) then they don't need them. If they can afford to drive then the car cost would imply they have funds.

Yes, I have no issue with driving licences and passports being at cost - you don't have to drive and you don't have to go abroad.

> £140 would probably only feed you for a week here! Besides even if you have 4 ID cards in a family, that's an average cost of £2.30 per month, hardly ground breaking.

The issue isn't £2.30 per month - it'd be fine if it was payable by monthly direct debit (but then that's back to putting it on general taxation). The issue is a large up-front sum. Because ID would become mandatory for taking part in society it has to be available to *everyone* legitimately in the UK, even those who are completely destitute. Hence either means-tested or free.

I can afford £35. The bloke who kips on a used mattress round the back of the station clearly can't, and he's already shut out of many aspects of life without adding more. At least he should get one for free.

> I don't mind the cost, I see the benefits in terms of better financial security, less fraud etc... Perhaps rather than say it's the governments job, their responsibility etc... everyone should take a bit of responsibility and help fund aspects of society that benefit themselves and others.

I agree, but that should be by an increase in general taxation, not a "poll tax" style regressive effectively-mandatory fee, however small.

> I suspect that the £35 cost is a nominal fee and doesn't reflect the actually cost of checks, staff time etc...

I would agree, but it's still too high. Set the services we need, and set income tax to pay for them (which would probably mean a couple of pence on basic and maybe 5p on higher, I suspect). Honest and up-front in my book.
marsbar - on 24 Nov 2016
In reply to summo:

I'd be in favour of it if it didn't cost too much and we didn't have to carry them all the time. I just don't see it happening at the moment.
1
summo on 24 Nov 2016
In reply to pass and peak:

> Don't need chip, they have the retina scan, they have mine and I'm fairly certain they have yours, along with a large portion of the people on here. Anyway slight side track, I carry my UHIC in my wallet along with driving licence just in case I get asked, but would be rather surprised and annoyed if it was at admissions for A and E.

they do have mine. I would still have to show my ID card if I walk into A&E here, but they invoice you the £30 later. If you come in via an ambulance on trolley, they are a little more understanding and treat first, but at some point during your stay they will certainly ask for either the ID card or personal number.
summo on 24 Nov 2016
In reply to marsbar:

> I'd be in favour of it if it didn't cost too much and we didn't have to carry them all the time. I just don't see it happening at the moment.

everyone is glued to their mobile phone and how many people go anywhere without at least one bank card with them? It's hardly onerous to have some form of identification. You are right I don't see it happening in the UK for many years, perhaps only more terrorism will be the driver of it.
summo on 24 Nov 2016
In reply to Neil Williams:
> I would agree, but it's still too high. Set the services we need, and set income tax to pay for them (which would probably mean a couple of pence on basic and maybe 5p on higher, I suspect). Honest and up-front in my book.

I agree and in the main that is the Nordic policy, less subsidiary taxes, higher taxes up front for everyone, workers and employers. Lowest to the highest earners; everyone pays into the pot with a very low zero tax threshold of under £2k. Although tax up front here is more than a few points higher than the UK, especially for higher earners.
rallymania on 24 Nov 2016
In reply to marsbar:

i think the problems with the way the ID cards was pitched was much of the problem

first off, the gov of the time didn't have a spectacular record with IT projects (and storing ID details for 65 to 70 million people is a pretty major IT project)

there was significant concern that the DB would be secure and the info in it not sold off.
that it's use would escalate beyond it's original remit and that was considered unacceptable
the estimated cost per card that each citizen would have to pay was something like £150, to many people that is way much
Jim C - on 24 Nov 2016
In reply to Mike Rhodes:

If you have a EHRC then they ensure that they claim the costs back.
I think (could be wrong) it is a clearing system at the end of the year the various countries add up the bill against the respective countries, and if ours is say a Million to France and France is a Million to us we call it quits;)

> It's a simple procedure that needs implementing and enforcing in the UK.
I agree

Jim Hamilton - on 24 Nov 2016
In reply to rallymania:

> the estimated cost per card that each citizen would have to pay was something like £150, to many people that is way much

Aren't most people (in England & Wales ?) issued an NHS number - can this be used somehow?
Dave B on 24 Nov 2016
In reply to neilh:

Some thoughts, but all i could fit down in a lunch slot...

I find it slightly worrying that a 'simple solution' is being proposed.... because they never are:

Ignoring emergency treatment.

Things I would expect to be needed for it to be a useful system:

1) Training ALL staff in all forms of acceptable documentation. You will find that hospitals are 24 hours now, some consultations happen 'in the community'. This means I see my specialist in a place with no receptionist. All paperwork is done by the specialist.
2) A system that will help identify fraudulent information.
3) An IT system capable of SAFELY recording this information. Remember it will have to be online and could well be a target of cyber-attack and leave millions of vulnerable individuals details (and possible high quality info e.g. passport scans/utlitiy bill info) available for all and sundry for a cheap price on the internet of dark web.
4) Auditing of this information. Just because somehow has a driving license or utulity bill, doesn't mean they shouldn't pay. Just because some says they saw a piece of ID doesn't mean they did, in any large system there will be a very few who will compromise it.
5) A system that integrates with payment systems.

Questions:
1) What happens to Mabel, 96, who forgets her ID on the first day of treatment?
2) What is the likely cost to the NHS of missed appointments through having no acceptable form of ID after the booking has been made?
3) Is the ID check made on the 'first day of treatment' (e.g. by the GP) and then good for the duration of the treatment, or repeatedly for each session?
4) What happens to persons whose circumstances change - e.g. become foreign citizen, become UK citizen, become eligible for free treatment after payment begin , e.g progression of illness to involve other specialisms
5) would the paying customers, sorry patients(!) become more demanding at the expense of other patients. That 1 minute consultation costing £100 or £200 might be the patient saying, sorry, I have paid for X time and you will give me X time, which prevents that consultant from seeing another patient.


My concern is that this becomes another reason for an expensive, poorly implemented, (IT) system that may shut people out of treatment who are eligible, will cause the deterioration or demise of someone irrespective of eligibility, or is the justification for a system that is the basis of a pay-per-treatment system.. and while we are at it, get the 'foreigners' to pay for it. At what cost to the rest of the NHS system? Do we really want to employ MORE people to do the job of checking and buy in systems to enable the checking if this costs is more than, or even a only reasonable proportion of the money that would be reclaimed.

Anyway, won't this be solved easily soon anyway because we have left the EU and there won't be any foreigners in the country? ;-)

rallymania on 24 Nov 2016
In reply to Jim Hamilton:

i'm sure it could, i was responding to the questions about why the previous ID cards were rejected

although the idea of ID cards often makes sense, there's still issues

how do you prove the documents you present to get the ID card aren't faked?
making the card itself counterfeit proof (if that is actually possible) would be very expensive
the DB to manage everything would also be very expensive to build and manage.

a passport currently costs from £72.50, but the ID card was going to cost twice that.

marsbar - on 24 Nov 2016
In reply to rallymania:

Fair enough.
marsbar - on 24 Nov 2016
In reply to Jim Hamilton:

They couldn't even manage to match my NHS number and my prepayment card. They sent me (and quite a number of others) a fine which wasn't correct. I don't hold much hope for anything more complicated.
Big Ger - on 24 Nov 2016
In reply to marsbar:

How about these, we all carry one over here;

http://www.bondijunction7daymedicalcentre.com.au/file/2012/04/medicare-card.jpg

There, that wasn't so hard was it? Even your deaf, dumb and blind person who lives in a tree with his elderly parents in remotest Shetlands, can have one.
Big Ger - on 24 Nov 2016
In reply to Neil Williams:

> The NHS is not funded in that way, so a billing infrastructure simply doesn't exist in the same way.

Ok, so things can never change then, got it.



marsbar - on 24 Nov 2016
In reply to Big Ger:

It's not that things can never change, it's do we need to spend money knee jerk on an unspecified and uneconomically viable change, just to please the Daily Mail readers?
marsbar - on 24 Nov 2016
In reply to Big Ger:

As for carrying ID, I don't wish to live in a fascist state. I have the right to not carry ID at the moment, why should I give that up?
Big Ger - on 24 Nov 2016
In reply to marsbar:


> As for carrying ID, I don't wish to live in a fascist state. I have the right to not carry ID at the moment, why should I give that up?

So you don't carry a driving license/passport/Tesco club card, due to the fascistic nature of it?

I must tell all my Aussie colleagues not to ask for medicare cards when doing an assessment, or next thing you know they'll be marching on the Opera House in jackboots singing "Es zittern die morschen Knochen"

You're embarrassing yourself now.

1
Big Ger - on 24 Nov 2016
In reply to marsbar:

> It's not that things can never change, it's do we need to spend money knee jerk on an unspecified and uneconomically viable change, just to please the Daily Mail readers?

'Deliberate' use of the NHS—use by those who come here specifically to receive free treatment or who come for other reasons but take advantage of the system when they're here—is hard to quantify. It's thought to be very roughly between £110 million and £280 million a year.
'Normal' use of the NHS—by foreign visitors who've ended up being treated while in England—is estimated to cost about £1.8 billion a year.
The majority of these costs aren't currently charged for. Only about £500 million is thought to be recoverable or chargeable at the moment.
Rob Exile Ward on 24 Nov 2016
In reply to Big Ger:

I so wish I lived in the egalitarian, efficient paradise that is Australia. You have solved every human problem, it seems.
FesteringSore - on 24 Nov 2016
In reply to neilh:

Perhaps I'm missing something but why can't medical treatment be linked to NI and NHS numbers. If somebody attends a doctor's surgery or hospital surely there could be a computerised system for checking the validity of a given NI/NHS numbers and anyone(from abroad) without NI/NHS has to show a passport by which means they can be billed through the appropriate embassy.
Rob Exile Ward on 24 Nov 2016
In reply to FesteringSore:

You're correct, you are missing something. But don't worry, you could become a civil servant because most of them miss the point(s) as well.

You're missing three things. 1) It's not easy to create and maintain a central, secure and up to date database of 60 million people that can be accessed by the 100,000 employees of the NHS. 2) For 95% of people remembering their NHS/NI numbers or whatever is a straightforward and realistic task. Sadly, for 5% of people, it's less straightforward - children, people with learning difficulties, the elderly - and blow me, those are just the people who are most likely to need help the most, and will die without it. 3) On a day-to-day basis, the NHS and NHS admin is permanently stretched. Now, I am of the view that it could be significantly improved with better management and less political interference; but imposing an additional administrative burden without additional funding and expertise isn't a good way to go about it.
Big Ger - on 24 Nov 2016
In reply to Rob Exile Ward:

> I so wish I lived in the egalitarian, efficient paradise that is Australia. You have solved every human problem, it seems.

I bet you do, but we have enough negative, defeatist, misery guts, of our own thanks.

No one claimed Australia "solved every human problem", so why is it so unacceptable to offer another country's solution to the problem?

Can the UK learn nothing from other countries, is it that perfect there, are you an isolationist, parochialist or Little Englander?
2
nutme - on 24 Nov 2016
In reply to Neil Williams:
> Personally, I'm in favour of NHS emergency treatment being free to all without exception. There is almost no scope for health tourism there anyway - if you've broken your leg you can hardly fly across Europe to the UK before you have it treated. And I don't want anyone to be in unnecessary pain, whether they are legally in the UK or not.

Well.. You don't say. Just last year a friend of mine broke his leg on ski trip in Poland. We managed to board BA plane two days later and fly to UK without a single question at any point. Next morning he went to AnE in London to have his leg fixed. We were well aware it was broken as our party 'doctor' is a vet and does understand human bodies quite well.

Broken limbs in 99% don't really stop you from travelling. With exception of US maybe - their customs are really nuts.

I think for real AnE is should be free for all. But accrual AnE - when the life is on the stake. Like you been stabbed and inner organs are damaged. Or stroke. Not a fucking broken leg or blood in the poo!
Post edited at 23:31
Neil Williams - on 25 Nov 2016
In reply to Big Ger:
> Ok, so things can never change then, got it.

Sure they can, but the point is that setting up a per-treatment billing infrastructure in the NHS is neither a small nor a cheap one, and to do it just to bill the occasional non-citizen receiving treatment may not actually be profitable - as it is simply not required for the NHS's primary purpose (because it is not funded as an insurance system), the full cost would go onto that.

It's not dissimilar to why station ticket barriers are open in the evenings. It would cost more to staff them than to put up with the small amount of fare dodging.
Post edited at 00:04
Neil Williams - on 25 Nov 2016
In reply to nutme:
> Well.. You don't say. Just last year a friend of mine broke his leg on ski trip in Poland. We managed to board BA plane two days later and fly to UK without a single question at any point. Next morning he went to AnE in London to have his leg fixed. We were well aware it was broken as our party 'doctor' is a vet and does understand human bodies quite well.

Well, he's brave/mad/has a high pain tolerance - if I'd broken my leg I'd be in the nearest A&E in whatever country (that's what I pay travel insurance for). I absolutely would not be waiting two days. That's nuts.

> Broken limbs in 99% don't really stop you from travelling. With exception of US maybe - their customs are really nuts.

Broken legs *should* stop you travelling by air, the risk of complications are huge. You took a big risk. Your choice, but not a sensible choice.

> I think for real AnE is should be free for all. But accrual AnE - when the life is on the stake. Like you been stabbed and inner organs are damaged. Or stroke. Not a f*cking broken leg or blood in the poo!

I can't agree. Everyone has a basic human right not to be in pain. I'm happy to pay for a few people (and it is only a few) to sort that out, to be honest. It is not a huge sum of money.
Post edited at 00:13
1
Neil Williams - on 25 Nov 2016
In reply to Big Ger:
> No one claimed Australia "solved every human problem", so why is it so unacceptable to offer another country's solution to the problem?

Australia has an insurance-based healthcare system. The UK doesn't, it has one funded in a more abstract way by clinical commissioning groups, not associated to specific patient treatments. The solutions for the former don't necessarily work for the latter.

> Can the UK learn nothing from other countries, is it that perfect there, are you an isolationist, parochialist or Little Englander?

An insurance-based (mandatory social insurance[1]) healthcare system with defined benefits may be worth considering if the NHS continues to have problems - but billing a few "foreigners" who cost us a noise-level amount of money is not in my book a good reason to make that massive change. We should only make that change if it will benefit *us* as a country.

[1] Mandatory insurance, paid for based on income, not need/risk - as most European countries have.
Post edited at 00:13
Big Ger - on 25 Nov 2016
In reply to Neil Williams:

> Australia has an insurance-based healthcare system. The UK doesn't, it has one funded in a more abstract way by clinical commissioning groups, not associated to specific patient treatments. The solutions for the former don't necessarily work for the latter.

But why should this stop the UK introducing a NHS user card?

> An insurance-based (mandatory social insurance[1]) healthcare system with defined benefits may be worth considering if the NHS continues to have problems - but billing a few "foreigners" who cost us a noise-level amount of money is not in my book a good reason to make that massive change. We should only make that change if it will benefit *us* as a country.

It's thought to be very roughly between £110 million and £280 million a year.

'Normal' use of the NHS—by foreign visitors who've ended up being treated while in England—is estimated to cost about £1.8 billion a year.

The majority of these costs aren't currently charged for. Only about £500 million is thought to be recoverable or chargeable at the moment.


If we introduced a card, then billing would be easier surely?



summo on 25 Nov 2016
In reply to marsbar:

> As for carrying ID, I don't wish to live in a fascist state.

Norway, Denmark, Sweden.... those fascist ID card carry citizens of those fascist governments who treat their population so badly...
Big Ger - on 25 Nov 2016
In reply to summo:

Australia, New Zealand, Algeria, Belgium, France, Germany, Hungary, Italy, Kenya, Slovenia, Spain, Taiwan, are all under the jackboot mate.
summo on 25 Nov 2016
In reply to marsbar:

> As for carrying ID, I don't wish to live in a fascist state. I have the right to not carry ID at the moment, why should I give that up?

my point was really, if you have a very open society, where everyone is identifiable, people's finances or tax arrangements are open, everyone has a right to X or Y plus they can prove that right quickly and simply.... then you leave less places in society for evil fascist inequality to hide.
marsbar - on 25 Nov 2016
In reply to Big Ger:

I'm not embarrassed. I have the right to leave my front door without any of those things and I like that. Just because other people think they can't go out without a phone doesn't make it so. It's called freedom. It is gradually being eroded and people don't notice.
1
ads.ukclimbing.com
marsbar - on 25 Nov 2016
In reply to summo:

Not compulsory to carry.
Big Ger - on 25 Nov 2016
In reply to marsbar:

> I'm not embarrassed. I have the right to leave my front door without any of those things and I like that. Just because other people think they can't go out without a phone doesn't make it so.

But if you wish to drive a car, you need a current driver's license. If a big nasty police officer asks to see it, you won't get very far telling him; "I don't have one as I do not wish to live in a fascist country.


> It's called freedom. It is gradually being eroded and people don't notice.

It's called "government by consent," it's been around for a century and it's not going away

summo on 25 Nov 2016
In reply to marsbar:

> Not compulsory to carry.

it's not compulsory to carry here, if I don't intend to drive, collect a parcel, visit a government dept., the doctors etc...

Even the random things like hiring piece of equipment, a trailer or some building tool, one scan of your ID and that's it, no deposits against bank cards, forms to fill out etc..
summo on 25 Nov 2016
In reply to marsbar:
> It's called freedom.

Is freedom an open & transparent society, or one full of secrets?
Post edited at 08:21
Neil Williams - on 25 Nov 2016
In reply to Big Ger:

> But why should this stop the UK introducing a NHS user card?

It wouldn't, but you are missing the point.

> It's thought to be very roughly between £110 million and £280 million a year.

Which is peanuts compared with the massive cost required for introducing an IT system to track these costs that are not presently tracked. Unless we do something like introduce nominal fees not related to the actual treatment costs (which might not be a bad idea) it isn't easy.

> If we introduced a card, then billing would be easier surely?

A card isn't the problem (there already is one, it would just need improved security). The problem is that we presently do not log each specific cost against an individual's treatment, so the infrastructure does not exist to produce an itemised bill. We would have to start doing that on a new IT system, and to set it up would cost hundreds of millions if not billions.
marsbar - on 25 Nov 2016
In reply to Big Ger:

If a lovely police officer wishes to see my licence, they will ask me to produce it within 7 days at a police station that suits me. There is no requirement to carry it with me and I don't.
marsbar - on 25 Nov 2016
In reply to Neil Williams:

My concern is if we were able to set up a billing system (for those scrounging foreign types obviously) the next step would be to use that billing system on all of us.

The government would like nothing more than to wreck and demolish the NHS, but inability to organise the practicalities my be our saving grace.

marsbar - on 25 Nov 2016
In reply to Big Ger:
At the risk of invoking Godwin's law http://www.usmbooks.com/nazi_kennkarte.html

They were brought into Poland by the Nazis and Polish people still have to carry ID cards today.
Post edited at 10:08
zebidee - on 25 Nov 2016
In reply to Indy:

> Its estimated at between £120 million and £300 million a year so your right... minimal.

The NHS England budget for 2013/14 was £110 billion.

So let's do the sums ...

£110b = £110,000m

£120m / £110,000m = 0.11%
£300m / £110,000m = 0.27%

So yes minimal in the scale of the NHS budget.
Indy - on 25 Nov 2016
In reply to zebidee:

Are you really that stooopid? instead of being an apologist for 0.27 of the NHS budget maybe you'd like to tell the child with a rare cancer that treatment is too expensive or that 92 year old Mrs Smith has had to wait in a corridor for 14 hours because of lack of beds due to funding or Mr Jones who died while waiting to see a cancer specialist due to underfunding. How many nurses would £120 million pay for or drugs?

I'm fully happy for you to keep paying for the NHS but give your entitlement to an ineligible foreigner but don't go giving other peoples entitlement away.
marsbar - on 25 Nov 2016
In reply to Indy:

0.27% isn't 0.27

0.27 is 27%

Hope this helps.

And 0.27% won't be enough to pay for all those life saving treatments when we've pissed it up the wall, and a whole lot extra on administrative and IT costs.

If I draw it on the side of a big red bus will that help?
zebidee - on 25 Nov 2016
In reply to marsbar:

> 0.27% isn't 0.27
> 0.27 is 27%

I just expressed it in percentages ... you want the raw numbers - okay:

£120,000,000 / £110,000,000,000 = 0.0011 ... which is 0.11%
£300,000,000 / £110,000,000,000 = 0.0027 ... which is 0.27%

Perhaps if I wrote that on the side of a bus you might not jump to conclusions.
marsbar - on 25 Nov 2016
In reply to zebidee:

My reply wasn't to you it was to Indy. He called you stupid and then proceeded to use your correct 0.27% as his incorrect 0.27

He is the one I was suggesting needed it writing on the side of a bus as he can't tell the difference between 0.27 and 0.27%

I was agreeing with your point that it's not enough money to be worthwhile chasing.

So, about that jumping to conclusions.....
zebidee - on 25 Nov 2016
In reply to marsbar:

Apologies ... I got mixed up between the two swift responses.

That said, here's a pretty good blog post on pretty much everything that's been said here. Just structured a bit better.

Passport checks before you get NHS treatment http://defencebrief.blogspot.com/2016/11/passport-checks-before-you-get-nhs.html
marsbar - on 25 Nov 2016
In reply to zebidee:
No worries.

Some interesting stuff in there.

Of that £110M to £280M figure, £60M - £80M is foreigners while the majority are British ex pats returning to the UK for free treatment to which they are no longer entitled £ this figure is thought to be between £50M and £200M!

Just to put these figures in perspective, the UK Parliament is about to spend £7bn refurbishing their office building in Westminster and up to £41bn replacing the submarines that carry trident nuclear missiles (that figure doesn£t even include the missiles themselves by the way)!

When you take out the British ex pats, health tourism accounts for between 0.05% and 0.07% of the budget.


So Big Ger, summo, you are an ex pats with British Passports. How do we make sure you don't get an ID card?! Have you paid for NHS care when you've been back in the country? Do you think you should?
Post edited at 12:43
GrahamD - on 25 Nov 2016
In reply to Indy:

>How many nurses would £120 million pay for or drugs?

That is peanuts compared with the amount the NHS has already pissed up the wall on failed IT projects. That is measured in billions. What is the projected IT cost and administritive cosy of your proposal ?
1
Hugh J - on 25 Nov 2016
In reply to Indy:

Here's a typical example of what you're talking about:

http://www.youtube.com/watch?v=gfxewnndNQ8
Big Ger - on 25 Nov 2016
In reply to marsbar:

> If a lovely police officer wishes to see my licence, they will ask me to produce it within 7 days at a police station that suits me. There is no requirement to carry it with me and I don't.

So why should it be any different for a healthcare card?
Big Ger - on 25 Nov 2016
In reply to marsbar:


> So Big Ger, summo, you are an ex pats with British Passports. How do we make sure you don't get an ID card?! Have you paid for NHS care when you've been back in the country? Do you think you should?

I paid 40 years of NI contributions, and tax in the UK. Which is more than a lot of people who use the NHS. I also carry private health cover with BUPA.





marsbar - on 25 Nov 2016
In reply to Big Ger:

I don't have a problem with you using the NHS. I have a problem with the reporting playing on the foreigners angle when that's not the case. I have a problem with the general lack of common sense and inability to see beyond the media and the stereotypes. We can afford the NHS. We are a reasonably rich country. Some people want to wreck it because it suits their politics and their mates. Meanwhile you are arguing that ID cards or medical cards or whatever are a good idea, when they are not cost effective and the whole foreigners are taking our NHS is just another misdirection while the politicians screw us over and the journalists who should be challenging them are helping them instead.
marsbar - on 25 Nov 2016
In reply to Big Ger:

> So why should it be any different for a healthcare card?

In Germany a child with a broken arm was sent away from A and E to get ID.

Meanwhile in the UK the staff at minor injuries managed to figure out without any cards being involved that my niece isn't entitled, and got me to fill in a form. They saw her quickly without sending me home for paperwork.

Tell me again why we need a card?

Big Ger - on 25 Nov 2016
In reply to marsbar:

Well apart from the fact that no one has argued for ID cards, just for some form of identification to use NHS services, and no one has said that "foreigners are taking our NHS ", you make good points.

marsbar - on 25 Nov 2016
In reply to Big Ger:

I give up talking to you.
Big Ger - on 25 Nov 2016
In reply to marsbar:
> In Germany a child with a broken arm was sent away from A and E to get ID.

So, Germany got it wrong in one instance, so we cannot have ID?

> Meanwhile in the UK the staff at minor injuries managed to figure out without any cards being involved that my niece isn't entitled, and got me to fill in a form. They saw her quickly without sending me home for paperwork.

> Tell me again why we need a card?

To make sure that those using the NHS are entitled to, did you miss the whole debate?
Post edited at 20:54
Big Ger - on 25 Nov 2016
In reply to marsbar:

> I give up talking to you.

Thanks, that's the nicest thing you've ever said to me.
Big Ger - on 25 Nov 2016
In reply to marsbar:

You're pro-EU aren't you? We should take a leaf out of the EU's book, don't you think?

AUSTRIA
Health care Available immediately, but only if you pay “social insurance”
BELGIUM
Health care Available after a year
ESTONIA
Health care Available immediately but cash payments required for some treatments
FINLAND
Health care Public health service charging flat-rate fees
FRANCE
Health care Only available with a card proving entitlement, issued to residents
GERMANY
Health care Only available with a health insurance card
GREECE
Health care 100 days of work required to qualify
HUNGARY
Health care Not immediately available
IRELAND
Health care Free after living in Ireland for three consecutive years
LATVIA
Health care Public health service with fees for GP and hospital visits
LITHUANIA
Health care Three months qualifying period
LUXEMBOURG
Health care Not available immediately, as insurance-based
ROMANIA
Health care six-month qualifying period
SPAIN
Health care Only available with a card proving entitlement
HOLLAND
Health care only available with a certificate proving entitlement



Heike - on 25 Nov 2016
In reply to neilh:
I think you are being a bit dishonest there, when you have an emergency in Germany you always get treated without question, you have to provide an insurance card or EHIC card if you are seen to for a non-emergency.
Post edited at 21:15
neilh - on 26 Nov 2016
In reply to Heike:
I was helping out with a weeks scout trip. Girl fell over when we went to an ice rink .

We had the EHC cards with us. But they demanded the passport as well.

Sorry to say but it was true.
Post edited at 08:19

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