UKH

https://www.theguardian.com/society/2018/nov/13/nhs-denied-treatment-for-mi...

The cost to the NHS of 'health tourism' is 0.3 of it's total budget (the figures are around on the web), yet we now have a policy in this country which means that people will die because of being too poor, like the woman with cancer mentioned in the article. 

'' Treatment deemed urgent or “immediately necessary” is meant to still be carried out regardless of ability to pay. However, the Guardian has learned of a patient with an advanced form of blood cancer who was denied urgent chemotherapy after the hospital demanded upfront payment. Elfreda Spencer, a 71-year-old Jamaican woman, was taken ill in 2016 while visiting her family in London. Tests at Hammersmith hospital diagnosed her with advanced stage multiple myeloma.

The hospital consultant advised that Spencer undertake chemotherapy as soon as possible. But Imperial College healthcare NHS trust, which runs Hammersmith hospital, demanded a £30,000 upfront deposit before it would start chemotherapy, and refused the family’s desperate offer to pay £500 a month to enable treatment to begin.

As a result, Spencer went a year without receiving any treatment, during which her cancer became terminal. She later received treatment at London’s Royal Free hospital, but died in January 2018 of sepsis. A spokesman for Imperial College healthcare NHS trust said it was investigating Spencer’s case.''

I wouldn’t expect to receive ongoing cancer treatment while on holiday no matter where I am. Emergency treatment yes, but chemo no way! When the doctor said ‘straight away’ I’m sure they could have allowed for a flight back to Jamaica.

Just to be clear, do you mean 0.3 (i.e. 30%) or do you mean 0.3%?

https://fullfact.org/health/health-tourism-whats-cost/

The Jamaican lady was possibly not the best example, another fellow was discharged from hospital with chest pains after it was found that he couldn't pay for the surgery needed to prevent a stroke or a heart attack.

This isn't the reasonably decent country I grew up in - it can feel like, when it's become as callous as this, for what is less than half of 1% of the budget for the NHS. It doesn't matter if other countries are harsher, none of us would choose to be unwell and unable to pay. 

It's a part of the current Conservatives government's 'harsh environment' plan, and it's very callous.

It’s a sad story, but if I was travelling abroad I would expect to need insurance. I know that can be incredibly expensive for older people or people with existing conditions, but that is what most people do. 

Edit: your second example is worse. I would expect emergency treatment to be offered to all. 

In Nye Bevan's words (kinda sorta), we have become the kind of country where we would rather 'exploit the most disreputable emotions' than 'rejoice in the opportunity to practise a civilised principle'.  It's a damned shame.  He was right then (writing in 1952), and he's right now.

Link:  https://beastrabban.wordpress.com/2016/02/12/nye-bevin-on-the-treatment-of-...

Yes it is, but it's also less than half of one percent, too, which 'health tourism' costs the NHS (is it tourism or or 'oh shit-ism'?).

People are left to die or remain extremely unwell for that. 

Edit: If the dislikers could articulate their points of view, that might help towards changing my mind, and exploring the issue more fully. A dislike is like a 'so ner' being randomly interjected. 

Your link suggests a figure of £300 million and my estimate based on 0.3% of the £125 billion NHS budget is £375 million. Don't you think that's a sizeable sum?

Now, along with everyone else I'd wager, I'm all for providing emergency treatment to anyone with an unexpected health emergency. But treating existing known conditions of visitors who have made no contribution to the cost, and doing so at the expense of vital public services, is something I'd expect our government to legislate to avoid, not complain about on an internet forum.

Couldn't have put it better myself!

The NHS isn't at all geared towards seeking and chasing payments so I'd be interested in where the figure had come from. As the Guardian piece linked says....The true figure across all trusts is certain to be higher, given that 64 trusts did not supply figures. 

By the by, taking the 0.3% at face value, what do you think would happen to that figure if the law was changed and the NHS had to provide free health care to anyone who hopped onto a plane and came over? 

People can already expect to wait 3 years for a kidney transplant with the NHS providing free health care to 70 million people, what do you think will happen to that waiting list if free NHS cover is extended to 7 billion?

Just to remark that, according to the link you gave, the 0.3% relates to *deliberate* health tourism, meaning someone who knows they need treatment and so travel to the UK to obtain it. 

The Jamacian lady is not in that category (according to your post), since she fell ill while here.  Again, from your own link, such cases add up to about 2% of the budget, not 0.3%.  Though that would be somewhat offset by Brits receiving treatment abroad under similar circumstances.

So the actual figure (again, going by your link and the report cited in it), would be about 1.5%.  

The link is clear about what it is, £300 million a year on people who deliberately visit the UK to obtain treatment for which they're not eligible.

'Oh shit-ism' is around £1.5 billion on top of that.

The policy is clear that charging up front should purely be for elective, not life-saving, treatment. I honestly don't have an issue with that.

For me, it’s look after your own first. We are not the Red Cross for the world and we have enough folk who’ve paid their national insurance who need lifesaving  treatment first. Personally I would stop all non essential treatment and surgery including gender changes. But then, that’s just my opinion.

Ooph........do you have to fulfil both of the first two criteria, if so, I claim my £5.

You are a Daily Fail troll...

The like is from me. Opinions are opinions. 

Fine, the problem is, how do you differentiate between people who are entitled to free treatment and those who aren't in a system that's free at the point of use ?

Well you need some sort of centralised nationwide ID card system, or health card system (which effectively will amount to the sale thing) which is is likely to cost a lot more than you're 375m, and anyway, people don't want it.

What's happening instead is that now if you come in with a white face and a British accent nobody asks you for anything, but if you don't they ask you to prove that you are British or otherwise entitled to free treatment. 

So we have three choices if we want to keep the system free at point of use:

- No checks at a cost of 0.3bn a year in fraud

- Checks against a national ID database, estimated cost 1.5bn

- Institionalised discrimination on how you look/sound in the NHS, which is despicable and unlikely to be reliable.

Which one do you pick ?

Yes, discrimination on facies works sometimes.

I'd bet that if she was white and didn't sound foreign nobody would have asked any question. Witnessed it myself when me and my wife registered together in a new GP practice. I'm white and I sound British, and she has a Middle Eastern complexion. The receptionist didn't ask me for anything, but then she turned to my wife with a suspicious look and asked her to come back with payslips and proof of residence...

Fine, how much do you think checking the ID and immigration status - which can be extremely complex - of everybody that comes in for treatment would cost ? Given the volume of people using the NHS the   bureaucracy required is likely to cause more problems and delays and cost a lot more than whatever is lost to fraud.

Personally I'm fine with charging people with no entitlement to NHS treatment as longs as everybody has to go through exactly the same checks without discrimination. 

Odd of you don't take into account that you are dealing with a 71 year old who needs to be with her family in such a situation. She was told by the the NHS consultant himself that she should not travel and instead undergo treatment in the UK.

When it became clear she couldn't get treatment they started making arrangement to seek treatment in Jamaica, but the Jamaican high commission referred her instead to a UK charity that led to another referral. By that point the cancer was already terminal.

It's very easy to point the blame on the patient without trying to understand the circumstances -  until you find yourself in the same situation.

I have seen checks take place at our local nhs hospital in and e on white Europeans. They were ahead of me in the queue. ID taken and all recorded at reception. 

So I think your point is weak  

"Witnessed it myself when me and my wife registered together in a new GP practice. I'm white and I sound British, and she has a Middle Eastern complexion. The receptionist didn't ask me for anything, but then she turned to my wife with a suspicious look and asked her to come back with payslips and proof of residence..."

cool story bro

Well yes the problem is there are no rules and the checks are not consistent. Some places have systematic checks in place. Some other it's basically spot checks if you don't look/sound British. NHS staff are not immigration officers and have no clue as to how to handle this.

You say there were ID checks. Did they check everybody that came in regardless of whether they sounded / looked British ? 

Did YOU have to show and ID ?

Fine, if that's the case that means everybody has to have an ID to get NHS treatment. And we are back to my point that this isn't possible to have these systematic checks on everybody without effectively introducing mandatory IDs by the backdoor.

The reality is that it's very difficult to check the immigration status of someone unless they can show their are British with a passport or have a visa or document proving that they are entitled to public funds - unless you have a central national ID database.

So again, as I've said, I'm not against checking whether people are entitled to treatment or not, that is, as long as EVERYBODY has to go through the same level of checks and is asked for the same standard of proof.

LOL 

Unfortunately true and not isolated. One of my friend (French) experienced the same thing when he came in with his Scottish wife.

What is your connection to Britain exactly. Do you live here? Are you an immigrant?What is your beef with Britain because you haven't got a good word to say about the country or its institutions?  You have no profile to speak of and hide behind your annonimity. You contribute nothing towards anything to do with climbing or anything that is non political for that matter so what is your modus operandi here? 

Is there any great problem with checks based on non-UK accents?

If I turned up at an A&E in Germany I'd expect to have to do more to prove who I am than a local would, and wouldn't have a problem with that. 

Who did they check, his wife?

You don't live here anymore.  Take your beef, sorry, boeuf, elsewhere.

I’ve been asked for my id and GP address at A&E before getting treated. I don’t see what the issue with that is? I look about as ‘english’ as you can look. 

Don’t travel without insurance. Don’t expect healthcare you’re not entitled to. Don’t procrastinate for a year and give yourself a death sentence. Don’t assume everyone should do things for you. I fee very sorry for this little old lady, but she sounds like she got herself into this pickle and didn’t do anything to get out of it. 

Again, I have no issue with that, on the contrary.

But that means that effectively everybody needs to hold a passport.

Yes, it's discriminatory, and - completely unreliable - to apply different checks and standard of proof  based on skin colour and/or accent.

I'm British and spent most of my life in Britain ? 

Not anymore. And yes.

I've got many good things to say but nothing good to say about discriminatory checks on skin colour and/or accents at NHS entry points. 

Instead of resorting to jingoism and brand  me as some kind of traitor, why don't you look at the point being made and ask yourself if it is so unreasonable to simply ask that everybody who comes in the NHS is made subject to the same checks and standards of proof ?

Maybe, but It's a quick way not to have to check everybody.

I don't get asked for ID when I go into a pub. I'm clearly old enough. Some people do. Is that discrimination and ageist?

Yes it is treating people differently according to accent.  Is there anything wrong with that?

And yes it is an unreliable method in that it won't check everyone who needs to be checked. As you've explained, a rigorous procedure would be expensive.  So what's wrong with a easy and cheap, though unreliable, method?

Yeah, right.  R the B must be an immigrant or something.  He's awfully slow getting to his feet if he hears the national anthem, and I heard he was seen wearing a white poppy last week.  A white one!  If he's not a foreigner he's probably a communist or something eh?

The kind of people who occasionally try to tell me I should be proud to be English are precisely the reason I find it impossible to do so.  Patriotism is the last refuge of the scoundrel, but the first resort of the sun-burned jingoistic littlejohn flying a Union Jack in his front garden (with a 50% chance of it hanging upside down).

But it's only over the last couple of years I've occasionally found myself actually being ashamed of my nationality.  We sent Boris Johnson out into the world to represent us as our Foreign Secretary.  Boris Johnson!  It's time to stop sneering at the Americans, even the Trump supporting slack-jawed yokels, for we too are a nation of f*cktards.

The great majority of us are anonymous here you numpty, or is "Wanderer100" your real name?

I don't think that being denied treatment or submitted to complex and lengthy immigration checks just because you have some accent, a foreign name, or a dark skin colour, even when you are British or otherwise living in the UK legally, can be be compared with the minor annoyance of not be able to get a drink because you may not look old enough.

Has anyone British (to use your term) been denied treatment? 

Yea, it's utterly wrong for the state to instituonalise discrimination and put extra checks and delays on people based on their skin colour or accent.

and it's also illegal, unfortunately this happens. 

https://www.citizensadvice.org.uk/health/discrimination-in-health-and-care-...

You don't think there is a problem with imposing extra checks and delays in access to treatment on people just because they have a dark skin or speak with some foreign accent ?

What you are saying is that effectively you're ok with  considering people with dark skin colour or accents suspicious from the onset.

Maybe the NHS should be putting up signs "please refer to the immigration check desk if you are black or sound foreign" ? After all, it would be cheap an efficient wouldn't it ?

Ho, wait, I know, they shouldn't complain about blatant discrimination and instead just "grow some bones"

Yes, many Windrush immigrants, for example, who were de facto British citizens and/or had ILR but didn't have documents to prove it have been denied treatment or asked to pay for it.

The problem here it seems is that the NHS told her she would not travel but then also denied her treatment.

That illustrates the shambolic and inconstent handling of the issue.

Simple solution: make it mandatory for everybody to hold some sort of health card or an ID before they can seek treatment.

That may cost more than what is lost to fraud, but I wouldn't have a problem with it. However I do have a problem with rules being applied inconsistently and  institutionalised racial profiling.

I broke my leg in France and the first thing they demanded was a credit card. 

I have no problem with that - I don't pay French taxes so why expect free treatment?

In France everybody is asked to pay for treatment - regardless of whether you are foreign or not. You are then given money back if you're entitled to social security.

Which btw you would be entitled to with your EHIC.

Don't be so disingenuous, the whole point with Windrush is that we told them they weren't British.

No objection here. The rest of the world seem to be able to manage it, rather than just wave their hands and say 'Oohh, it's all too complicated'.

In the part of Cambridgeshire where my white face with a British accent parents live they have to take their passport with them when attending hospital appointments.

Whenever I have had to seek treatment I have never been asked for extra ID simply because when I give over my details - my NHS history et al is all there on the computer.  I guess if I wasn't from this country and gave my details - whatever my ethnicity might be, then there would be no information, so therefore further checks could then be asked by the person at the desk.  

Absolutely fine with that - but then we just need to be honest and tell people you can't access NHS unless you show a passport.

Well, exactly, you see the problem here, if even the Home office doesn't even know who is British and who isn't, how do you expect NHS staff who are not immigration specialist to know ?

That is the case in many, many countries - anyone who disbelieves this please just go to a hospital in those many, many countries and try [especially for non-emergency treatment] to get past the registration desk without either [a] being found eligible for free or subsidised treatment via a computer check, or [b] showing or telling them how you are going to pay for treatment. Won't happen, I have been there, done that

So you get diagnosed with cancer in Jamaica and go on 'holiday' to the UK. Where, opps, you seek a cancer diagnosis and get treated for it by our NHS.

Not really going to work is it?

Coming soon to a hospital, probably quite a long distance from the town you live in.

I think it's unfair and unjust that foreigners have to pay to come to the UK to use the NHS. We should renationalise BA and offer free flights from around the world for anyone wanting to use the NHS.

What could possibly go wrong?

No, he's  probably none of those things but he is highly critical and negative about many aspects of British culture and British life and seems to delight in making the most negative observations he can dream up when he comes across anything he can attack such as the fake news reported in this thread. 

I'm not sure what your point is here. I'm not telling people to be proud of their country but I get a little fed up with the constant moaning and running down of the country and its institutions by Rom. 

At least I have bothered to create a profile and you can put a face to my moniker which at least makes me identifiable and not hiding in the dark behind my user name. 

FFS I'm simply arguing that everybody should be subject to the same checks in order to access the NHS regardless of skin colour or accent. 

If you consider that anti-British then you're the one painting a terrible picture of British culture and values.

It's not my fault if they are archaic and utterly f*cked.

This is not specific to the UK, at all, mind you.

And still not revealing your identity. Hypocrite.

Another strawman for your vast collection PP ?

With the advances in medical technology and the need to concentrate expertise etc then this is a reasonable conclusion. 

And having seen  too many  friends being diagnosed and treated wrongly at small hospitals and then for it to be corrected at the big ones ...the sooner the better

Those front line NHS staff are remarkable people.  In addition to Nye Bevan's argument I already posted above, which is no less correct for being over half a century old, here's another angle: the clinicians of the NHS, being extraordinarily professional and compassionate people, would prefer to treat everyone who presents to them in need of help to the best of their ability.  Since it's in my interest that they remain compassionate and their morale, which god knows has taken quite a beating in the last few years, should be as high as possible I would like to see them given the perk of being allowed to do so.

I realise that costs a lot of money.  0.3% of the NHS budget (which I pay my share of with 20% odd of my taxes).  But I'm cool with paying 0.06% more tax than I otherwise would to allow NHS staff to exercise the compassion that we rightly demand of them.  For the posters here who so begrudge their 0.06% that they would prefer immigrants, foreigners etc., who can't afford to pay up front be left to die in the street, I reckon I can afford to pick up the slack on behalf of at least couple of you too.  You're welcome.

Right, so you reckon a 0.06% tax rise will cover the extension of free NHS health care from the current 70 million people to almost 7 billion people? While your at it why don't you ring your car insurers and tell them you'll happily pay an extra 0.06% on your premium so they can offer free insurance to everyone else on your street.

Crikey, I didn't realise A+E was that busy!  How on earth did they all get here?

Well, on Monday our local A&E had a seven and a half hour wait to see a doctor and Hospital beds were at a projected minus 51 for that evening. 

So crikey! Quite busy.

I agree with you, ultimately the cost of fraud is 300m. Seems like a lot bit no doubt there are no shortage of British people going abroad, getting free treatment and never paying the bills.

So ultimately the net figure might be even lower. Add to that the fact that the cost of checking the immigration status of everybody who comes in is likely to cost nearly as much and cause delays, bureaucracy and inconvenience for everybody, it seems to me much simpler and cheaper to just do nothing about it.

Hang on. This little old lady could afford a flight over from Jamaica. Presumably she had a return ticket. Why not just go back and get treatment there? If you ask nicely most airlines will stump up for a whole row or first class seat if you’re in medical need. 

This isn’t a case of denying people callously. This is someone doing a whole load of things wrong and expecting the system to change just for her. In the end she basically killed herself (by the sounds of it).

i will happily deny non- emergency treatment to anyone not paying their fare share just as I would expect to be turned away from any other hospital in any other country if I turn up asking for free chemo. That’s mental. 

https://www.theguardian.com/uk-news/2018/may/23/go-die-not-interested-windr...

She had a UK passport and worked 30 years in the UK, mostly in the NHS.

It seems to me that the law as it currently is is completely bonkers. We have a system free at the point of use for residents but no way to check who is resident or not.

Note that this applies to British people also, Brits living abroad are not normally entitled to NHS either.

But how are the NHS supposed to do regular residency checks on every patients ? They obviously can't.

And more humane.  And in keeping with the original ethos of the NHS.  (See my link above - according to the original vision of founder of the NHS, by definition, nobody gets treated who is not eligible for treatment.)

And for the benefit of those who've chipped in things like "Well, the first thing that happens in a French hospital is that they check your credit card!" - we even get to throw a bone to the little-englanders: how nice to have one thing where we might actually have some justification to feel morally superior to the French!

Come on La benya (hm..  suspiciously foreign-sounding user name): surely that's worth the terrible injustice of 0.06% of your taxes being used to preserve the life of a little old Caribbean lady you suspect might secretly be a jet-set international freeloader and basically deserves to die?

She made her choices and they ultimately lead to her dying. No one else fault but hers. 

I’d happily pay more for the NHS, as long as everyone else does as well and only those people use it (incidentally I have private medical and saved the NHS about £15k this year by using it).

Also, Jamaica has hospitals- it’s not the Sudan. 

Also- would it matter if I was foreign? As long as I paid my NI and we’re entitled to use the NHS. The key fact here is.... she wasn’t! 

Where? I fancy free elective medical treatment somewhere nice and sunny.

Have you thought about extending that idea? All that costly bureaucracy in prosecuting people for speeding or burglary, that can't be cost effective in the slightest. In fact incarcerating murderers is really expensive, it seems to me much simpler and cheaper to just do nothing about it.

If the NHS just resorts to checking black and brown people because they might be foreign, that is discrimination, yeah.

Accent proves little, so presumably you think checking non-white people's nationality too is the sensible policy?

Cyprus is quite sunny at this time of the year!

I'm sure Rom won't mind paying for your aorta valve replacement.

Yes, generally speaking, I tend to extend the idea of common sense: if a policy is cheaper and causes less harm than another one then I tend to prefer that.

As I've said repeatedly, I'm not against the idea of doing residency checks on patients before they access treatment even at an extra cost if it gives people more trust in the system (although I suspect it won't prevent those who have an axe to grind with foreigners from complaining). That is as long as the checks are done without discrimination.

I'm not even against not having a system that is not free at point of use.

A truly idiotic analogy. Of course prosecuting speeding, burglary and murderers is useful because not doing so puts other people at risk.

Treating occasionally people who are not entitled to it doesn't cause any harm to anybody especially if the ressources needed to actually implement the controls would cause more harm and take more ressources.

A better analogy would be a corner shop investing in a multi million pound security system fit for a jewellery store just for the sake of preventing the occasional kid from stealing a bunch of sweeties. It doesn't make any sense.

If you actually read the article, you might not come over as a mix of both cold hearted and ignorant. 

"Elfreda Spencer, a 71-year-old Jamaican woman, was taken ill in 2016 while visiting her family in London. Tests at Hammersmith hospital diagnosed her with advanced stage multiple myeloma."

I won't be paying for it, if he comes as a visitor the UK will, because it's covered as part of the EHIC system so the expense will be charged back to the UK.

So here is sensible solution to the problem.

Plenty of Brits here, especially retired ones, enjoying the excellent Cypriot healthcare system. Ho wait....

FFS, can you really not make the effort to actually read the bloody article so you stop writing bollocks?

If you can jump through enough hoops (France for example), prove this, prove that, prove the other, claim this, claim that, claim the other ...
As every good Scout knows: Be Prepared!

https://www.nhs.uk/using-the-nhs/healthcare-abroad/healthcare-when-travelli...

I have. What exactly is your issue? She waited in this country instead of going back to Jamaica. Once she finally received treatment it was to late and she died. She wasn’t entitled to treatment. She didn’t have insurance. Who’s fault was it?

Well all you need really is your EHIC.

We could imagine a system in the UK similar to the french "carte vitale" that everybody needs to apply to.

That would be the price to pay to make sure only those entitled have access to the NHS. If people are happy with that so am I.

What grinds my gear is those who suggest we should ask NHS staff to be immigration lawyers.

In the last couple of years of nursing I had to do some mandatory training of immigration issues. This included policing those not entitled to free NHS care. Myself and my colleagues never engaged with it. A family with a premature baby in NICU generally isn't in any sort of emotional state to deal with that.

It would be a better analogy if it did actually cost a million times more for the system than the sweeties, i.e. £300 billion per year to implement. Even it cost a billion quid to set up it would pay for itself within 5 years, unless you actually believe checking ID costs more than a hip replacement.

As for being victimless, if we actually condone, or in some cases welcome, chancers ripping ~£350 million a year out of the NHS then that abuse will spread. People won't want to contribute to a system that doesn't monitor how the money is spent or care about abuse. In the current and future financial climate the last thing we need is a loss of faith in, and resentment towards, the NHS.

The £300 million a year is peanuts view is akin to running up £70k on the credit card and thinking “Oh well, might as well buy that designer handbag I don't need”.

She wasn't denied treatment. It's nice when you can do the research.

You got your sums completely wrong. It's 300m not billions. How much do you think the cost would be to roll out an national database and periodically check the residence status of the whole population ? Experience in similar countries like France suggest it's pretty much in the hundreds of millions per year to administer.

As I've said, I'm not against it if people are happy to pay more just for having some degree of confidence that they won't be screwed by Jonny foreigner.

But I somewhat doubt that people will stop peddling the ideas that foreigners are scrounging the health system even if we have these checks. Certainly plenty of people in France moaning about health tourism despite the fact that they have a very expensive IT system with physical photo ID health cards to check everybody's entitlement.

Nobody saying it's peanuts, I'm simply saying, to cost to eliminate this cost may well exceed the original cost, and it will introduce extra bureaucracy, delays,  and effectively mandatory IDs. If people are happy with that, fine by me.

She was denied free treatment. Of course nobody will ever deny you treatment as long as you can pay !

In any case it illustrates the difficulty of having a free at point of use system with restriction on access but in practice no consistent and practical means to implement the rules fairly.

alternatively we can move to a pay first - get money back later insurance type system. I actually think it would be better. But people don't want it ! The NHS is the religion of the British electorate !

She was visiting her family in the UK when taken ill, not ill when she got here. She was diagnosed with cancer in the UK after her daughter took her to see her GP. Her first consultant advised she shouldn't travel - i.e. shouldn't got back to Jamaica and should start treatment immediately. Her family paid over 5000 GBP to that trust for the original care, but the trust then demanded the up front payment of 300000 GBP to continue treatment (the law was also different then - 2016 - meaning it was up to the discrection of the trust how they dealt with the cost). Spencer's British family couldn't afford that, but offered to pay 500 a month, an offer that the trust turned down.

Her daughter after this process decided to repatriate her mother to Jamaica and sought advice from the Jamaican High Commission in London who "advised the family to contact the UK-based charity Doctors of the World. This led to a referral to London’s Royal Free hospital." She was given some emergency care there, but again they wouldn't offer palliative chemo due to Spencer's nationality and Spencer died at that point. The Royal Free also involved a debt collection agency to try and recover costs from Spencer's British daughter and her family.

You said:

That simply isn't true. An elderly woman, on holiday visiting her family in a foreign country, made no choices, the choices were made for her. By her daughter in, what I'm sure she felt, was her mum's best interests. By the first consultant who told her not to travel, and by his or her bosses in the trust who wouldn't grant discretionary funding for the treatment their doctor was suggesting. By the government by taking away trusts' discretion on this issue. By her government's High Commission who gave her ultimately what was fatally poor advice.

So if you want to turn Elfreda Spencer's death into a political football and give it a kick, at least take the time to read the reporting of the case carefully so you're not just making stuff up. Regardless of what you think of how the NHS treats (or doesn't treat) non-citizens, that seems like just showing some basic humanity.

I’ve been thinking on this thread.

Allowing people in to the UK who have no right to treatment here, and who have no insurance for treatment, creates a situation where some of those people will die needless deaths.

We should not allow a situation like that where people can easily fall into a place where medical staff are forced into either breaking rules or not providing treatment.  This is is nobodies interests for a whole raft of reasons.

Treating anyone regardless is I think not sustainable as outlined by several posters.

Instead, perhaps valid and sufficient medical insurance should be a mandatory condition of entrance to the UK for people who do not have access to the NHS through residence or through a mutual care treaty with their state.  

This would shift enforcement out of the NHS and over to our borders.  Enforcement or even light touch paperwork checking has no place in a hospital in my view - it has all sorts of negative consequences for people on every side of the issue.

Heck, the state could sell the insurance.

I'm sure that technically, perhaps even legally, you're not doing the right thing. But I want to say that I at least am massively appreciative that you're applying your moral values and making that decision in a situation which I'm sure you never wanted to be put in, in the first place.

Thank you.

Surely that is exactly what https://www.gov.uk/guidance/nhs-entitlements-migrant-health-guide#immigrati... is?

That is, but only for visas of over 6 months. If someone is here for less and doesn’t have sufficient cover for treatment or repatriation they’ve got a big problem.

My dad was diagnosed with late stage terminal cancer when in the states for two weeks.  If he’d not taken out insurance that could have been a far worse nightmare. 

That isn't what was said in the Guardian article, have you got a separate Link to refer to?

From your article "The law changed in April 2015 – three months before Pennant’s cancer diagnosis – so that overseas visitors would be charged for NHS healthcare. Despite being a British citizen and still paying UK taxes through her state pension, Pennant’s retirement to Jamaica means she is no longer entitled to free NHS healthcare." So she had no entitlement. You disagree with that law, that's fine. But in this case the law appears to have been complied with.

 That running a national health service is difficult hardly needs illustrating.

You're people. So you don't want an insurance system. And the NHS is your religion. But perhaps you mean "other" people.

Your analogy was a 'multi million pound security system for some sweeties’. Assuming 'some sweeties' cost about £10 and the hypothetical security system £10 million, then the system was a million times more expensive than the sweeties.

However, you are right in that my sums were wrong, a million times £300 million is actually £300 trillion, so your analogy is even more idiotic than my original one.

Other than than, I'm pretty much in agreement that a national ID system would be costly, but  IMHO necessary.

You asked me to read the article again and then rattle off loads of additional information that isn’t in that article. 

The article states the doctor said she should  start treatment as soon as possible... like, when she gets home. 

I’m probably being cynical but that’s a big coincidence getting diagnosed while in holiday... how many times to you go and see an oncologist while paddling in the Jamaica?

i don’t know the health system in Jamaica but if they can afford care over here, could they afford it over there? If they could, why didn’t they go over there and if they couldn’t then they were looking for free healthcare and while it’s sad that she died it sort of not the NHSs fault. 

You can try and take the moral high ground all you want but the NHS is not at fault. 

It's all in the Guardian article specifically about her case https://www.theguardian.com/society/2018/nov/13/cancer-patient-died-after-n...

I'm not trying to take any moral ground on NHS funding, I just found your statement that it was all her own fault and all down to her choices (here you continue to imply dishonesty on Spencer's part) both misleading and mean spirited.

I don't disagree I'm simply highlighting how the "rules" are implemented inconsistently and discriminatorily.

which is exactly why it doesn't need to be an immigration enforcement service either.

Indeed I meant other people, it was obvious.

So we agree on that.

But now you can be pragmatic and realise that it's unpopular and it doesn't look like we'll get one.

Basically what grinds my gear is people moaning about health tourism but who think that stopping it won't have consequences on how they interact with the service and won't have any cost. That's all. 

Oh well now you’re asking to read a different article I will of course oblige. 

“During this period, we advised Ms Spencer and her family that she was clinically well enough to return to Jamaica to receive treatment there but she refused, despite her visa having expired in June 2016. We made it clear that, as she was not eligible for free NHS treatment, she would be charged”

“Spencer’s six-month tourist visa was just expiring; Wright had been applying to have it extended.”

They were trying to fiddle the system. But you’re are totally right, im wrong to lay the blame at the poor woman’s feet... it’s the daughters fault too. 

I'd have thought, actually, that accent would be the better indicator.

Not perfect, far from it, but I don't object to receptionists checking on that basis. 

So I guess foreign sounding folks have to get used to being systematically treated with suspicion and submitted to extra checks just because of their cultural background / origin.

I guess of course you don't mind as long as you're white and English sounding, the rest can fuck off and grow some bones, is that it ?

Maybe there needs to be a separate queue for those who sound foreign ?

That is just racism, plain and simple. And in complete violation of most human rights laws and the equality act btw.

Rom, you really are an obnoxious shit, aren't you?

If pointing out that institutionalising discrimination on the basis of accent is plain and simple racism is being "obnoxious" as this would be recognised as such by our laws and human rights treaties, I'm happy to be so.

You just have to call a cat a cat.

Your resort to insults is what happens every time someone points out the frankly extreme nature of your little political Jihad.

And you're still a coward, being a nasty obnoxious shit while anonymous.

The quality of your argumentation never ceases to impress.

Do you really think discrimination on the basis of accent is acceptable and sustainable in a modern, liberal, and multicultural society ?

Can I ask - not trying to argue, just interested...

Do you actually know the policy and how it is implemented? or is this all just conjecture. 

The allegations of random racist non policy, wouldn't seem to me to pass muster for such an important policy.  Leaving who gets treatment to Janice on the reception who thinks you look a bit foreign or talk funny just doesn't seem to hold much water in an organisation which has policies set out for just about everything.

It is not policy, and it is completely illegal under the equality act and pretty much any other anti discrimination laws.

But it's happening anyway because NHS frontline staff are not trained to handle this are given the impossible job of acting as immigration officers whilst having no practical way to do the checks.

It's only natural that given the situation they find themselves tempted of racially profiling patients who come in, without malicious intent.

But when you're in the queue to register and you're the only one one who's being sent away to get proof of residence, payslips, and passport just because you look or sound foreign it's quite humiliating and makes you feel like a second class citizens.

So indeed NHS staff need to be given clear rules and they need to be applied to everybody the same way.

Unfortunately this is has happened - NHS trusts themselves and migrants rights organisations have raised the issue.

To be clear.  Are you suggesting that anyone from anywhere should be able to present themselves at any time to an NHS facility and expect to get free treatment, regardless of the cost to the NHS.  If you are then you are being very naive and irresponsible with UK Tax payers money.  If you are not suggesting that then you have to accept that some form of discrimination will have to be applied.

Al

Unless you're talking about some tiny lunatic fringe, the colour of a persons skin has had bugger all relevance as a signifier of Britishness for many decades now. 

I can see why you're doing it though, handy ploy to boost a weak argument by conflating any opposition with racism.

Whenever I attend a hospital or health centre I get asked for my date of birth and place of residence. This enables the receptionist to cross-check against the computer records they have held for my whole life. Could it be that, far from discrimination, what you are railing against is the difference in reception accorded to those that have long-standing health records, including an NHS and NI number, and those who do not, having either enjoyed such perfect health that they have never even seen a need to visit a GP, or who might conceivably not be eligible for free treatment.

I have noted the nuance in your argument and your acceptance of the general principle at play. I also agree that it would be expensive to introduce new measures to complete more thorough checks. However, I do feel you're letting your unfortunate past experiences with our immigration authorities colour your responses. And, not for the first time, you've allowed that to spill over into observations and a confrontational style that conveys, to UK natives, a distaste for our country that makes no friends in what should be a community of ideas.

You have well-informed contributions to offer on numerous topics. Just mind how you deliver them.

That's a great idea, in theory, but that's not what's happening, they're closing more hospitals and making everyone go to city hospitals, not just for the hard stuff where expertise might be crucial, but for the mundane and the run of the mill stuff. Our A&E is under threat, and they seem to think journey times of 45 mins to an hour are acceptable. Out town has a population of 60K+ my home town is 120K+ and they've done the same there. So let's not pretend it's about concentrating expertise, there should be more experts in more places.

Consequently the hospital is full, there's no where to park, getting there is a nightmare if you don't drive and visitors are struggling to visit, especially people with children, who need to be home to drop them off and pick them up

I am.  Nye Bevan was.  It was a founding principle of the NHS and it's the principle it has operated on for almost its entire history until relatively recent attempts to get NHS staff to act as a sort of cross between an immigration official and a border guard.

Well, so many folks on this thread are saying.  Presumably mostly perfectly humane people and would prefer to see people treated if the cost wasn't a problem.  (Even the tories, though IMO, Nye Bevan was right about them too.)

Well as luck would have it, it turns out the cost really isn't a problem.  The cost of treating people who are "not entitled" to treatment has never been a significant proportion of the NHS's budget.  I would rather see £300 million per annum spent on treating people who need treating, and accepting the downside that a few of them might be taking the piss, than see similar sums and rather more continue to go to Richard Branson and other dodgy contractors under privatisation schemes who most definitely are.

It strikes me as somewhat comparable to IDS's benefit sanctions.  People want to see people they perceive as taking the piss punished, they're happy to turn a blind-eye to the odd hard-luck case that there's no way to spin as the fault of the 'victim' and they don't even seem to mind that much if it doesn't actually save any money - if the administrative costs of clawing money back take a big chunk out of, or even cost more than, the money that is recovered.

And then there is the morale of the NHS staff being put in this position.  They are amazing compassionate people, I don't want to put them in a position that will make their jobs, some of them already about the most difficult jobs I can imagine dealing with, even more emotionally punishing. 

Someone posted above that they don't implement this policy because their patients are in no position to deal with it.  Should they be sacked?  I certainly don't want to see those staff leaving and being replaced with people detached (or callous) enough to take it in their stride.

It was suggested above that my position was that the NHS should expand its coverage from the 70 million odd people in the UK to all 7 billion on the planet.  Of course I'm not saying that, I'm saying the NHS should continue to treat all of the people in the UK as it has for most of its history.

The discrimination should be left to the real border guards, and I'd have no problems with it being an entry requirement for those on student visas and the like that they can show they have medical insurance to cover their stay.  Once they are here, the costs of treating them are not as high as all that and the costs of putting systems in place to deny them treatment is hardly insignificant either. 

Many of the posters here are also saying that of course they're only talking about non-emergency treatment, they're not so callous that they'd want to deny people emergency care.  Well, guess what.  If you deny people non-emergency care for long enough, they often end up needing emergency care after all, that ain't cheap and it isn't going to get anyone through A+E any faster.

And then, as Nye Bevan put it, you get to "Rejoice at the opportunity to practice a civilised principle."  Well worth the 0.06% of my taxes it apparently costs me personally to treat the 'ineligible' to have something I can actually take a bit of national pride in.  With the depth of division in our society, the sordid nature of all the compromises in our foreign policy, our withdrawal from UNESCO (again) and the apparent ineptitude and naked venal self-interest of so many of our politicians, god knows it would be nice to have something left of what we used to regard as a key part of our national character - a little generosity of spirit.

Edit:  Aaargh.  Apostrophe error.  My inner pedant is cross with me, but grateful that I noticed in time to edit!

Top marks for the most hypocritical statement on UKC today.  Is there some 'rule' of the internet about this?  Regarding someone in an online discussion accusing someone else of being obnoxious? 

I used to respect you Coel, I'm not sure now if you were less unpleasant then than you seem to be lately or whether it's just a cognitive bias of my own that I didn't notice it in your endless wrangles with Niggle where I generally tended to agree with your PoV.  If I didn't already waste far too much of my time on here I'd go back into the archive to try to figure it out.

You're entirely entitled to your opinion, but generally over plenty of threads there are far more obnoxious comments directed at me by people like Rom than I direct at others. 

Though I don't claim to be blameless and plenty of times just lose patience with others. 

If you feel that strongly about it have you ever considered voluntarily increasing your tax/NI contribution?  That might shame the rest of us into thinking like you do Or perhaps start some sort of crowd funding so those that want to contribute can.

If you personally are not prepared to pay more then it's just virtue signalling conversation. And even if you did contribute what gives you the right to dictate how others spend their money?

Al

With about 0.06% of my tax/NI contribution going to fund this, it wouldn't be the most efficient way of going about it though eh?  In a certain light, I guess you could regard charitable donations as a sort of voluntary tax, but I don't think there's an appropriate charity to make a donation to in this case.

Tell you what.  I'm not in favour of renewing Trident.  So lets just do a little creative accounting and say I'm not paying any tax towards that and am picking up the slack on behalf of about 80 odd people on this issue instead.

Ah, right.  And here I was thinking the right to express an opinion on how taxpayer's money should be spent went rather hand in hand with living in a democracy.

You're quite correct free health care for anyone in need, at point of delivery was indeed a founding principle. But circumstances change, at the inception of the NHS the range of treatment options was tiny and relatively inexpensive compared to today. Travelling across continents however was a massively expensive an d time consuming endeavour. Today flying from one side of the world to the other costs a pittance when compared to the cost of long term cancer treatment or organ transplant.

Your argument is essentially the same as the NRA's insistence on the right to bear arms based on legislation drawn up during the era of muskets.

Edit: ...and you keep banging on about it only going to cost an extra 0.06% on income tax. You're completely away with the fairies. Can you imagine how many Americans alone would stump up a few hundred quid airfare and hop over for free treatment?

I'm using that figure slightly facetiously there, but it isn't about what it would cost, it's about what it does cost.  (It's 0.3% - the figure quoted in the OP - of the 20% odd of our taxes that goes to fund the NHS)

I'm not arguing for a change in policy, I'm arguing against one.  A very recent one - *much* more recent than the advent of affordable trans-atlantic travel and Americans generally being aware of the existence of the NHS.  (Bafflingly, they seem to absolutely hate the whole concept.)

If, as you say, 'health tourism' would be such an overwhelming problem in the immediate future why was it not in the recent past?

You are quite right to point that out to me you are just expressing an opinion and I was wrong to not respect that.  We should balance emotions with economic prudence and I sometimes get the sense that your type of opinion is based on too much of one and not enough of the other.  Perhaps you see me in a similar light but the other way round but it's just opinions. As long as you don't start calling me an unfeeling bar steward I'm sure we can get along.

Al

Absolutely not I've said the opposite ten times now.

all I want is that everybody has to go through the same eligibility checks. No special checks for foreign looking or foreign sounding people.

No, it's not, I've experienced it myself as well as people I know, all of them with established health records.

Many other cases have been reported in the media, even the NHS trust have complained about the situation they are in.

I find your comment wholly unfair. I have absolutely nothing against UK natives in general. Would I have spent most of my life in the UK and went through the expensive and arduous process of getting citizenship if  I didn't ?

As for my past experience with immigration authorities, they are not isolated, it's pretty much the norm. I don't have enough fingers on my hand to count the number of friends and colleague who have been treated like absolute shit by the home office.

However I do have an axe to grind with people like Coel who think that racially profiling people based on their accent on the NHS is perfectly acceptable.

It's very gracious of you to say so.  I wouldn't dream of it, and I dare say we can.

It isn't just a question of balancing emotions vs economic prudence, it's also about evaluating that economic prudence.  I'm sure we all agree that it's desirable to treat everybody (unfeeling bar stewards aside), the only argument is about whether we can afford to do so.

There's clearly a powerful belief underlying this discussion that we have the hordes clamouring at the gate waiting to rush in and overwhelm us. Stichtplate suggests a horde of US citizens even, but I just don't see it.  Nobody seems to be coming up with any evidence to support this belief, even Coel who is normally a strong advocate of supporting beliefs with evidence.  I'm inclined to believe they aren't there now, that it would not be a problem to revert to just not asking about people's right to reside here or whatever, because until very recently we did exactly that and it wasn't a problem.

Moving away from the topic a bit...  (We've done it to death haven't we?  I know I've basically just been repeating/rephrasing myself for a while now.)  Stichtplate's post above got me thinking - hypothetically what would happen if the UK, some other European country, or somewhere in Central America perhaps, invested the price of a few jet fighters and a handful of cruise missiles in offering free cancer treatment (say) to USA citizens who have no medical cover?  Would significant numbers take it up?  As a propaganda exercise, would it be a way to win hearts and minds?  Would the US government (the current president especially) regard it as an attack on their sovereignty and completely lose their shit?

This is a very interesting line of conjecture. The obvious comparison would be with Merkel's decision to open borders to a million stateless migrants. That has likely gone well for the migrants but it has backfired badly on the state of Germany with the collapse of her coalition and the rise of a new "Nazi", sorry alternative, party.

The thing is that you have to establish a principle and it's the principle that has to be judged not the specific instances of things going wrong.  I personally do not have any issues with checking individuals for eligibility to services.  I cannot see any other way of ensuring that those who have contributed are not disadvantaged because finite resources have been allocated to someone who has not contributed no matter how deserving at an emotional level that may seem.  It's never that direct but I wonder how some of those who are in favour of unlimited access would feel if they were directly impacted.  Some people respond as if the NHS is a bottomless money pit.

Al

 Recently when I moved and changed GP, I was asked for my passport when registering, even though I have a NI and NHS number.  Might it just be that in this age of 'Austerity' and the current governments 'make it difficult for foreigners' and the tightening up on health tourism (which goes down well with some voters) that something as simple as a further box (or series of checks) has been added to the database, requesting that proof of UK citizenship is needed whenever a new application is processed or the patient comes for such treatment that requires UK status.  In my case the box was ticked - and like at a bank the type of ID was recorded and documented.   Where the person has no acceptable form of ID then it kicks off a range of checks??

This is not racial profiling, as I have been asked by my parents regarding ID - as their passports have expired, and at their age they are not planning on renewing, and as my Mum has no driving licence they run into difficulties when asked for valid ID during various official processes.

With regard to the NHS, the recent wind rush example of the elderly man being asked to prove residence or pay for treatment, tells me that there is actually a process of box ticking that flags UK status up, and its not down to PC Savage types to decide. Maybe it is the process of holding up treatment for these cases that NHS trusts are uncomfortable with.

Given that there are official guidelines for lifting desks in the NHS, I simply don't believe that it is down to non trained staff to filter as they wish.  

The reality is that the far right has been at 20% for decades now in Europe anyway.

The real news is the collapse of the two main political forces in Europe that have kept it at bay, namely the Social democrats and the Christian Democrats.

As politics exploded along new lines this creates a "gap in the market" the far right could leverage, but their actual support is not that much higher.

This has had varied consequences depending on the electoral system of each country.

In France for example, with a strong presidential system and run off vote, this has forced a complete realignment of the politics along the new lines, between the liberals and the authoritarian, and kept the far right at bay.

In the UK a FPTP system forces this new split within parties, so the conservatives have absorbed the far right, and labour has absorbed the far left, with profound divisions within the parties that are probably greater than the division between them.

In Germany a highly federal and proportional system means that realignment also occurs, with alliances between the moderates.

In the US as well it's a strong federal democracy capable to withstand even someone like Trump.

The situation in the UK is more dire because the system is archaic and cannot cope with this transformation. Hence the deep crisis we are witnessing.

But hopefully this forces change and maybe we'll come out of this with a more decentralised and more robust democracy. One can only hope...

I think you are correct in your analysis, the only thing I would question is the definition of "far right".  There seems to have been a move in recent years to label anything slightly right of centre as being "far right".  This has not been helpful and led to some demonisation and alienisation of otherwise moderate, respectable, conservative (small c) people.

Al

I'd don't really care about such labels. What happened to Windrush I think was a clear example of why we shouldn't let this type of politics infiltrate the mainstream, whether you call it far right or not.

The conservative made a massive error in my view of trying to eliminate the UKIP threat by embracing their rethoric, it arguably won them a general election but spectacularly backlashed in the Euref, as they unleashed demons they couldn't control. But as pointed out previously it's the dynamic of electoral system that forced them to do that.

Unfortunately this was the case previously that indeed NHS staff were asked to make checks on immigration status without being given the proper rules and guidance.

As a result you end up with this type of profiling, although it is not malicious in nature.

Thankfully following a strong pushback from NHS trusts who had been warning about the issue for a while, the government introduced better rules and now it's clearer that checks apply to everybody. There still is the problem that they have no practical way of conducting them properly and efficiently due to the lack of central ID database.

May I point out that the issue is very similar for landlords and there is still no fix. They can face massive fine for renting to people with no right to stay but they have no way to assess the sometimes very complex immigration status of tenants regularly.

As a result 48% of them report being less likely to rent to foreigners - not because they are racist, but simply because they don't know how to do the checks, and don't want to take any risk. So the incentive is to prefer tenants who look and sound British.

This whole thing of pushing immigration checks on civil society is a disaster with far reaching consequence and instigates a climate of suspicion and fear. And unfortunately with 3 millions EU citizens about to be thrown into that hostile environment it doesn't bode well for the future. Caroline Nokes had a complete car crash at a parliamentary committee when she had to explain in front of a bemused chairman how she had no clue as to how employers were going to be supposed to check the right to work of millions of EU citizens in case of no deal.

Everything I'm saying is well documented and mostly common sense but apparently pointing it out makes me "anti-British" according to some... that makes me sad.

Has anyone on this thread (or indeed anywhere else) argued for that? At most some people seem to be suggesting that it's better to pay for the treatment of a few people who don't have a right to that treatment from the NHS, than to either institute a national ID system, or ask for proof of eligibility from people who aren't white or speak with an accent.

Thanks for taking the time to expand. 

Argued for what?  I don't know what you mean.

Ok, well to ignore (vastly more significant) other factors that might have made access to healthcare poorer for many of us and look solely at 'competition' from others wanting to use the same finite resource, I would be very surprised if some rather short-sighted cuts in public health, education and the like don't have a much greater impact.  Even the selling-off of school playing fields.  If I need an operation, say, and can't have it because demand is so great it strikes me as much more likely to be demand from obese Brits than impecunious foreigners. 

I really am repeating myself now, but Timmd's point wheich I've also been trying to make a lot in this thread, and which has scarcely been addressed let alone refuted, is that it really isn't all that much money.  Which in any case can't effectively be clawed back without incurring significant costs and inflicting other, less tangible, damage along the way.  (Such as on the morale and ultimately the calibre of the NHS staff being asked to do the policing.)

If you want border guards to protect the NHS fine, lets require visitors to have appropriate medical insurance to cover their stay and have the job done by actual border guards at our actual borders.

Read the thread.

At no point I've suggested we should be treating the whole world for free. Nor did anybody else. I'm even mildly in favour of a system that would not be free at point of use.

I've merely suggested that, given that free at point of use is what we have, we have to consider whether the cost of treatment to non-eligible patients is actually inferior to the cost of systematic checks.

So what exactly are you saying? That the plight of the woman in the OP is terrible but you don't want the system changing? That we should afford the same free healthcare to anyone within our borders but on a nudge-nudge, wink-wink basis and just hope nobody outside our borders, in desperate need of treatment notices?

I'm guessing that you've not had to register an elderly relative with "a white face and a British accent" at the local practice recently?

As I've pointed out the rules in England have changed recently following such controversy !

Unlimited access, as you wrote and i quoted you as having written! 

In that case WTH did you say that nobody checks anything if you havea white face and a British accent?

FTFY 

Because this was the situation in many places.

Here's a link that may be of interest to those who've followed this thread.  Just one small example of money being leached out of the NHS that strikes me as much more concerning than the cost of a migrant's chemo:

https://nhaparty.org/firm-linked-to-grenfell-tower-disaster-is-suing-an-nhs...

G.P. practices are not supposed to discriminate on the basis of U.K. national eligibility afaik - but try being homeless or from the travelling community for the last several decades and registering with a G.P. for example - almost impossible  - I've been asked to provide several forms of I.D. to register at the local G.P. especially in urban areas of the U.K. for the last 15 years. 

D

Given that there are official guidelines for lifting desks in the NHS, I simply don't believe that it is down to non trained staff to filter as they wish.  

NHS is full of full on authoritarian dictator types who relish the opportunity to say 'Non!'.  Ever been to A&E? Not particularly unlike any large organisation. 

D

Maybe part of the immigration checks for tourists and non residents entering the UK should be a requirement for them to produce proof of medical insurance to cover the period of their stay? Obviously the level of cover would have to be specified, but in principle I don't see why it couldn't be introduced. 

It's like going climbing in Switzerland without climbing insurance and then being shocked when you get a medical bill after your accident.

I found out recently that Britain actually could have limited the number of immigrants from the EU once it accepted Poland and Romania, like other EU countries have done, but it didn't choose to. Which I found quite interesting, in the context of the NHS, and Brexit. 

It can be introduced.

Ask yourself, how much would it cost to check the health insurance of 40 millions tourists every year. And then compare that to how much a typical visitor spends in the UK.

???

happens in plenty of other countries who seem to do it quite easily. 

Plenty of others ? Enlighten us and name them, since you say they manage easily you must have the list in mind !

The only one I could find that would apply such a requirement on a British visitor is Cuba. 

In the context of NHS and Brexit, people who have moved here from elsewhere in the EU are as likely as any of us to be NHS staff, disproportionately likely to be doctors and have recently been helping to make up the shortfall as we've been failing to train enough new nurses.  It's ridiculous to talk about them as a drain on the NHS, far from it, they're a resource.  And lets not forget that they tend to be younger and healthier than the general population, while they're working and paying taxes here they contribute more, on the whole, than the rest of us.

https://fullfact.org/immigration/immigration-and-nhs-staff/