Two of the United Kingdom’s largest HIV charities have produced an information leaflet giving advice to people who fear that they are not entitled to free NHS care and may therefore be charged for using NHS sexual health and HIV services.
Some recent migrants to the UK, as well as individuals of uncertain status, failed asylum seekers and British passport holders who are not usually resident in the UK can be charged for using HIV services and any antiretroviral medicine they are prescribed. There is concern that some individuals from these groups may be putting their health, or, if they are pregnant, the health of their unborn child, at risk because they are not coming forward for appropriate HIV care because of worries about cost.
Sexual health
Sexual healthcare is free from the NHS, regardless of a person’s entitlement to free NHS care. So too is a test for HIV (but not everybody is entitled to free treatment and care). Treatment for tuberculosis is also universally free.
Who can get free NHS HIV care?
As the leaflet, which has been prepared by the Terrence Higgins Trust and National AIDS Trust explains, free NHS treatment and care is available to the following categories:
- Those who have been lawfully living in the UK for the last twelve months.
- Refugees or asylum seekers with a current application.
- Members of the UK’s armed forces.
- Individuals coming to live permanently in the UK, although those applying for permanent residence will be charged until this is granted.
- Those in prison, or in immigration detention.
- Citizens from countries that the UK has a bilateral healthcare agreement with.
However, charges for NHS HIV care may be made if a person:
- Has entered the UK without proper papers or permission.
- Has had their asylum application refused and is awaiting deportation.
- Is in the UK on a visitor’s visa.
- Has overstayed any sort of visa.
- Has a British passport but does not normally reside in the UK.
Treatment for people who aren’t entitled to free NHS HIV care but can’t afford to pay
The leaflet explains that treatment should not be refused by the NHS for a life-threatening condition, or a potentially life-threatening condition. This means that if you have HIV, you should be able to access NHS HIV care, even if you cannot pay for it. The decision to treat is a clinical decision and rests with the doctor. Yet the hospital where the care is provided will try and recover their costs. This could involve an interview with an Overseas Payment Officer who will assess an individual’s ability to pay.
It is important that the hospital’s administration knows what a person’s real financial circumstances are. Hospitals can write off the cost of treatment if it is clear that a person cannot pay for it, or may simply ask for a token payment of a few pounds per month.
Chief Executive of the National AIDS Trust, Deborah Jack, commented: “We know that charging people for accessing NHS HIV services causes those affected a great deal of distress and confusion…we hope that this resource, will demystify the procedure, reduce the uncertainty and help people to get the treatment they need.”
“Entitlement rules are widely misunderstood, and frequently misinterpreted”, said Lisa Power of the Terrence Higgins Trust. She hoped the leaflet would “help people with HIV and those working with them to understand the basics and where to get help with more complex issues.”
Concerns about confidentiality
Treatment provided by the NHS is meant to be in confidence, and as the new leaflet explains, this means that a patient’s details should not be made available to anybody outside the NHS – for example immigration officials – without an individual’s prior consent.
If, however, an individual is here legally they may be asked to provide proof, and the patient may have to contact the Home Office to do this.
Further information
Full NHS charging regulations can be read here
The leaflet can be downloaded from www.tht.org.uk or www.nat.org.uk.
Individuals with concerns about their entitlement to NHS treatment and care can contact THT Direct on 0845 12 21 200.
Failure of asylum claim whilst receiving free treatment
The leaflet also provides information about individuals who are already receiving free NHS HIV care but whose asylum claim fails, or whose visa expires and their right to residency in the UK ends. Patients in these categories still have the right while in the UK to continue to receive HIV treatment free of charge. However, the leaflet notes, “some NHS staff sometimes misunderstand this rule.”
“Entitlement rules are widely misunderstood, and frequently misinterpreted”, said Lisa Power of the Terrence Higgins Trust. She hoped the leaflet would “help people with HIV and those working with them to understand the basics and where to get help with more complex issues.”