Jeremy Hunt, the health secretary, is considering whether to charge foreigners for using ambulances and visiting A&E in a move that could further escalate tensions with the medical profession.
In a bid to raise money, Hunt is expected to announce a consultation within the next month on whether the NHS should charge patients from outside the European Economic Area (EEA) for emergency treatment.
While no one would be denied urgent care, hospitals would be allowed to withhold treatment for non-urgent medical problems until a payment was made.
Patients from inside the EEA would have to present their European Health Insurance card to receive treatment, and their government would be sent a bill.
Under the proposals, there would be certain exemptions on charging up front, such as for women in labour, while asylum seekers would be excluded from the system altogether.
The government has announced a number of crackdowns on so-called health tourism focused on enforcing current rules on foreigners being billed for routine care.
That has led to warnings from doctors’ groups that medics should not be forced to act as border guards by checking up on entitlement before treatment.
The British Medical Association warned in April that new guidelines asking the NHS to require proof of residence should not interfere with doctors’ primary duty to care for patients.
The proposals are likely to lead to warnings against the UK moving towards a US-style system whereby patients are asked for payment before receiving treatment. Hunt is already in a battle with junior doctors over their new contracts, with medics protesting and threatening to strike.
The move is being considered amid severe pressure on NHS funding, with warnings of an annual £30bn shortfall in the next parliament.
Spending on healthcare is ringfenced from spending cuts, but demographic changes mean the department is still looking for savings. Its estimates suggest that the extra charges for foreigners could save around £500m a year.
A Whitehall source said the proposals were only at consultation stage, with a number of possible options, and ministers would listen to views.
A Department of Health spokesman said: “International visitors are welcome to use the NHS, provided they pay for it. just as families living in the UK do through their taxes.
This government was the first to introduce tough measures to clamp down on migrants accessing NHS care and have always been clear we want to look at extending charges for non-EEA migrants. No one will be denied urgent treatment, and vulnerable groups will continue to be exempt from charging.”