Patients could be told to bring two forms of identification including a passport to hospital to prove they are eligible for free treatment under new rules to stop so-called health tourism.
The most senior official in the Department of Health told MPs on Monday that he was looking at making hospitals check patients’ papers to find out whether they should be paying, a proposal he admitted was “controversial”.
It would mean that those trying to access health services, including British citizens, might have to prove their identity before having operations and undergoing tests in hospitals, but it would not cover care received at GP surgeries.
Chris Wormald, the department’s permanent secretary, told the public accounts committee that passport checks were already taking place at one hospital in Peterborough which services a high immigrant population.
Wormald said: “On the general question of are we looking at whether trusts should proactively ask people to prove their identity – yes we are looking at that.
“Individual trusts like Peterborough are doing that and it is making a big difference – they are saying please come with two forms of identity, your passport and your address, and they use that to check whether people are eligible.
“It is quite a controversial thing to do, to say to the entire population you’ve got to prove your identity.”
Peterborough and Stamford hospitals trust covers an area that has received a high number of eastern European immigrants in recent years.
The senior civil servant told MPs that he accepted it was not part of “health service culture” but that it may be necessary to crack down on use of the NHS by visitors from abroad who do not have an automatic right to free care.
A National Audit Office report issued last month said the government paid out £674m to other European countries for the treatment of Britons abroad, but received only £49m in return for the NHS treatment of European citizens.
Wormald said he could not guarantee that ministers would meet their target to increase the amount the government claws back from European countries from the current £49m to £200m.
Other parts of the NHS have been experimenting with tougher identity checks. It was disclosed earlier this year that at least one hospital in south London piloted a scheme to cut what has been described as “maternity tourism”.
Expectant mothers going to St George’s in Tooting will have to provide papers showing they are eligible for free NHS care when they arrive for scans. Those unable to do so will be referred to the Home Office, and could face deportation.
Wormald said NHS trusts need to do far more to identify foreign people with no eligibility for NHS treatment if the target is to be met.
“Some trusts are looking to see whether they need to require people to prove their identity by bringing in a passport or some other form of ID – which is not the culture of the health service up to now,” he said.
“We are looking at whether more trusts should go down that route, as had been done in London and elsewhere, on people having to prove their identity.
“And we are looking at whether that is proportionate – whether in just some places, or the whole country.”
Wormald’s comments show that such an approach is being considered more widely. He said: “We are not here to criticise NHS frontline staff, but what we want is a culture of everybody who works in it to understand financial rigour. We need a culture where we are more careful with the tax pound.”
Asked whether the NHS will ever meet Jeremy Hunt’s target of clawing back £200m a year form European countries, he said: ‘I’m not going to guarantee whether we will meet it.”
A source close to the health secretary confirmed that the idea of passport identification had been floated and piloted and that plans for a nationwide scheme have not been ruled out.
But the source added that that the pilot was still at an early stage and that checks might only be applied in areas with shifting populations and large influxes of immigrants. “We have not yet made any decisions on this,” the source said.
A spokeswoman for Peterborough and Stamford hospitals NHS trust said: “In response to a national requirement, our trust devised a process for recovering money for the NHS from the treatment of non-EU citizens.
“This was looked at by the Cabinet Office and we understand our system may be used as a basis for other trusts to follow. We are delighted to have been identified as an exemplar of good practice.”