Too early for the C word? Try the new overseas visitors charging guidance, catering for various permutations of the B word.

For those doughty souls who haven’t yet given up the ghost on all matters Brexit, indeed who believe that all their yuletides have been foreshadowed at once with the tantalising prospect of a pre-Christmas general election to decide ‘whether-when-how’ we should Brexit under the current/in-waiting hegemony, the Department has rewarded your diligence with a new, pre-Brexmas edition of the Guidance on implementing the overseas visitors charging regulations with provisions operative in the event of various Brexit deal or no deal permutations.  Oh joy, Oh rapture unforeseen.  The perfect gift.

A quick recap for the benefit of those who have yet to acquaint themselves with the regulations or the guidance in any of their previous incarnations:

• Essentially, only those who are ‘ordinarily resident’ in England are entitled to NHS services (mostly) free of charge ie: Individuals whose residence is lawful, and adopted voluntarily and for settled purposes as part of the regular order of their life for the time being, whatever the duration.
• An ‘overseas visitor’ is any person not ‘ordinarily resident’ in the UK. After Brexit, once freedom of movement has ended, for example, EEA and Swiss nationals will need to comply with relevant new immigration rules in order to be ‘ordinarily resident’.
• The regulations – the NHS (Charges to Overseas Visitors) Regulations 2015 (as amended) – place an obligation on providers of certain services (not just NHS providers) to establish whether a person is an overseas visitor to whom charges apply or whether they are exempt (eg: because they have paid the immigration health charge on entering the UK).
• Where there is no relevant exemption, the obligation is to ‘make and recover’ charges from the person liable to pay.
• Charges should be recovered in full in advance of providing the services except where immediately necessary or urgent care is required.
• The Guidance comprises 131 pages designed to assist Overseas Visitors Managers (OVMs) and others in implementing the regulations.

The guidance is broken down into helpful, (somewhat) bite-size chunks of 13 chapters – think of it like an Italian wedding feast – covering exempt services, exempt individuals, ex-pats, armed forces members and war pensioners, vulnerable patients and the detained, reciprocal healthcare arrangements, international obligations, collaborative working, working with the Home Office and, surprisingly bringing up the rear of the baker’s dozen, “Financial and miscellaneous matters”.  How frightfully British.

Sprinkled liberally amidst are references to “exit day”, “leaving the EU without a deal” and “Exit Amendments”, seeking to cover the many (I hesitate to say all…) possible permutations.

I can think of more appetising offerings traditionally associated with the yuletide season, but this refreshed guidance laced with a good slug of Brexit remains at the heart of the Department’s current charging strategy and earns its place on every OVM’s desk.