FOREIGNERS in Britain will be denied National Health Service care unless they can first prove their ability to pay in the latest drive by the government to curb health tourism.

GPs and hospitals will also be ordered to conduct checks on the immigration status of patients before treatment under proposals expected in a review to be published in the new year.

Cabinet ministers have warned that racial tensions may build if foreigners are not stopped from exploiting the NHS.

A Home Office and health department review of the use of the NHS by non-European Union citizens will propose that doctors should check the eligibility of foreign patients with the Border and Immigration Agency.

Patients who are citizens of non-EU countries will have to provide documents which prove they are legally resident in Britain or give the NHS permission for further checks.

GPs are likely to resist any moves by ministers to curtail their discretion to treat patients or add them to their patient list.

Ministers are understood to be frustrated that doctors have ignored rules to make patients pay if they are not entitled to healthcare. Only British and EU citizens, and people ordinarily resident in Britain, are entitled to full state care.

The government estimates that the bill for treating overseas patients, including illegal immigrants, is at least £62m a year, but that is thought to be a significant understatement.

Up to half of the cost is met by the taxpayer because many overseas patients do not settle their bills before they leave the country, according to an internal NHS survey carried out in 2004.

Women in labour are automatically given free access to the health service, but senior doctors said heavily pregnant women are exploiting the system by visiting Britain on shopping trips and then giving birth. The problem is considered so serious that the government may ask airlines to stop heavily pregnant women flying to Britain from Nigeria, Pakistan and India.

The new restrictions will curb access to transplants, maternity services and lifelong HIV treatment by foreign nationals. Emergency care will still be available. One Whitehall source said the government was determined to cut GPs’ powers of discretion.

Hazel Blears, the secretary for communities and local government, told colleagues that community tensions will be exacerbated if people do not feel that health provision is allocated fairly.

Ministers say that new rules requiring health trusts to check if a person is resident in Britain or an EU citizen are being ignored because doctors do not want to refuse treatment to any patient.

The crackdown on health tourism would also make it harder for failed asylum seekers, who are supposed to lose their right to nonemergency healthcare once they have been refused asylum. At present, many are thought to evade this because they are already on GPs’ lists.

Pilots of the scheme have been conducted in three NHS trusts.

Meanwhile, an EU directive proposes granting nationals instant access to healthcare in other European countries.

Explore Health News

• Swine flu

Times Recommends

• UK regional accents thrive against the odds
• ‘Scarecrow’ wind farms put rare birds to flight
• What an anti-climax: G-spot is a myth