Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to the Ministerial Statement of 12 December 2018 on NHS Overseas Charging Regulations Review 2017, HCWS1174, what assessment was made of the needs of (a) pregnant women and (b) new mothers in that review.

The Department engaged with 79 organisations as part of the process of reviewing the National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2017 and received 57 formal responses. The Department met with and received responses from a number of organisations with expertise in maternity care, including a royal college, maternity staff groups and maternity stakeholder groups. A number of other organisations and individuals who contributed to the review also commented on the impact of the amendment regulations on maternity service users.

Although maternity treatment must always be regarded as immediately necessary, and therefore not subject to the upfront charging requirement, some evidence suggested that overseas visitors may not always be aware of this. The Department has therefore committed to develop user-friendly, culturally-appropriate guidance, that will clarify that maternity treatment is never subject to the upfront charging requirement and ensure this reaches those who may be impacted. The Department has also updated national guidance (published 24 December 2018) to make clear that termination of pregnancy services are to be regarded as urgent, and therefore not subject to the upfront charging requirement, where the overseas visitor cannot reasonably be expected to leave the UK before the date which an abortion may no longer be a viable option.

As a result of the 2017 amendment regulations some secondary care services, including community midwifery services, have become chargeable. However, these services were already chargeable if delivered by hospital employed or directed staff and the removal of the exemption was important in ensuring that charging rules apply in a fair and consistent manner, regardless of where a service is provided. The exemption from the charging regulations for conditions caused by sexual violence remains in place to protect this vulnerable group.