Call for review of how NHS boards are identifying and charging non-UK citizens for treatment


The Scottish Parliament’s Health and Sport Committee is calling for changes to the way in which NHS Boards in Scotland identify those who are not entitled to treatment under the NHS.



In a new report the Committee considers the current arrangements for the identification and charging of European Economic Area (EEA) citizens and non-EEA individuals when using NHS services in Scotland.

The Committee learned there is a lack of clarity in the charges levied for treatment and that it is currently not necessary for a GP to establish a person’s eligibility for NHS care before treating them.

The report identifies a varied and inconsistent approach from NHS health boards in Scotland, with some not reclaiming costs from those not entitled to free care. The Scottish Parliament Information Centre has calculated that over the past five years the amount outstanding to boards from non-EEA individuals which has not been paid exceeds £3.2m.

Evidence gathered by the Committee also shows that not all health boards are participating in the EHIC (European Health Insurance Card) Incentive Scheme, whereby NHS boards can claim 25% back of treatment costs of EHIC card holders. Following the Committee’s work, NHS Greater Glasgow and Clyde has now claimed over £200,000 with further retrospective claims available to them.

Lewis Macdonald MSP, Convener of the Health and Sport Committee, said:
“The evidence we had gathered in our earlier report into reciprocal healthcare arrangements had raised a number of issues regarding the operation of the current scheme.

“The Committee support the principle that anybody in Scotland can access GP services or A&E departments free of charge when needed. However, we are concerned that NHS boards are missing out on vital sums of money to which they are due by not being able to identify those entitled to NHS care.

“We believe the Scottish Government should begin a review of the current situation immediately and have asked them to adopt a clearer and more unified approach to ensure access to NHS treatment is applied fairly and consistently.

“Our research has also shown that the prices charged for NHS services to those not entitled to them vary considerably across the country without any justification for the differences in fees being provided. This is another issue which NHS boards and the Scottish Government must work to make simpler, clearer and more transparent wherever possible.”

The report also considered the healthcare costs for Scottish citizens abroad and outlined the importance of continuing with similar arrangements to those currently in place after EU withdrawal.


The full report is available here.

While gathering evidence for the report the Committee heard from every health board across Scotland and Paul Gray, Director General for Health and Social Care and Chief Executive of NHSScotland.

The Health and Sport Committee’s scrutiny of reciprocal healthcare schemes was
conducted to inform their consideration of the Legislative Consent Memorandum
(LCM) on provisions in the Healthcare (International Arrangements) Bill.

The Committee’s report on the Legislative Consent Memorandum – Healthcare (International Arrangements) Bill was published on 19 December 2018. You can read it here.





Contact information


Media information

  • Nick Connelly: 0131 348 5453 / 07866 125623
  • Text Relay calls welcome

Public information

  • Telephone enquiry line: 0800 092 7500 or 0131 348 5395 (Gàidhlig)
  • Text 07786 209 888
  • Ask a question online through live chat
  • We also welcome calls using the Text Relay service or in British Sign Language through contactSCOTLAND-BSL

Keep up to date with us on:

keep up to date with what's happening in Parliament on Facebook Follow the Scottish Parliament on Twitter @ScotParl keep up to date with what's 
happening in Parliament on YouTube

This website is using cookies.
We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we’ll assume that you are happy to receive all cookies on this website.