Worrisome application issue!

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Help! We have a huge issue. My husband just went in and had an appointment to see a doctor to try to speed up a letter or a bill. The doctor told him that he had dealt with this several times before, and that we are being mis-informed. That I *should* be allowed to use the NHS if the GP accepts me, and that he will not write a letter stating anything because that section on the application is scare mongering by the immigration department into getting money. He will only verify that they will not charge me if and when the immigration department inquires with him. He told my husband to have me write on the application - the clinic's info and his (the doctor's) info, and that the immigration office should contact the doctor directly for information. The doctor says that most of the time, no one follows up but that if they do, he would happily verify over the phone or by letter that he will not charge me.

I am beyond worried right now! Any advice would be greatly appreciated.

Okay, this isn't anything to panic about.

I've had a look on the NHS website, and it's something of a grey area as to what you should be charged for and what you shouldn't be charged for.

Because of this your GP may be correct in that a simple visit to the GP may be free of charge, but further treatments may not be. If you were registered as a temporary patient (you were in the area for less than 3 months), I believe he is correct in that you shouldn't be charged. However, if you were registered as a private patient, you have to pay.

See:
http://www.nhs.uk/nhsengland/aboutnhsservices/uk-visitors/Pages/accessing-nhs-services.aspx
and
http://www.adviceguide.org.uk/england/healthcare_e/healthcare_help_with_health_costs_e/nhs_charges_for_people_from_abroad.htm#h_gps_and_dentists

In terms of your visa application, if you really can't get the GP surgery to give you a letter, then just explain in your application what the situation is and what the doctor has said.

As it was only a simple appointment and prescription, it's not going to prevent your visa from being issued anyway.

It was not just a simple appointment though. I went in for a medical issue - they ordered blood tests to see if it was something that runs in my family (it wasn't and they didn't actually fix it). And because they asked if I'd had any problems in the past and I mentioned high cholesterol, they did a blood test for that as well. I then had to go for a follow-up appointment where I was given a prescription for the high cholesterol. The doctor ordered another blood test to be done in 3 months and another follow-up appointment. Both of those were done and another 3 month prescription given. I also was forced to go in and sign a waiver for a pap smear (because they were calling all females in after they dropped the ball with that poor 19 year old girl who died of cervical cancer cause they wouldn't give her a pap smear). And I technically visited my husband for 6 months,  not three. We traveled around a bit, so I was not in the country for more than 3 months at a time, but I was over there for 6 months.
Any ideas?

I also don't know if I was registered as a temporary or private patient.

It was not just a simple appointment though. I went in for a medical issue - they ordered blood tests to see if it was something that runs in my family (it wasn't and they didn't actually fix it). And because they asked if I'd had any problems in the past and I mentioned high cholesterol, they did a blood test for that as well. I then had to go for a follow-up appointment where I was given a prescription for the high cholesterol. The doctor ordered another blood test to be done in 3 months and another follow-up appointment. Both of those were done and another 3 month prescription given. I also was forced to go in and sign a waiver for a pap smear (because they were calling all females in after they dropped the ball with that 19 year old who died of cervical cancer cause they wouldn't give her a pap smear).

As far as I know, all these are considered basic, simple appointments.

From what I can tell from the links I posted above, as a temporary patient you would only have been charged if you were referred to a specialist or to a hospital for further treatment.

And I technically visited my husband for 6 months,  not three. We traveled around a bit, so I was not in the country for more than 3 months at a time, but I was over there for 6 months.
Any ideas?

You could contact the GP again and confirm what kind of patient you were registered as. If it was as a temporary patient, it sounds like you shouldn't have been charged anyway, so all you can do is explain what the doctor told you.

If it was as a private patient, your husband should try again to get a bill out of them or at least try to insist on a letter (he could print what it says on the NHS site). Maybe he could even go higher than the GP Surgery (can't remember what the county/regional offices are called) to try to sort it out.

Thanks. I will have him do that. I have a feeling we are just going to have to go above the GP's head or hope for the best on the application after explaining it. The GP refused to write ANYTHING. Not even a letter stating that he is aware of the situation and will not write a letter with specifics unless requested to by the immigration department.

Maybe he could even go higher than the GP Surgery (can't remember what the county/regional offices are called) to try to sort it out.

It's the Care Trusts for that area that can draw up bills.
http://www.nhs.uk/servicedirectories/pages/caretrustlisting.aspx

A bit about it.
http://www.nhs.uk/NHSEngland/thenhs/about/Pages/authoritiesandtrusts.aspx

He will only verify that they will not charge me if and when the immigration department inquires with him.

It would be so much easier for you if he just billed you and your travel insurance pays or you pay. Have you explained that to him? Him not bothering to take the time to draw up a bill or write a short letter, is just going to delay your application.

I hope his Practice Manager is keeping up to date with all the NHS changes coming in early next year, under the Immigration Act. Parliament has laid it out clearly in this law that doctors, dentist etc must not give away treatment and medication to those who aren't allowed it for free. The "I can't be bothered to bill" NHS staff won't be tolerated anymore.  UKVI now have access to the NHS records.

I also was forced to go in and sign a waiver for a pap smear (because they were calling all females in after they dropped the ball with that poor 19 year old girl who died of cervical cancer cause they wouldn't give her a pap smear).

GPs get paid extra money from the NHS is they persuade a % of the women on their books to have a smear. I assume this still happens.
http://news.bbc.co.uk/1/hi/health/114086.stm
Did he put you on his books as a temporary patient?

The problem is, visitors are one of the groups that are not allowed to have cervical smears for free, nor some other tests. Even if the GP decides to carry out his work bill free (to you), the plate gets sent away from his surgery to labs for testing and that needs to be billed.  As said, the same with visiting hospitals for tests if you are just a visitor; you must pay.

It might be best if you contact the local care trust from the link I gave on my previous post, and see what they suggest.

I just found this site from a surgery, that you can use as a rough guide for some costs.

http://www.brownlowhealth.co.uk/information/overseas-visitors/

I feel for you.  The doctor is being kind in not charging, but this could really slow down the length of time it takes to process your application (which you probably would prefer for the app to be processed quickly).  Provide all the info you can for UKVI and hopefully you will have a quick turnaround time. 

The problem is, visitors are one of the groups that are not allowed to have cervical smears for free, nor some other tests. Even if the GP decides to carry out his work bill free (to you), the plate gets sent away from his surgery to labs for testing and that needs to be billed.  As said, the same with visiting hospitals for tests if you are just a visitor; you must pay.

I did not have the smear. I had just had a woman's appointment before coming over to the UK, and I did not want one. But they would not allow me to cancel it over the phone. They required me to attend the appointment and sign a waiver with the nurse stating that I did not want one. So at least I don't have to worry about that. Thanks.

I just found this site from a surgery, that you can use as a rough guide for some costs.

http://www.brownlowhealth.co.uk/information/overseas-visitors/

Thanks for this. A very high rough estimate for what I would owe would then be much less than the 1000GBP limit that contributors to this thread have told me would automatically have my application denied. I'm hoping that worst case scenario would be that it would delay the application a little bit but that they would check with the clinic and insist on them billing me. Can they actually force them? Does anyone have any idea what would happen next if I just explained the situation in the application like the doctor said to do?

Only speculation....  We've had a few members have complications from NHS use (usually results in a very long processing time unfortunately).  One person gave birth on the NHS and the hospital refused to bill.  But they did respond to UKVI stating why they were not billing and the application was granted.

Still speculation, I imagine they will look at your NHS record and assign an appropriate value to determine if it's above or below £1,000.

You WILL get through this.  I just hate that the doctor won't help you out.  He's actually doing you a real disservice...   

So abit of an update

I'm able to sneak in with my sister to see the original doctor who was spoken too on Monday (lucky i know).

Also I just got off the phone to the surgery and they say that she is registered as a normal patient. They don't register private patients there according to the Secretary, and they rarely register temporary patients. Is this going to be a problem?

So I'll plead with him to at least write a letter stating that:
- she owes nothing to the surgery
- or to at least write a letter to tell them to get in touch with them directly

Is there anything else I should try and get him to write on the letter specifically?