I am not negative but I do have an interesting tidbit about the NHS charging people. My sister-in-law is a nurse in the A&E department at an NHS hospital and she said that they have to flag up anytime a foreign patient comes in. I did find it interesting, though, how they were given absolutely no guidance about how to flag up cases, just told to flag it if someone seems foreign.
They have had guidance. They are meant to use their SPINE system to check, even if the person turns up with what appears to be a valid BRP. UKVI use SPINE to advise the NHS staff of who can have access to the NHS without being billed by using green and red banners on a patients details. No banner, then the NHS staff are meant to contact UKVI.
Government departments have been advising UKVI for years, as it helps to find the illegals in the country, and that includes the NHS and schools. UKVI also has access to the NHS records to find people who have dissapeared. i.e. illegals who have failed to turn up for their reporting appointment at a centre, those absconding when they lose their appeals, overstaying visitors, those overstaying when their visa has ended or been curtailed etc.
SIL had no idea that A&E care was free at point-of-service for all but that any further treatment outside of the department was billable. I know that it's not her job to determine who pays for treatment but billing the appropriate people must be so difficult if hospital staff aren't given any sort of guidance!
The NHS have always been told to bill those who must pay as the NHS was only ever free at point of use for some people, but as we have seen on here, many staff could not be bothered to do the work to raise a bill.
The 2014 Immigration Act made it quite clear that their NHS trust will be now be fined if their staff can't be bothered to bill. The NHS were even issued with clear guidance again in April 2015, when this new law on the NHS came into force.
When they bill, they don't lose that money from their budget and under that Immigration Act 2014, they can add 50% to the bill if there is no insurance and their trust can keep all that money too.
If the patient has a BRP, their Trust still doesn't lose that money from their budget if they check on their SPINE system and see a green banner put there by UKVI. The Trust claim those treatment costs back from the government central fund where all the IHS payments are held.