2004 No. 614
NATIONAL HEALTH SERVICE, ENGLAND
The National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2004
Made 8th March 2004
Laid before Parliament 11th March 2004
Coming into force 1st April 2004

The Secretary of State for Health, in exercise of the powers conferred upon him by sections 121 and 126(4) of the National Health Service Act 1977 and of all other powers enabling him in that behalf, hereby makes the following Regulations:
1977 c. 49; see section 128 (1) as amended by section 26(2)(g) and (i), for the definitions of “prescribed” and “regulations”. Section 121 was amended by section 65(2) of the National Health Service and Community Care Act 1990 (c. 19) (“the 1990 Act”) and by paragraph 37(6) of Schedule 4 to the Health Act 1999 (c. 8)(“the 1999 Act”); section 126(4) was amended by section 65(2) of the 1990 Act, section 65(1) of, and paragraphs 4 and 37(1) and (6) of Schedule 4 to, the 1999 Act, section 67(1) of, and paragraph 5(1) and (13)(b) of Schedule 5 to, the Health and Social Care Act 2001 (c. 15) and sections 6(3)(c) and 37(1) of, and paragraphs 1 and 10(a) of Schedule 8 to, the National Health Service Reform and Health Care Professions Act 2002 (c. 17) and section 184 of, and paragraph 38 of Schedule11 and part 4 of Schedule 14 to, to Health and Social Care(Community Health and Standards) Act 2003 (c. 43). The functions of the Secretary of State under these provisions are, so far as exercisable in relation to Wales, transferred to the National Assembly for Wales by article 2(a) of the National Assembly for Wales (Transfer of Functions) Order 1999, S.I. 1999/672, as amended by section 66(5) of the 1999 Act.

1 Citation, commencement, application and interpretation
1 These Regulations may be cited as the National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2004 and shall come into force on 1st April 2004.
2 These Regulations apply to England.
3 In these Regulations “the principal Regulations” means the National Health Service (Overseas Visitors) Regulations 1989.
S.I.1989/306 as amended by S.I. 1991/438, 1994/1535, 2000/602 and 909.

2 Amendment of regulation 1 of the principal Regulations
In regulation 1(2) of the principal Regulations (citation, commencement and interpretation) in the appropriate alphabetical position insert—

““authorised child” means a child who has either been granted leave to enter the United Kingdom with his parent for the purpose of the parent obtaining a course of treatment in respect of which no charges are payable under regulation 6A or is the child of an authorised companion;
“authorised companion” means a person who has been granted leave to enter the United Kingdom to accompany a person who is obtaining a course of treatment in respect of which no charges are payable under regulation 6A;
“walk-in centre” means a centre at which information and treatment for minor conditions is provided to the public under arrangements made by or on behalf of the Secretary of State.”

.

3 Amendment of regulation 3 of the principal Regulations
In regulation 3 of the principal Regulations (services exempted from charges) after paragraph (a) insert a new paragraph—

“(aa) at a walk-in centre in respect of services similar to those at an accident and emergency department of a hospital ; or”

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4 Amendment of regulation 4 of the principal Regulations
1 In regulation 4 of the principal Regulations (overseas visitors exempt from charges)—
(a) at the beginning for the number of the regulation “4.” substitute “4. —(1)”;
(b) in the opening words delete the words “being a person, or the spouse or child of a person”;
(c) in paragraph (a)—
(i) delete the words “, if his employer has his principal place of business in the United Kingdom”;
(ii) for sub-paragraph (i) substitute—

“(zi) engaging in employment with an employer which has its principal place of business in the United Kingdom or which is registered in the United Kingdom as a branch of an overseas company, or
(i) being a self employed person whose principal place of business is in the United Kingdom;”

;
(iii) delete sub-paragraph (iii) and substitute—

“(iii) pursuing a full time course of study which is substantially funded by the United Kingdom Government or is of at least six months duration;”

;
(d) for paragraph (b) substitute the following paragraph—

“(b) who has resided lawfully in the United Kingdom for a period of not less than one year immediately preceding the time when the services are provided unless this period of residence followed the grant of leave to enter the United Kingdom for the purpose of undergoing private medical treatment or a determination under regulation 6A;”

;
(e) in paragraph (c) after the words “United Kingdom” where they occur for the second time insert “which has not yet been determined”;
(f) in paragraph (k)—
(i) after the words “ten years continuous” insert the word “lawful”,
(ii) after the words “United Kingdom” where they occur for the second time delete the words to the end and substitute “that has lasted for a period of no more than five years.”.
2 At the end of regulation 4 add the following paragraphs—

“2 Where a person meets the residence qualification in paragraph (1)(b) on a date during a course of treatment for which charges could have been made prior to that date no charge shall be made in respect of services received subsequently;
3 Where it is established that a person does not meet the residence qualification in paragraph (1)(b) and that person has already received services as part of a course of treatment on the basis that no charges would be made, no charges may be made for the remainder of that course of treatment.
4 No charge shall be made in respect of any services forming part of the health service provided for the spouse or child of an overseas visitor to whom this regulation applies where he lives on a permanent basis with the overseas visitor in the United Kingdom.”

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5 Exemption from charges during long term visits by United Kingdom pensioners
After regulation 4 (overseas visitors exempt from charges) insert a new regulation—

“4A Exemption from charges during long term visits by United Kingdom pensioners
1 No charge shall be made or recovered in respect of any overseas visitor who—
(a) is in receipt of a retirement pension under the Social Security Contributions and Benefits Act 1992 or the Social Security (Contributions and Benefits) (Northern Ireland) Act 1992;
1992 c. 4
1999 c. 7.
(b) resides in the United Kingdom for at least six months and in another member State for less than six months each year; and
(c) is not registered as a resident of another member State;
for services forming part of the health service which he receives during the period he resides in the United Kingdom.
2 No charge shall be made in respect of any services forming part of the health service provided for the spouse or child of an overseas visitor to whom this regulation applies where he lives on a permanent basis with the overseas visitor during the period they reside in the United Kingdom.”

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6 Amendment of regulation 5 of the principle Regulations
In regulation 5 (exemption from charges for treatment the need for which arose during the visit)—
(a) in paragraphs (b) and (e) after the words “ten years continuous” insert the word “lawful”;
(b) after paragraph (e) add the following—

“,or
(a) an authorised child or an authorised companion.”

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7 Exemption from charges for exceptional humanitarian reasons
After regulation 6 (exemption from charges for treatment provided to a member of the forces of the North Atlantic Treaty Organisation) insert a new regulation—

“6A Exemption from charges for exceptional humanitarian reasons
1 Where an overseas visitor who has been granted leave to enter the United Kingdom for a course of treatment applies, or someone on his behalf applies, for exemption from charges for services forming part of the health service, the Secretary of State may determine where he considers that exceptional humanitarian reasons justify it, that no charge shall be made or recovered in respect of that person and that course of treatment .
2 Such a determination may only be made by the Secretary of State if he is satisfied in the case of that person that—
(a) the treatment specified is not available in that person’s home country;
(b) the necessary arrangements have been made for temporary accommodation for that person, the authorised companion (if any) and any authorised child for the duration of the course of treatment; and
(c) the necessary arrangements have been made for the return of that person, the authorised companion (if any) and any authorised child to their home country when the course of treatment is completed.”

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8 Amendment of Schedule 1 to the principal Regulations
After Part III of Schedule I to the principal Regulations (diseases for the treatment of which no charge is to be made) add the following—

“PART IV Other Diseases
Severe Acute Respiratory Syndrome.”

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Signed by authority of the Secretary of State for Health
John Hutton Minister of State,Department of Health 8th March 2004

(This note is not part of the Regulations)
These Regulations amend the National Health Service (Charges to Overseas Visitors) Regulations 1989 which provide for the making and recovery of charges in respect of certain services provided under the National Health Service Act 1977 to certain persons not ordinarily resident in the United Kingdom (“overseas visitors”).
Regulation 3 exempts from charges, accident and emergency type services provided at walk-in centres.
Regulations 4 and 6 change the entitlement specifications for several of the existing categories of overseas visitor who are exempt from charges for services.
Regulation 5 exempts certain United Kingdom retirement pensioners who live for at least six months in the United Kingdom and in another member state for less than six months from charges when they are in the United Kingdom.
Regulation 7 enables the Secretary of State to make a determination in certain circumstances to exempt specified overseas visitors from charges for specified services for exceptional humanitarian reasons and regulation 6 exempts from charges for treatment, the need of which arose during the course of a visit, specified persons who accompany a person to whom an exemption for exceptional humanitarian reasons applies.
Regulation 8 includes Severe Acute Respiratory Syndrome (SARS) in the list in Schedule 1 of treatments exempt from charges.