Charging Systems for Migrants in Primary Care: The Experiences of Family Doctors in a High‐Migrant Area of London: Table 1
Bibliographic record
Abstract
BACKGROUND: There is speculation that a high number of migrants use free UK National Health Services to which they are not entitled. In response, the UK government has sought to develop and expand current overseas visitors (OVs) charging systems to target these noneligible migrants for payment. Current guidance to UK primary care providers is ambiguous, and little is known about existing procedures for dealing with new migrants. We aimed to explore the impact of OVs on primary care services and to assess the views of health-care providers about current charging systems. METHODS: We undertook a 23-point semistructured questionnaire survey of family doctors working within a high-migrant area of London. Outcome measures were the following: the impact of OVs on their practices, current procedures for registering this patient group, and doctors' concerns around expanding existing charging systems. RESULTS: Ninety-two doctors from 53 practices completed the survey (practice response rate 82.8%). Fifty-one (55.4%) of the 92 doctors reported having systems in place to identify and charge OVs requesting registration, and follow-up procedures differed across practices. Significantly more doctors [65 (70.7%)] reported not having any OVs on their practice lists receiving free consultations (p < 0.001; 298 OVs reported in total). Of the 24 (26.1%) doctors who did, this equated to approximately pound3,000 monthly lost income in total for uncharged consultations across all the practices within the survey site. Seventy-eight (84.8%) doctors want a better system to identify and charge OVs in primary care but question the workability of proposals to streamline charging procedures across primary and secondary care. Concerns were raised about the implications for migrants unable to access appropriate health care and the impact on public health priorities. CONCLUSIONS: We identified variations in current procedures for identifying and registering OVs, which may result in the inappropriate exclusion of new migrants from free primary care services in the UK. Our findings suggest that the number of OVs receiving free primary care services is low. We need to explore models of appropriate health-care delivery to new migrants in the UK context, drawing on models of best practice from established health services in other migrant-receiving countries.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".