Doctors, nurses and NHS managers have condemned government plans to make hospital patients produce their passport before being treated.
Numerous healthcare experts believe that the scheme is unworkable and a burden on overworked staff.
Many are also sceptical that it will raise the £500 million projected by ministers.
There are also fears that marginalised groups – such as people who are homeless and the 13% of the population who do not have a passport – will find it harder to access care.
The policy is currently operating only at the Peterborough and Stamford hospitals NHS foundation trust.
Despite growing anxiety among NHS staff, the Department of Health said the policy – which its top mandarin admits is “controversial” – might still be rolled out nationally.
It is keen for the NHS to increase dramatically the amount of money it recovers from people who are ineligible for free care from £73 million in 2012/13 to its target of £500 million annually.
Jon Restell, chief executive of Managers in Partnership, the union which represents health service managers, outlined some of the concerns of health service observers.
“Managers are worried about the unintended consequences for health inequalities, as marginalised groups may find it harder to access healthcare; for public health, where there are currently exemptions, for example around crisis mental health, TB and HIV. Will these continue? They are also worried about reciprocal arrangements with other countries. Is now the right time, at the start of Brexit negotiations, to be making these policy changes? What may be the impact on British citizens overseas?”
Restell also suggested that many vulnerable people may struggle to acquire two suitable forms of identification.
“Who is accountable for the care of a patient who can’t show ID? What happens if their condition subsequently worsens, possibly foreseeably, as a result of being turned away? ID checks are likely to create delays in clinics and elsewhere as ID is checked and queries resolved.”
The chief executive of Managers in Partnership also believes the scheme to be excessively bureaucratic.
“Most elective work [non-urgent care in hospitals] comes via referral from general practice, where registration requires eligibility checks. Why create a second check?”
Many NHS managers also believe that ID checks will generate little extra revenue beyond what is already received from overseas visitors and governments under existing arrangements.
“The system may well cost more to administer than the extra income it generates. Managers believe government underestimates how complicated this would be administratively. While we do not think it would necessarily burden clinical staff in practice, it would lead to delays and costs. The whole issue raises unresolved ethical questions about eligibility for healthcare and about compatibility with the values of the NHS and its staff,” Restell commented.
Nonetheless, it seems that the government intends to persist with trialling the passport scheme on a wider basis.