The National Health Service (Charges to Overseas Visitors) Amendment (No. 2) Regulations 1988

Statutory Instruments

1988 No. 472

NATIONAL HEALTH SERVICE, ENGLAND AND WALES

The National Health Service (Charges to Overseas Visitors) Amendment (No. 2) Regulations 1988

Made

8th March 1988

Laid before Parliament

11th March 1988

Coming into force

1st April 1988

The Secretary of State for Social Services, in exercise of powers conferred on him by section 121 of the National Health Service Act 1977(1) and of all other powers enabling him in that behalf, hereby makes the following Regulations:—

Citation, commencement and interpretation

1.—(1) These Regulations may be cited as the National Health Service (Charges to Overseas Visitors) Amendment (No. 2) Regulations 1988 and shall come into force on 1st April 1988.

(2) In these Regulations “the principal Regulations” means the National Health Service (Charges to Overseas Visitors) (No. 2) Regulations 1982(2).

Amendment of principal Regulations

2.—(1) The principal Regulations shall be amended in accordance with the following paragraphs of this regulation.

(2) In regulation 2—

(a) for paragraph (3) there shall be substituted the following—

“(3) Where the services forming part of the health service are provided for an overseas visitor, otherwise than as an in-patient of a health service hospital, at, or by staff employed to work at or under the direction of a hospital of any class, there shall be made and recovered, in respect of each occasion on which such services are provided, a charge the amount of which shall be—

(a) except where it falls to be determined under sub-paragraph (b) below, the sum specified in the column of Schedule 3 covering the class of hospital in which that hospital is included opposite the entry in Column 1 of that Schedule which relates to the services provided;

(b) in the case of the procedures to which paragraph 5(i) of Schedule 3 relates, the sum determined by multiplying the number of unit values, specified in Schedule 4 for the group into which the relevant procedure falls, by the appropriate unit charge specified against paragraph 5(i) in the column of Schedule 3 covering the class of hospital in which that hospital is included.”

(b) After paragraph (4) there shall be added the following paragraph—

“(5) For the purposes of paragraph (2) and Schedule 2, a “single room” means a room used for the accommodation of one patient only, such room having a floor area of not less than 10 square metres (or 8 square metres where a room is for the accommodation of a child under the age of 10 years) and being completely enclosed by walls or partitions and doors and having been decorated within the previous 7 years.”

(3) For Schedule 2 (daily charges for services provided for overseas visitors as in-patients) there shall be substituted the Schedule set out as Schedule 1 to these Regulations.

(4) For Schedule 3 (charges for services provided for overseas visitors otherwise than as in-patients) there shall be substituted the Schedule set out as Schedule 2 to these Regulations.

(5) For Schedule 4 (units of cost value for purpose of determining charges for radiodiagnosis examination procedures) there shall be substituted the Schedule set out as Schedule 3 to these Regulations.

Revocations

3.  The following Regulations are hereby revoked:—

(a) The National Health Service (Charges to Overseas Visitors) Amendment Regulations 1983(3), regulations 2 and 5;

(b) The National Health Service (Charges to Overseas Visitors) Amendment Regulations 1987(4), regulation 2(3) and (4) and Schedules 1 and 2;

(c) The National Health Service (Charges to Overseas Visitors) Amendment Regulations 1988(5), regulation 2(3).

Signed by authority of the Secretary of State for Social Services.

Tony Newton

Minister of State,

Department of Health and Social Security

8th March 1988

Regulation 2(3)

SCHEDULE 1 SCHEDULE 2 TO THE PRINCIPAL REGULATIONS AS SUBSTITUTED BY THESE REGULATIONS

Regulation 2(2)

“SCHEDULE 2 DAILY CHARGES FOR SERVICES PROVIDED FOR OVERSEAS VISITORS AS IN-PATIENTS

(1) Class of hospital in which services are provided		(2) Single Room	(3) Other Accommodation
		£	£
Class A	(Long-Stay Hospitals)	93	84
Class B	(Psychiatric Hospitals)	85	77
Class C1	(Mainly acute and other hospitals in non-teaching districts)	149	136
Class C2	(Acute and other hospitals in non-teaching districts)	170	154
Class D	(Hospitals in London teaching districts (other than hospitals in Classes A and B))	231	210
Class E	(Hospitals in provincial teaching districts (other than hospitals in Classes A and B))	185	168
Class F	(London Postgraduate Teaching hospitals managed by Special Health Authorities except the Hospitals for Sick Children and the National Heart and Chest Hospitals)	253	230
Class G	(The Hospitals for Sick Children and the National Heart and Chest Hospitals)	392	357”

Regulation 2(4)

SCHEDULE 2 SCHEDULE 3 TO THE PRINCIPAL REGULATIONS AS SUBSTITUTED BY THESE REGULATIONS

Regulation 2(3)

“SCHEDULE 3 CHARGES FOR SERVICES PROVIDED FOR OVERSEAS VISITORS OTHERWISE THAN AS IN-PATIENTS

(1) Services Provided	(2) Hospital Class A-E	(3) Hospital Class F and G
	£	£
1.   For a patient on each attendance at a hospital other than attendances directly associated with the procedures listed in paragraphs 4—12 below.	14.50	21.50
DAY CASES 2.   Charges per day exclusive of charges for procedures listed in paragraphs 4—12 below. For the purpose of this item a day case is a patient who attends as a non-resident patient for investigation, treatment or operation and who occupies a bed without staying overnight.	28.50	29.50
DAY PATIENTS 3.   Charges per day exclusive of charges for procedures listed in paragraphs 4—12 below. For the purpose of this item a day patient is someone who attends regularly for a course of treatment without necessarily occupying a bed or staying overnight.	34.00	35.00
PATHOLOGY 4.   For each request.	7.50	15.00
RADIODIAGNOSIS, NUCLEAR MEDICINE AND ULTRASOUND i. 5.   For each procedure listed in Schedule 4 (charge per unit value).	6.50 per unit for the first 6 units, 1.00 per unit thereafter.	9.00 per unit for the first 6 units, 1.25 per unit thereafter.
ii. C.T. Scanning. For all scans.	96.00	115.00
RADIOTHERAPY 6.   For treatment in any one day:	18.00	44.50
PHYSIOTHERAPY AND REMEDIAL GYMNASTICS 7.   Per attendance	5.50	11.50
OCCUPATIONAL THERAPY 8.   For treatment in any one day	8.50	10.00
OTHER DIAGNOSTIC PROCEDURES i. 9.   Audiometry.	5.00	5.00
ii. Electrocardiography. For each testing session.	9.50	17.50
iii. Electroencephalography. For each testing session.	38.50	83.50
iv. Electromyography. For each testing session.	24.00	50.50
USE OF OPERATING THEATRE FACILITIES 10.   Operating theatre facilities booked as required:
i. For less than 10 minutes.	22.50	28.00
ii. For 10 minutes to 30 minutes.	44.00	56.00
iii. For more than 30 minutes.	67.00	84.00
DIALYSIS 11.   For haemodialysis or intermittent peritoneal dialysis: i. With training or routine at a hospital per session.	111.00	111.00
ii. Routine, at home — per session	70.50	70.50
iii. Minimal Care Unit — per session	90.50	90.50
For continuous ambulatory peritoneal dialysis (including continuous cycling peritoneal dialysis) — per day.	33.50	33.50
SUPPLY OF DRUGS AND MEDICINES 12.   For the supply of a drug or medicine which is designed to elimininate, prevent the replication of, or in any way inhibit the mode of action of any Human Immunodeficiency Virus—for each quantity sufficient for one day’s treatment.	14.50	14.50”

Regulation 2(5)

SCHEDULE 3 SCHEDULE 4 TO THE PRINCIPAL REGULATIONS AS SUBSTITUTED BY THESE REGULATIONS

Regulation 2(3)

“SCHEDULE 4 UNIT VALUES FOR PURPOSE OF DETERMINING CHARGES FOR RADIOLOGICAL PROCEDURES

Group A: 1 unit value for each procedure

Abdomen erect and/or supine

Acromio-clavicular joint(s)

Ankle

Chest PA and/or lateral and/or obliques and/or rib views

Clavicle

Elbow

Femur

Finger or fingers of one hand

Foot

Foreign body demonstration

Hand

Hip

Humerus

Knee

Larynx

Localisation of treatment field

Mandible

Nasal bones

Calcaneum

Patella

Pathological specimen

Pelvis

Hips and pelvis

Post-nasal space

Radius and ulna

Sacro-iliac joints

Sacrum and/or coccyx

Scapula

Shoulder

Sinuses and antra

Sterno-clavicular joint

Sternum

Teeth

Thoracic inlet

Thumb

Tibia and fibula

Toe or toes of one foot

Wrist

Perineum

Soft tissues of neck

Group B: 2.5 unit values for each procedure

Cholangiography, post-operative

Cholecystography

Facial bones and/or cephalometry

Fluoroscopy with mobile image intensifier

Mammography

Mastoids

Orthopaedic measurement

Pelvimetry

Pneumothorax, diagnostic

Skull and/or pituitary fossa and/or optic foramina and/or internal auditory meati

Small bowel biopsy

Spine

Lumbar spine

Lumbo-sacral spine

Lumbo-sacral spine and sacro-iliac joints

Lumbo-sacral spine with obliques

Cervical spine

Cervical spine with obliques

Cervical spine with obliques and flexion and extension views

Lumbar spine and cervical spine on one patient

Teeth, panoramic tomography

Temporo-mandibular joints

Ultrasound, all types

Salivary glands

Skeletal survey

Group C: 6 unit values for each procedure

Cholangiography, operative

Cystography

Cystometrography

Cysto-urethrography

Dacrocystography

Endoscopy

Foreign body localisation

Gastro-intestinal tract, upper (includes examination to the mouth of the upper small bowel or any part thereof)

Orthopaedic pinning

Hysterosalpingography

Intra-uterine transfusion

Kidney, exposed

Laryngography

Mammary ductography

Retrograde pyelography and/or ascending ureterography

Sialography

Sinography

Tomography, as a separate examination

Urethrography

Cholangiography, infusion

Cholangiography, intravenous

Gastro-intestinal tract, lower

Pharyngography

Fluoroscopy, other

Computed tomography of the Head without contrast enhancement

Computed tomography of the Head with contrast enhancement

Computed tomography of the Neck without contrast enhancement

Computed tomography of the Neck with contrast enhancement

Computed tomography of the Thorax without contrast enhancement

Computed tomography of the Thorax with contrast enhancement

Computed tomography of the Abdomen without contrast enhancement

Computed tomography of the Abdomen with contrast enhancement

Computed tomography of the Pelvis without contrast enhancement

Computed tomography of the Pelvis with contrast enhancement

Computed tomography of a Limb without contrast enhancement

Computed tomography of a Limb with contrast enhancement

Computed tomography of the Spine without contrast enhancement

Computed tomography of the Spine with contrast enhancement

Group D: 12 Unit vales for each procedure

Aminiography

Arthrography

Biopsy and/or aspiration under imaging control (includes Amniocentesis including ultrasound examination before and after the procedure)

Bronchography

Cholangiograpy, percutaneous

Excretion urography

Gastro-intestinal tract, upper including small bowel

Gynaecography

Stereotaxis

Nerve injection under imaging control

Ventriculography

Nephrostogram, post operative

Antegrade pyelography

Group E: 30 Unit values for each procedure

Aortography

Bile duct, external drainage

Cardiac catheterisation without angiocardiography

Discography

Insertion of pacemaker

Lymphangiography

Myelography

Nephrostomy, percutaneous

Phlebography

Programmed stimulation study

Retrograde cholangio-pancreatography

Lumbar radiculography

Meatography

Shuntography

Group F: 60 unit values for each procedure

Angiocardiography

Angioplasty, including angiography pre- and post-angioplasty

Arteriography, all types

Embolisation

Encephalography

Pituitary implant

Magnetic resonance imaging

Bile duct, internal drainage

Bile duct, dilation of stricture

Bile duct, stone extraction

Kidney, stent insertion

Kidney, stone extraction or destruction

Dilatation of oesophageal stricture

Dilatation of pyloric stenosis

Insertion of caval filters

Management of varicocoele

Removal of intravascular foreign body

Ablation of function of spleen

Ablation of function of kidney

Ablation of function of parathyroid

Ablation of function of adrenal

Cisternography”

Explanatory Note

(This note is not part of the Regulations)

These Regulations further amend the National Health Service (Charges to Overseas Visitors) (No. 2) Regulations 1982, their main effect being to increase the sums prescribed for charges to certain overseas visitors for services forming part of the health service.

Regulation 2 substitutes new Schedules of charges for overseas visitors, both as in-patients (the new Schedule 2) and otherwise (the new Schedule 3).

Regulation 2(5) substitutes a new Schedule 4 to the principal Regulations, by which radiological procedures are no longer allocated individual unit values. They are classified into six groups instead and unit values are specified for each group in ascending order. There is a higher charge per unit value for the first six units than for subsequent units.

Regulation 3 makes consequential revocations.

(1)

1977 c. 49; see section 128(1) for the definitions of “prescribed” and “regulations”.

(2)

S.I. 1982/863; relevant amending instruments are S.I. 1983/302, 1984/300, 1987/371, and 1988/8.

(3)

S.I. 1983/302.

(4)

S.I. 1987/371.

(5)

S.I. 1988/8.