Published: 12 March 2024

Our correspondents, Van Ameyde Marine, have notified the Club about significant changes to UK Immigration (Border Agency) guidelines which may impact seafarers receiving medical treatment in the UK through the NHS (National Health Service).

When a crew member falls ill or injured in UK ports, the NHS usually provides medical treatment. In most cases, a seafarer is treated as an “Overseas Visitor (Patient)”, defined as “a person not ordinarily resident in the United Kingdom” by the NHS (Charges to Overseas Visitors) Regulations 2015. After completing the medical assessment and treatment, an invoice is usually issued in the individual’s name, even though the shipowner is liable for paying the medical bill. The seafarer is exempt from paying these charges themselves when treated as an overseas visitor under the NHS scheme¹.

In an attempt to improve payment efficiency, new legislation is being introduced, making it clear that non-payment could potentially affect the ongoing immigration status of a seafarer.
According to the new guidance published on 19 February 2024, overseas visitors, “qualifying debts” are described as debts relating to single or multiple invoices of:

• £500 or more that have been outstanding for 2 months or more (from date of invoice), if invoiced on or after 6 April 2016.

• £1,000 or more (if invoiced between 1 November 2011 and 5 April 2016).

These qualifying debts are reported to the Home Office, listed as one of the grounds for visa or entry clearance refusal, potentially affecting UK crew changes for shipowners. A seafarer seeking entry clearance to join a ship in the UK must convincingly meet specific criteria as determined by the decision maker. They must not fall under any of the general grounds for refusal or leave to enter, as outlined in part nine of the Immigration Rules. Part nine provides the following regarding these NHS charges: 

“9.11.1. An application for entry clearance, permission to enter or permission to stay may be refused where a relevant NHS body has notified the Secretary of State that the applicant has failed to pay charges under relevant NHS regulations on charges to overseas visitors and the outstanding charges have a total value of at least £500”.

We recommend that shipowners remain vigilant and settle their NHS bills promptly to avoid any future complications at UK ports.

We would like to thank Van Ameyde Marine for their kind update during the preparation of this article.

For further information, please do not hesitate to contact us.

¹Legally, the person liable for paying the charge is likely to be the patient themselves. There are three exceptions and one of them is:
For an overseas visitor who is present in the UK in the course of employment on board a ship, the liable person is the owner of that ship.