The National Health Service (NHS) is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. Only the English NHS is officially called the National Health Service, the others being NHS Scotland and NHS Wales. Health and Social Care in Northern Ireland is called the HSC rather than the NHS.
Each system operates independently, and is politically accountable to the relevant government: the Scottish Government, Welsh Assembly Government, the Northern Ireland Executive, or the UK government (for the English NHS).
Despite their separate funding and administration, there is no discrimination when a resident of one country of the United Kingdom requires treatment in another although a patient will often be returned to their home area when they are fit to be moved. The financial and administrative consequences are dealt with by the organisations involved and no personal involvement by the patient is required.
Treatment of persons not resident in the United Kingdom is subject to mostly uniform arrangements made by or delegated to the UK Department of Health rather than any individual health service.
Foreign nationals always receive treatment free at the time of use for emergencies. Treatment for injuries caused in a road traffic accident has been chargeable since the 1930s but such charges were not generally enforced until the Road Traffic (NHS Charges) Act 1999 came into force to direct the charges to the insurers of the vehicles involved; this necessarily involves patients in the charging process even though they are not personally billed for treatment. Foreign nationals also receive free treatment if they have been legally resident in the UK for 12 months, have recently arrived to take up permanent residence, are claiming asylum or have other legal resident status. Citizens of European Economic Area nations, as well as those from countries with which the UK has a reciprocal arrangements, are also entitled to free treatment.
Foreign nationals may be subject to an interview to establish their nationality and residence status, which must be resolved before non-emergency treatment can commence. Patients who do not qualify for free treatment are asked to pay in advance, or to sign a written undertaking to pay.
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