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<p>The Department engaged with 79 organisations as part of the process of reviewing
the National Health Service (Charges to Overseas Visitors) (Amendment) Regulations
2017 and received 57 formal responses. The Department met with and received responses
from a number of organisations with expertise in maternity care, including a royal
college, maternity staff groups and maternity stakeholder groups. A number of other
organisations and individuals who contributed to the review also commented on the
impact of the amendment regulations on maternity service users.</p><p> </p><p>Although
maternity treatment must always be regarded as immediately necessary, and therefore
not subject to the upfront charging requirement, some evidence suggested that overseas
visitors may not always be aware of this. The Department has therefore committed to
develop user-friendly, culturally-appropriate guidance, that will clarify that maternity
treatment is never subject to the upfront charging requirement and ensure this reaches
those who may be impacted. The Department has also updated national guidance (published
24 December 2018) to make clear that termination of pregnancy services are to be regarded
as urgent, and therefore not subject to the upfront charging requirement, where the
overseas visitor cannot reasonably be expected to leave the UK before the date which
an abortion may no longer be a viable option.</p><p> </p><p>As a result of the 2017
amendment regulations some secondary care services, including community midwifery
services, have become chargeable. However, these services were already chargeable
if delivered by hospital employed or directed staff and the removal of the exemption
was important in ensuring that charging rules apply in a fair and consistent manner,
regardless of where a service is provided. The exemption from the charging regulations
for conditions caused by sexual violence remains in place to protect this vulnerable
group.</p>
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