Hospitals have been ordered to routinely ask patients for utility bills, bank statements or payslips in a bid to prove their entitlement to free healthcare.
Under the new laws, which came into force yesterday, it is mandatory for NHS hospitals to collect “upfront payment” from those who are not entitled to free care.
The price list, setting out the charges was only published yesterday morning, after the policy came in.
It comes alongside Department of Health guidance which instructs staff to ask 32 questions in order to establish likely residency.
Patients should be asked for evidence of a “settled home address in the UK”. These could include utility bills, council tax records, bank statements, tenancy agreements, proof of property ownership or insurance policies, the guidance states.
While staff are not told to ask the questions to every patient, separate guidance warns that trusts could fall foul of discrimination law if they target non-white patients.
Senior NHS managers said it was “unrealistic” to expect hospital staff to have time to ask patients dozens of questions in order to find those who should be charged for treatment.
One senior source said they anticipated a “soft launch” of the rules, which were unlikely to be fully enforced immediately given the detailed demands being made.
A tariff setting out costs which should be charged says patients outside the EU should be charged 50 per cent more than the working costs to the NHS.
Examples include rates of £ 15,802 for spinal surgery, £10,277 for paediatric brain surgery or £4,138 for delivery of a child, and £1,825 for an eye operation.
Another NHS senior manager said hospital trusts were unlikely to prioritise enforcement of the rules at a time when winter pressures are mounting.
“I think trusts have got other priorities right now, trying to keep the show on the road, and ensure there are enough doctors and nurses to treat patients safely,” he said, suggesting the administrative workload was too heavy.
The British Medical Asssociation criticised the lack of consultation about the mechanics of the plans. Dr Chaand Nagpaul, BMA Council chairman said: “It is vital that patients do not face bureaucratic or financial obstacles that prevent acutely sick and vulnerable individuals from seeking necessary treatment. This would be morally unacceptable and could end up costing the NHS more money due to lack of timely treatment.”
GPs visits are excluded from the charges. But the chairman of the Royal College of GPs raised fears that practices could end up overloaded by patients because of this.
Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, said: “We have a number of concerns around plans to start charging. We recognise that the NHS must not be abused and measures must be taken to tackle health tourism - but it should not be the role of doctors and other health professionals to police this.
Phillippa Hentsch, head of analysis at NHS Providers, said: “NHS trusts recognise that overseas patients who are not entitled to free non-urgent care should pay. These regulations are designed to support this. Some trusts are already making good progress. However it can be difficult to identify which patients should be charged. Trusts were told there would be further support to implement these changes. We look forward to seeing the full range of measures that will be made available.”
Health Minister Lord O'Shaughnessy said: "The NHS is a cherished national institution that is paid for by British taxpayers.
"We have no problem with overseas visitors using our NHS as long as they make a fair financial contribution, just as the British taxpayer does. The new regulations simply require NHS bodies to make enquiries about, and then charge, those who aren't entitled to free NHS care. All the money raised goes back into funding and improving care for NHS patients.”
No one would be denied urgent treatment on cost grounds, he stressed.
A Department of Health spokesman said: "All hospital trusts must now comply with the upfront charging regulations and we expect them to have the correctly trained staff in place to meet their organisation's demand.
"We have no problem with overseas visitors using our NHS as long as they make a fair financial contribution, just as the British taxpayer does. The new regulations simply require NHS bodies to make enquiries about, and then charge, those who aren't entitled to free NHS care. All the money raised goes back into funding and improving care for NHS patients."