I think the only way will be some form of national identity card with proof of entitlement to the NHS but is that really what we are about. National Healthcare which includes all is going to give those at the sharp end exposure to less deserving cases but I really hope we don't have to do some form of means assessment prior to entitlement. If we start billing, we only need a whole raft of PCT people to monitor, assess, target, collect and fine non payers and when this happens .... Probably the sacastic approach is always going to be a winner.