NHS Tourists Owe Hospitals £40m in Unpaid Fees

Hospitals are owed as much as £40m in outstanding fees for the treatment of foreign nationals, a Pulse investigation reveals.


The findings are set to reignite the debate over health tourism, and follow cases where GPs have been under pressure to register foreign nationals not entitled to secondary care.

Where foreign nationals are not eligible for NHS care, they, their insurers or their country of origin will be approached for payment.

Acute trusts across England were approached under the Freedom of Information Act to ask how much they were owed for the treatment of foreign nationals who were not entitled to free NHS care.

A total of 35 acute trusts replied and were able to provide figures, and their average unpaid debt for the provision of care to foreign nationals was £230,000. If that figure is extrapolated across all 168 trusts in England, it puts the total owed the NHS by foreign nationals at £40m.

St George's Healthcare Trust had the largest outstanding debts, totalling £2m from £3.55m invoiced to foreign nationals for health treatment from April 2009. Barnet and Chase Farm was next, with £488,000 outstanding from invoices worth £934,000.

The most inefficient trust in collecting money was Royal Wolverhampton, which collected only 24% of the £419,000 owed, followed by Newcastle-upon-Tyne, which collected 36%.

Other hospitals admitted to writing off fees. Northampton General said it wrote off £140,000, despite only having been reimbursed £87,300 to date. St George's wrote off more than £95,000, while University Hospitals Coventry and Warwick, and Royal Wolverhampton wrote off £79,000 and £41,000 respectively.

A spokesperson for St George's said: A high percentage of our patients require life-saving trauma, neuroscience, cardiovascular or paediatric care. We're working hard to improve the way we record overseas patients and the debt recovery rate.

Dr Richard Vautrey, deputy chair of the BMAs GP committee, said: Hospital trusts must put in place arrangements that ensure people cannot exploit the system. However, we need to be careful that we are not putting barriers in place that prevent people from getting access to healthcare. It can be quite challenging. It is too simplistic to call it health tourism. The reality is a lot more complex.

Richard Hoey, editor of Pulse, said: The amount of unpaid debt is likely to at least in part reflect the degree of confusion across the NHS about which foreign nationals are eligible to free NHS care, and which are not.

GPs are in theory allowed to exercise discretion about whether to register foreign nationals who are not eligible for hospital care, but in practice they are sometimes put under pressure to take them on.

Where NHS hospitals give care to patients they know are not entitled to it for free, they have a responsibility to taxpayers in the UK to chase payment promptly after treatment.

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