Hospitals are failing to claw back hundreds of millions of pounds from health tourists, a damning report reveals today.
Barely any improvement has been made on charging foreign patients for NHS treatment, despite a major crackdown four years ago.
Most doctors aren’t even aware they should be charging such patients – or don’t think it’s their duty.
Today’s analysis by the National Audit Office highlights how hospitals are particularly bad at recovering costs from EU residents.
Bimbo Ayelabola, 38, had to have a Caesarean section at Homerton Hospital, East London, after travelling to the UK while pregnant in 2011
Bimbo and her five children back in Lagos, Nigeria, after she had them in Britain in 2011
And it warns that the health service will fall £200million short of a target to recoup £500million a year by 2018.
The analysis comes at a time when the NHS is struggling with a high deficit and problems with overspending.
Only yesterday, a report by the General Medical Council claimed the ‘intense pressure’ created by a £2billion total in hospital deficits was having a corrosive effect on morale in the medical profession.
However, this is the same figure that some experts say is the total cost of health tourism to the NHS every year.
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Last night, campaigners said it was still ‘far too easy’ for health tourists to abuse the system and called on NHS hospitals to demand all patients provide proof of ID.
Though trusts have designated staff to chase payments, guidelines from the Department of Health state that doctors and nurses must do all they can to help identify health tourists.
However, the British Medical Association warned against imposing stricter rules, saying that it wasn’t doctors’ responsibility to ‘act as border guards’. Despite repeated promises by the Government to crack down on the problem, today’s NAO report reveals:
- 42 per cent of doctors aren’t aware that overseas patients should be charged for treatment;
- Half of those doctors who do know the rules don’t think its their duty to recover costs;
- Hospitals only recover a sixth of the amount owed by EU patients. This equated to £56million of a possible £305million last year;
- They get back half the money they are owed by patients outside of the EU – but that only includes those they actually detect.
Ministers have repeatedly tried to crack down on the scale of abuse and in 2013, set an ambitious target of recouping at least £500million a year by 2017/18. But the NAO estimates that hospitals will fall £200million short of the target.
And closer scrutiny of the figures shows they have barely got any better at getting money from foreign patients.
Of the £300million figure, £168million will come from the immigration health surcharge. This is a £200-a-year levy paid for migrants coming in from outside the EU, imposed last year.
Hospitals are failing to claw back hundreds of millions of pounds from health tourists, a damning report reveals today
So this means that only £136million will be recovered directly from patients in hospital, up from £97million in 2013/14.
Receptionists were told to ask all new patients for forms of identification and doctors and nurses were told to report anyone suspected of being a health tourist.
The Mail has repeatedly highlighted the scale of health tourism and this summer we exposed how overseas patients were jumping the queue for cataract operations.
Last year we revealed how managers and doctors were trying to cover-up the problem, even bullying staff for trying to make patients pay. And only this month a major teaching hospital, St George’s in South London, admitted that 900 foreign pregnant women had given birth for free.
The Government has repeatedly promised to crack down on health tourism. By law, only patients who are ‘ordinarily resident’ in the UK – and have lived here for at least six months – are eligible for free treatment, operations and scans.
DAILY MAIL COMMENT
With up to £2billion at stake, you might expect hospitals to be absolutely determined to collect money from overseas patients who aren’t entitled to free non-emergency treatment.
Yet even though we’re constantly being told the NHS is in a funding crisis, only a small fraction (under £300million) of the total owed by these so-called ‘health tourists’ is being collected.
Doctors say – rather unhelpfully – that it’s not their job ‘to act as border guards’. (Would they feel the same if it was money owed by their private patients?)
But it’s surely up to administrators – who are forever bleating about lack of cash – to implement a system which ensures the NHS isn’t taken for a ride.
The BBC yesterday made a meal of a survey suggesting that the morale of overworked doctors was at an all-time low. Imagine how it could be lifted by the injection of £1.7billion into their hospitals every year.
But lifesaving procedures, AE treatment and GP services are free for everyone.
The NAO analysed hospital accounts and also reviewed a survey of 2,170 hospital staff on their awareness. This found that 42 per cent of doctors and 55 per cent of nurses didn’t realise overseas patients needed to be charged.
And 48 per cent of doctors and 27 per cent of nurses who were aware of the rules didn’t think it was their role to recover costs. Some NHS trusts are known to be wary of making nationality checks in case they offend a British citizen by asking them to prove their nationality.
The head of the NAO Amyas Morse, said: ‘Hospital trusts remain some way from complying in full with the requirement to charge and recover the cost of treating overseas visitors. In the past two years, the amounts charged and amounts recovered have increased.’
Tory MP Philip Hollobone said: ‘It’s simply not good enough. It’s difficult enough to fund a national health service.
‘Frankly it’s impossible to fund our NHS as an international health service. Members of the public think it’s perfectly reasonable for people who are not British or not resident in this country not to qualify.’
Professor J Meirion Thomas, a former cancer surgeon at the Royal Marsden Hospital in London, said: ‘Hospitals lose approximately £2billion a year to health tourism. The only way to curb it is to ask all new patients to present ID.’
John O’Connell of the TaxPayers’ Alliance said: ‘Those in need of emergency care should get treatment but these are huge sums of taxpayers’ money that are being written off.
‘We have a national, not an international health service, and for too long it’s been far too easy for visitors to use NHS services without contributing to the cost.
‘The Government will have to start penalising those trusts who are failing in their duty to taxpayers.’
Barely any improvement has been made on charging foreign patients for NHS treatment, despite a major crackdown four years ago
In one case a Nigerian woman who cost the taxpayer £145,000 when she had quintuplets on the NHS said she was never billed for the treatment.
Bimbo Ayelabola, 38, had to have a Caesarean section at Homerton Hospital, East London, after travelling to the UK while pregnant in 2011.
The Mail tracked her down to her home city of Lagos where she is now working as a successful make-up artist charging £40 per hour.
When confronted, she said: ‘I have never received my bill. If I had it, I would pay it.’
Dr Mark Porter of the British Medical Association said: ‘A doctor’s duty is to treat the patient in front of them, not act as a border guard.’
A Department of Health spokesman said: ‘This Government was the first to put in place measures to ensure the NHS isn’t abused, and the amount of income recovered has already more than trebled in three years to £289million.’
The approach of NHS hospitals is in sharp contrast with that of private hospitals where ability to pay is determined at the very beginning.