‘Health tourists’ run up unpaid NHS bill of £62m – less than £1 per capita…

Richard Kerbaj and Jon Ungoed-Thomas  in The Times 14th March 2015 report: ‘Health tourists’ run up unpaid NHS bill of £62m

In a system costing so much, and around 10% of our GDP, how can I  get worked up about £1 per head overhead for foreigners. The citizen’s cost of being a “good Samaritan” through the fiscal system seems small at first. But I can guarantee that this is an underestimate, perhaps by as much as 1000% or a factor of 10…. Nevertheless, this is a distraction from the proper Health Service story which is explicit in The Times leading article of the same date. (Saving the NHS – Political parties are in denial over how to fund the growing pressure on the health service. We need an honest debate about new means of paying for it). By the way, is a 70 year long dependency on Doctors and Nurses from abroad a “reverse” tourism, or migration?

Ben Jennings on plans to charge for 'health tourism'

A MOTHER who appeared in a photo opportunity with a health minister visiting a Norfolk maternity unit in 2013 was an “NHS tourist” from Zimbabwe who is still facing demands to settle her hospital bill.

Caroline Nyadzayo, 34, is being pursued for £3,000 — part of a £62m unpaid bill for health tourism revealed today by a Sunday Times investigation. Nyadzayo was pictured in a local paper alongside the health minister Daniel Poulter. He was visiting the Norfolk and Norwich University Hospital after the reopening of the maternity suite.

The disclosure is likely to embarrass the government, which has faced a long-running controversy over the scale of “health tourism” in the UK.The investigation by The Sunday Times has found that one London hospital trust alone is owed more than £17m — or nearly 30% of the unpaid bills that trusts around the country are trying to recoup from foreign patients who were not entitled to free treatment.

One patient racked up an unpaid bill of more than £420,000. Several owe more than £100,000 from treatments including dialysis, bone marrow transplant and chemotherapy. Another is being chased for more than £15,000 for bills relating to alcoholism.

Officials say they are aware of the risk of the NHS being a magnet for the seriously ill from overseas because it will not turn down anyone who needs urgent treatment.

Nyadzayo, who works as an advertising executive in Harare, confirmed that she was still being pursued by the Norfolk and Norwich trust to pay the £3,000 she owed after giving birth at the hospital in December 2013.

She claimed to have complained to Poulter when she was photographed with him on December 5, 2013 that she was under “enormous pressure” because she was being pursued for the cost of her care by the hospital. However, Poulter said he could not recall Nyadzayo saying that.

Nyadzayo said this weekend that it was “unfair and nonsensical” that she was still being pursued for the money because the father of her son is British.

“I understand that the NHS [is] looking after the interests of its citizens such as healthcare and ensuring foreigners who are not entitled to it do not abuse it,” she said.

“I know the system may believe I travelled [to Britain] to abuse the NHS benefits, but as a matter of fact I just wanted to have my first baby as a family and surely everyone is entitled to that.”

Asked on what basis she was allowed into the country after initially being stopped by border authorities at Norwich airport in October 2013, she said: “I had my visa cancelled and [was] held by immigration for about five hours.

“I was told because I was 31 weeks pregnant it was likely that I was going to use the NHS to my advantage. Both my partner and I were interviewed… we said we would pay for the birth. But we had no idea how much we would be charged.”

The scale of the problem of health tourism has been underestimated for years. In 2013 Jeremy Hunt, the health secretary, said the lowest estimate of the losses was £12m. This figure was widely quoted amid claims that some experts were exaggerating the scale of the problem. Subsequent estimates have dwarfed that figure, although there is still a lack of reliable data.

Nearly 100 trusts provided data to The Sunday Times under the Freedom of Information Act, revealing a total unpaid debt from foreign patients of more than £62.8m between 2010 and 2015. However, more than 40 trusts failed to provide any figures. Some trusts are working hard to establish the scale of the problem, while others have been accused of turning a blind eye to the issue.

King’s College Hospital NHS Foundation Trust — one of the trusts that has devoted resources to identifying overseas visitors who are not entitled to free care — has established that it is owed £17.9m from the past five years, but is still finalising figures for this year.

One patient at King’s College Hospital ran up a bill of £207,482 for renal therapy between 2010 and 2013. At the East and North Hertfordshire NHS Trust one overseas patient has been receiving dialysis since 2008 and has an unpaid bill so far of £171,626.

The biggest unpaid bill in the figures provided to The Sunday Times was £428,103 for the treatment of a haemophiliac patient between 2011 and 2014 at Guy’s and St Thomas’ NHS Foundation Trust. The same trust also provided chemotherapy costing £126,053 in 2013 and 2014 for a foreign patient who has not paid the bill. University College London Hospitals NHS Foundation Trust has provided a bone marrow transplant for a foreign patient with the unpaid bill totalling £148,950.

Other unpaid treatments include a £15,263 bill for treating a foreign alcoholic at Northampton General Hospital NHS Trust in 2013 and 2014.

Barts Health NHS Trust gave unpaid treatment worth £186,857 to one foreign patient, while two others received treatment worth £145,030 and £143,130 respectively. Barts has declined to provide details of these unpaid treatments.

The Department of Health said Poulter did not know Nyadzayo was being investigated for being a health tourist when he visited the hospital in December 2013: “We want international visitors to feel welcome to use the NHS provided they pay for it — just as families in the UK do through their taxes.

“That’s why this government is the first to introduce rules, which come into force in the next few weeks, to help recoup up to £500m a year by 2017-18, making sure the NHS is better resourced and more sustainable at a time when doctors and nurses on the front line are working very hard.”

Guy’s and St Thomas’ trust said emergency or urgent treatment was alway provided to patients who required it.

King’s College Hospital trust said: “We have a dedicated team identifying overseas patients and invoicing them for treatment. However, there is more work to do.”

University College trust said the patient who had the bone marrow transplant had not travelled to the UK specifically for treatment and the legal advice had been that it was correct to proceed.

Steve Bell cartoon, 5.3.2013

This entry was posted in A Personal View, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

1 thought on “‘Health tourists’ run up unpaid NHS bill of £62m – less than £1 per capita…

  1. Pingback: An election debate by pithed, fearful politicians. Impotence and denial ensure no significant change in philosophy. | NHS reality. An NHS soapbox. Speakers' corner for the NHS.

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