NHS hospitals only received a THIRD of the £91million they billed ‘health tourists’ from outside of Europe last year – despite a pledge to crack down on fee dodgers
- Hospitals in London were the worst offenders and racked up bills of over £40m
- Some recouped only 10 per cent of the invoices and wrote off millions of pounds
- The British Medical Association said the system ‘is not cost effective’
- Non-emergency non-European patients are supposed to pay upfront
- But doctors do not always enforce this and hospitals have to collect debts later
NHS hospitals only managed to claim back 38 per cent of the money they billed health tourists from outside of Europe last year.
Just £35million out of a £91m total was reclaimed by the health service for care it provided to citizens from countries not in European Economic Area.
London hospital trusts were the worst affected, in some cases getting paid only £1 for every £10 they were owed and writing off more than £4million in a year.
Statistics for 2018-19 revealed hospitals had to write off £30million in total, some of which was payments from previous years.
One of the country’s leading medical unions said the current system is ‘not cost effective or beneficial to the NHS’, the Health Service Journal reported.
Hospitals are losing money despite the NHS last year pledging to push them harder to charge their patients up front rather than trying to get the money back later.
Barts Health Trust, which runs St Bartholomew’s Hospital in London (pictured), invoiced overseas patients for £10.2million worth of NHS treatment last year but only got £1.1m of that paid back
NHS healthcare costs racked up by patients from outside the European Economic Area (EEA) were last year £4million higher than they were in 2017-18.
The amount recouped by the NHS was £5million higher, but hospitals are still scrapping almost as much debt as they can get paid off.
The NHS received £5m more in repayments than in the previous year but in turn wrote off £3m more.
Losing money to health tourists – people who travel to the UK expressly for NHS treatment – has long been a contentious issues for doctors and politicians.
Often, patients have left the country by the time they are chased for the money, which makes it more difficult to force them to pay.
John Chisholm, ethics chair at the British Medical Association, told the HSJ: ‘The system as it stands is not working and, given the difficulties in recouping charges and assessing a patient’s ability to pay, it is not cost effective or beneficial to the NHS.’
NHS Improvement last year formed an ‘overseas cost improvement programme’ to put pressure on 51 hospitals to recoup more of the money they were owed.
The programme promised to make sure hospitals were using ‘best practice’ when attempting to collect invoices and to make it clearer who ought to pay for what.
Healthcare is only free for people who are ordinarily resident in the UK, and visitors from any other country are required to pay – although some emergency care is covered by the European Health Insurance Card (EHIC) scheme.
Deputy chief executive of NHS Providers, which represents hospital and ambulance staff, Saffron Cordery, said: ‘Trusts understand that as far as is practicable, these costs should be recovered, and there is evidence that we are seeing improvements in the amount recuperated.
WHICH TRUSTS WERE OWED THE MOST BY OVERSEAS PATIENTS IN 2018-19?
Source: Health Service Journal
‘Despite this, we know that large sums of this income are still being written off.
‘Recovering costs can be challenging, and efforts to do so must not compromise patient care.’
In its 10-point funding and efficiency plan revealed in 2019, NHS England listed number nine as ‘Collect income the NHS is owed’.
It said: ‘In respect of cost recovery from non-UK residents, the National Audit Office says that “the best available estimates suggest that the NHS is recovering significantly less than it could”.’
An NHS Improvement spokesperson said: ‘The NHS recovered an additional £20m last year from overseas patients compared to two years ago, and continues to provide expert support to trusts to ensure as much money as possible is recovered so it can be reinvested into frontline care for patients.’
The HSJ analysis showed Barts Health Trust, which runs health services in East London, was owed the most (£10.2million) but only managed to recoup only £1.1m.
And Barking, Havering and Redbridge University Hospitals Trust wrote off the most debt, wiping £4.7million from its records. It received just £600,000 of £2.3m owed.
Nine of the top 10 hospitals which racked up the most debt were all in London, all with more than £2.4million.
Sandwell and West Birmingham Hospitals Trust was the only one outside the capital to make it into the top 10, sitting ninth with a debt of £2.5m for the year.
Emergency medical treatment is free for everyone but government policy dictates patients from outside the EEA should be charged upfront before planned treatment.
This, however, relies on doctors enforcing the rule and refusing to treat before being paid.
Around 500 doctors at the BMA conference in the summer, however, voted ‘overwhelmingly’ to scrap this rule and said it was racist.
‘We are doctors not border guards,’ said Dr Omar Risk in a debate at the conference. ‘Charging migrants for accessing NHS services is a fundamentally racist endeavour – we are complicit in the oppressive regime.’
MailOnline has contacted Barts Health Trust for a comment.
‘Health tourism’: What are the rules?
What is ‘health tourism’?
This is when patients who are not entitled to free NHS care are treated without paying their bills. It covers short-term migrants, holidaymakers and foreigners who deliberately target the NHS. The exact cost is put between £200million and £2billion a year.
What are the rules?
Only patients who are ‘ordinarily resident’ in the UK are entitled to free care, which usually means being here for at least six months. This excludes care in A&E units and GP surgeries which are free for everyone. In all other situations, staff are legally obliged to check eligibility. Anyone who isn’t eligible for free care should be invoiced.
What about EU citizens?
Staff should record details and the Government will then invoice their member state. But the UK is notoriously inefficient at billing or collecting the cash. Other EU member states are better at charging the UK.
Who enforces these rules?
Hospitals are meant to employ officers to collect bills. But not all do and others have only one or two staff to check thousands of patients.
What if patients don’t pay?
If the treatment is urgent, patients will be treated and billed afterwards. If it is less serious patients may be refused care until they cover the costs. The situation varies between hospitals and some patients will be treated regardless. Many hospitals employ costly debt-collecting agencies to chase patients after they have been discharged.
What is the BMA doing?
It has voted to abandon the policy of charging overseas patients for free treatment. The union will now lobby for a change in the law. If this does not happen, doctors may decide to ignore the rules anyway.
Source: Read Full Article