Post by Focus on Jun 30, 2013 17:40:35 GMT
Foreign health tourists have left the NHS with a £24 million unpaid bill in just one year, an investigation has found.
The sum owed by overseas patients taking advantage of Britain’s free hospital care has doubled in 12 months, according to new data obtained under the Freedom of Information Act (FoI).
Last night, following our investigation, officials told reporters that Health Secretary Jeremy Hunt would within days be announcing major plans to crack down on the ‘hit and runners’.
Promise: Health Secretary Jeremy Hunt has said that the Government will crack down on 'hit and runners' following the Mail on Sunday's investigation
Mr Hunt said: ‘I’m clear we must all work together to protect the NHS from costly abuse. We want a system that is fair for the British taxpayer by ensuring that foreign nationals pay for their NHS treatment.’
These inquiries have established that:
Fear of being labelled racist means NHS staff are reluctant to confront health tourists, according to a whistleblower.
For every £100 the NHS spent on caring for health tourists last year, only £23 has been paid back.
One individual cost the NHS £217,000 – but not a penny has been repaid.
Six hospital trusts in London are owed more than £1 million and another 23 across England are owed at least £100,000.
These unpaid bills are ‘just the tip of the iceberg’ because the checking system is so flawed that most health tourism goes undetected, says a leading surgeon.
The surgeon offered to carry out a review of health tourism – but mandarins turned him down.
Anyone in Britain can currently register with a GP for free and obtain an NHS number.
People who have lived in the UK for less than a year should pay for non-emergency hospital treatment – but many don’t because staff assume the NHS number means they are eligible for free care.
Expensive : The sum owed by overseas patients taking advantage of Britain's free hospital care has doubled in 12 months, according to new data obtained under the Freedom of Information Act (FoI)
Figures obtained from 120 hospital trusts on how much they had spent caring for overseas visitors identified as being chargeable.
The other 40 said they did not collect the information, or failed to respond to our FoI request.
The source also asked for figures on how much each trust was still owed by these patients. Data was requested for the last two financial years, 2011/12 and 2012/13.
The amount these 120 hospital trusts billed such patients grew from £24.7 million to £30.9 million over that period – a 25 per cent increase.
But the total unpaid bill – likely to be written off – more than doubled from £9.9 million to £23.8 million.
The new figure is equivalent to £1 for every UK income tax payer per year. The figure includes 20 trusts which gave cumulative debts across both years.
Health tourist : Bimbo Ayelabola, who came to Britain 'on a family visit' from Nigeria when pregnant and gave birth to quintuplets costing the NHS £200,000
The famous five : Bimbo Ayelabola's picture of her quintuplets
London hospital trusts have the biggest unpaid bills: all six with £1 million or more outstanding are found inside the M25.
Barts and The London NHS Trust, which runs six hospitals, topped the 2012/13 list. Its unpaid bill exceeded £3.5 million. This includes some debt carried over from the previous year.
The others are: Kings College Hospital NHS Foundation Trust (owed £2.1 million), Guy’s & St Thomas’ NHS Foundation Trust (£1.6 million), Imperial College Healthcare NHS Trust (£1.3 million), Epsom & St Helier University Hospitals NHS Trust (£1.25 million), and North West London Hospitals NHS Trust (£1.2 million).
Yet the problem is not confined to the capital. Hospital trusts in Buckinghamshire, Nottingham, Leicester, Teesside, Cambridge, Essex, Gloucestershire, Kent, Norfolk, Surrey and Sussex all have unpaid health tourism debts greater than £100,000.
Professor J Meirion Thomas, a leading NHS cancer surgeon who has campaigned to get the issue taken more seriously, said: ‘These startling new figures show the problem of health tourism is escalating and that Ministers have failed to grasp the nettle.’
He added: ‘While £24 million is a lot of money, I believe it is only the tip of the iceberg. The true cost runs into billions of pounds every year.’
The £24 million figure only related to those who had admitted to being chargeable patients, or had been found out, he explained.
‘The majority of health tourism is unrecorded because it’s so easy to get an NHS number and claim you have the right to hospital treatment, and because the systems for checking ineligibility are so poor.’
He continued: ‘Most hospital trusts employ people to check if patients are entitled to free care, but they are under-resourced.
In addition, NHS culture is to treat and not ask if a patient is eligible for free care.
'Last week the British Medical Association reiterated its position that doctors should not act as the UK Border Agency.
Costly : St Barts Hospital in London had the highest unpaid bill
‘This culture might seem laudable – but it is costing the taxpayer dear.
‘But it is not just a money issue – in some places it is having an impact on capacity.
These are not trivial matters: we are talking about timely access to cancer treatments or renal dialysis, and whether or not there is room on the labour ward.’
Prof Thomas offered to carry out a ‘quantitative review’ of health tourism to estimate its total cost to the NHS, but was rejected by a senior Department of Health official.
Mr Hunt has now just commissioned such a review, but Prof Thomas was not asked to contribute.
Dr Una Duffy, a Luton GP, explained what doctors had to deal with. She said: ‘Sometimes we get relatives of UK residents come over from India, Muslimstan, Bangladesh or countries in Africa.
They arrive needing a long list of medication, or blood tests or hospital treatment.
‘They argue they qualify for [free] “immediate and necessary treatment” as they haven’t got their medication, and urgently need it.’
She added: ‘I had a young couple from south-east Asia who came here for IVF treatment, because they could not get it in their home country.’
She said GPs were told by NHS England that they should register patients, which often gave them free access to hospital treatment.
Mr Hunt will tell MPs that migrants will have to pay to see a GP, while they will also be given distinct NHS numbers to make sure they are charged for non-emergency treatment.
He will also announce plans to give British ex-pats free NHS care for life if they have paid National Insurance for 10 years or more.
A three-month consultation on his ideas will begin later this week. But doctors’ groups, which believe health tourism is only a small problem, said they would fight the idea of charging foreigners to see GPs.
Dr Clare Gerada, chair of the Royal College of GPs, said: ‘Where there’s obvious abuse we do need to address it, but we should not over-egg this.
'Even if health tourism cost £200 million a year, that was only equivalent to ‘a few hours of funding for the NHS’, she said.
She continued: ‘Charging at the GP’s front door is another folly which is just unworkable. We will only push people to A&E if we do.’
She said the NHS had existed for 65 years ‘for better or worse, as a universal healthcare system that does not charge’.
Checking if those who ‘looked foreign’ were entitled to free GP appointments would be ‘very divisive’, she argued.
Dr Richard Vautrey, deputy chairman of the BMA’s general practice committee, said: ‘When you put it in the context of the billions spent on healthcare, it’s a tiny amount.’
He thought the current health tourism situation was acceptable, although he did say GPs wanted ‘greater clarity regarding eligibility’.
He also believes the bureaucracy of implementing Mr Hunt’s plans could cost more than the money saved.
'Women lie to get on a flight and have babies here': People don't report it for fear of being branded racist, says whistleblower
I am an NHS overseas visitor manager and my job is to make sure everybody who is treated at our hospital is entitled to free health care.
I think me and my team do a good job of cracking down on health tourism – but we haven’t had much support from senior management.
The feeling I get is that people are too nervous to challenge things. Management has a very strong belief we could be seen as racist if we refuse treatment.
We get letters from patients’ solicitors, which usually go down the Human Rights Act route, and people panic.
We have to deal with very complex legal issues, which can be hard when you don’t have management’s support. We really feel out on a limb.
But we treat everybody exactly the same, whether they are black, white or Asian, or if their name is Smith or Mohammed.
One of the big groups we tackle is actually British expats who come back just to get treatment.
They present with their old NHS number – which is usually a sign someone is eligible for free care – and use their old UK address. That makes them very difficult to detect.
Another group is people from outside the EU, issued with four- to six-month visit visas, who come to the UK purely to access free NHS hospital care.
They come with very complex pre-existing conditions that can be very
expensive to treat.
But they go to a GP, get registered and are automatically given a permanent NHS number.
In the last year we have identified nearly 200 chargeable patients. Four out of five had NHS numbers.
Dilemma : The whistleblower says that hospital management worry that they will be seen as racist if they turn away health tourists
We invoiced them just under £200,000. We’ve only got £60,000 back and we don’t expect to recover much more. Most patients have paid nothing.
The biggest offenders – in order – are from Nigeria, Poland, British expats, Portugal, Bangladesh, and Muslimstan.
The departments most affected are maternity, ophthalmology, radiology, oncology, gynaecology and cardiology.
Some women come here specifically to give birth. They lie to get on the flight, saying they are less than seven months pregnant when they are not.
When they land they say they are eight months, so no airline will take them back.
Sometimes flying this late triggers early labour, so they go straight to hospital.
We’ve had more than one case like that this year. Except for the care they receive in A&E, this is chargeable.
In all, this might cost £20,000 – but we know we won’t get a penny back. The money just gets written off.
Four trusts around here don’t have overseas visitor managers, even though I reckon health tourism is a bigger problem for them.
The thing is, if you don’t identify the overseas patients who are getting treated for free, then it doesn’t look like you have a big problem with writing money off.
Also, hospitals get paid to treat people, wherever they are from. It’s the local health authorities – now clinical commissioning groups – who pay.
Word has got out in migrant communities around here that questions will be asked at this hospital trust. But there’s a ‘balloon effect’ – health tourists just go and try elsewhere.
We are well aware that we’ll never catch everybody. We’d need ten times the staff to do that, and besides, there are people who know exactly what to do and what to say.
I don’t blame people coming here from poorer countries for treatment and we have to deal with some very harrowing cases. At the end of the day these are people’s mothers, fathers, sisters and brothers.
For the price of a flight you can put your sick relative on a plane and get them treated. Maybe I’d do the same.
You can’t blame people for taking advantage of what’s on offer. You blame the people who don’t put the systems in place to stop it in the first place.
In black and white ... immigrants are sucking Britain's NHS dry and the government are s..t scared of doing anything about it, and why?, because they don't want to be called 'wwayycist' - fcking lily livered cowards!! - Fx
