According to an investigation conducted by Pulse, hospitals are owed as much as £40m in outstanding fees for treating foreign nationals.

The results will most likely fuel the debate over health tourism again and expose incidents in which GPs were under pressure to register foreign nationals who are not eligible to receive secondary care. In instances where individuals are not entitled to NHS care, their insurer or their country of origin will be approached for payment.

Pulse approached acute trusts across the UK under the Freedom of Information Act to obtain information on outstanding payments owed for the treatment of foreign nationals who were not eligible to free NHS care.

They received a response from a total of 35 acute trusts that were able to provide figures. The average unpaid debt for the provision of care to foreign nationals amounted to £230,000, extrapolated across all 168 trusts in England, the total figure owed to the NHS by foreign nationals would be £40m.

The largest outstanding debt was at St George’s Healthcare Trust. Their total outstanding from a total of £3.55m invoices to foreign nationals for health treatments from April 2009 was £2m. Barnet and Chase Farm came second with having written invoices worth £934,000 of which £488,000 were still outstanding.

The two most inefficient trusts in recuperating outstanding monies was the Royal Wolverhampton, with only 24% collected from the £419,000 the trust was owed and Newcastle-upon-Tyne which managed to collect just 36%.

Some hospitals admitted that they wrote off fees, with Northampton General stating that they wrote off £140,000 regardless of having only been reimbursed with £87,300 to date. Other hospitals included St George’s, which wrote off over £95,000, whilst University Hospitals Coventry and Warwick and the Royal Wolverhampton wrote off £79,000 and £41,000.

According to a St George’s spokesperson:

“A high percentage of our patients require life-saving trauma, neuroscience, cardiovascular or pediatric care. We’re working hard to improve the way we record overseas patients and the debt recovery rate.”

The deputy chair of the BMA’s GP committee, Dr Richard Vautrey, declared:

“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.”

The editor of Pulse, Richard Hoey, concluded:

“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.”

Written By Petra Rattue