With health tourists costing taxpayers £1.8bn-a-year the time has come for them to cough up, says former GP Dr Robert Lefever
As a country we damage the service given to our own people — who are entitled to it — when we give it away to someone else
HEALTH tourists will be forced to pay upfront for non-urgent treatment from April, under new Department of Health rules.
Those unable to pay will be refused care in a bid to reduce the estimated near £2billion a year the NHS spends on foreign patients.
It will mean hospitals must check each patient is eligible for free care, for example by asking to see a passport and a utility bill.
Health secretary Jeremy Hunt said: “We have no problem with overseas visitors using our NHS aslong as they make a fair contribution, as the British taxpayer does.”
Below, a GP-turned-counsellor who worked in the NHS for 16 years, tells how the new system may work.
THE NHS is not a world health service.
The world doesn’t pay for it. We do.
Any service, investigation, operation, treatment or drug given to one patient cannot be given to another.
The resource has been spent.
When I fly to America, I take valid health insurance with me so that, if I’m taken ill during my visit, my treatment will be paid for.
It surely cannot be too much to ask that tourists coming to the UK do the same.
My solution to the problem of health tourism would be to insist all entrants to the UK present valid health insurance certificates along with their passports and boarding passes.
Airlines should be made financially responsible for confirming the validity of the certificates.
That would keep NHS staff out of the firing line.
But I doubt that this will happen at the moment.
Instead, the Government has come up with its own plan to help plug the enormous health tourism bill to the NHS: Charge overseas patients who are not eligible for free care, before they receive treatment — and if they can’t pay, turn them away.
NHS staff will find that difficult.
But the current system, by which patients are billed after their treatment, doesn’t work.
Patients may not have the money to pay for their spiralling costs and bills go unpaid.
It is perfectly possible for administrative staff to check a person’s paperwork when they arrive at hospital, to determine whether or not that person is eligible for free care.
I don’t believe this would require any extra staff members.
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But even if hospitals had to employ a few extra “revenue managers”, to walk around with chip-and-pin devices and take payments, the costs of these staff members would be unlikely to top the £500million a year Jeremy Hunt says the NHS will recover by implementing the new plan.
If the idea of handing over your debit card from your hospital bed sounds crass, it may be possible for patients to sign a form to agree to longer-term payment plans.
That will depend on the individual hospital trust.
However, administrative staff can’t decide what is urgent and what is not.
That is up to a doctor — and in the NHS they don’t like dealing with issues around money.
They like to believe — ignoring the taxpayer — that the service they give is free.
And that money should not change hands except in the private sector.
And not even there if healthcare is believed to be a birthright, rather than a commodity.
“Making profits from the sick” is an utterly hated principle.
But this is the bullet that has to be bitten.
We damage the service given to our own people — who are entitled to it — when we give it away to someone else.
Or let other people steal it from us.
Funding the NHS becomes a bottomless pit unless we keep control of it.
The rules are already clear.
UK citizens and, currently, EU nationals are entitled to receive NHS care. Other foreigners are not.
No one is suggesting that someone in a life-threatening situation should be turned away or forced to sign a cheque before getting emergency treatment.
Doctors in NHS like to believe the service they give is free
Dr Robert Lefever on the NHS
They will be cared for then billed afterwards, as they are now.
The grey area is with non-emergencies.
Currently, overseas patients turn up at A&E even if they are wanting routine operations like a hip replacement or cataract operation.
If they are treated then handed a bill, there’s no guarantee the hospital trust will get that money back.
At the moment, it’s up to the centralised NHS to chase those bills, but each hospital needs to take responsibility for their own payments system.
If it comes out of your time and your doctors’ expertise, you need to do your utmost to get the money for it.
Every case will have to be judged individually by the doctor. And, yes, doctors will complain about having to make such decisions — but they will simply have to do it.
You can’t carry on moaning about an underfunded NHS if you’re not prepared to do your bit by trying to help claw back millions of pounds for it.
Let’s be clear, the patient will STILL have to pay for their care.
The only decision for the doctor to make is whether they pay before or after that care.
There are no official figures for deliberate health tourism but it is thought to cost between £100million and £300million per year.
NHS treatment given to unentitled foreigners who happen to fall ill while they are here is estimated at £1.8billion.
That’s a vast shortfall.
It would pay for the salaries of a huge number of nurses — or whatever else we believe the money should go to.
But most importantly, that money will be ploughed back into our NHS.