NHS failing to recover unpaid bills from overseas patients due to 'chaotic' system, say MPs

MPs say the NHS is failing to identify patients who should be charged while Government also failing to get money back from European countries with reciprocal agreement

Jane Kirby
Wednesday 01 February 2017 01:53 GMT
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Government widely expected to miss target to recover up to £500 million a year by 2017/18 from all overseas patients
Government widely expected to miss target to recover up to £500 million a year by 2017/18 from all overseas patients (Getty)

The system for recovering cash from overseas patients who use the NHS is "chaotic", MPs have said as they urged the Government to "get a grip" on the issue.

In a damning report, MPs from the Commons Public Accounts Committee (PAC) said they were "not confident" the Department of Health is taking effective action to recover money from people who leave the NHS with unpaid bills after treatment.

It said the NHS was failing to identify patients who should be charged, while the Government was also failing to get money back from European countries where reciprocal agreements are in place.

In 2014/15, the UK recovered only £50 million from these countries but paid out £675 million.

The Government has a target to recover up to £500 million a year by 2017/18 from all overseas patients, though it is widely expected to miss this.

Some £289 million was charged to all overseas patients in 2015/16, though not all this will be recovered. At the moment, trusts collect only around half of the amounts they invoice.

In evidence to PAC, the Department of Health admitted that "very little happened" for more than 30 years after legislation was first introduced to recover money from overseas patients in 1982.

NHS hospitals are now being given "financial incentives" to do more to recover costs.

The new report calls on GPs to do more to help identify those patients who should be charged for NHS care following a referral to hospital.

And it points to a wide variation between NHS trusts in debt collection rates, from 15 per cent to 100 per cent. Just 10 out of 154 hospitals accounted for half of the charges to visitors from outside the European Economic Area (EEA) and Switzerland in 2015/16.

But the report warned that forcing all patients to show their passports or another form of identity, as introduced by some trusts, could penalise some people who do not have the documents but are eligible for free NHS care.

The report says the Department of Health must draw up an action plan by June to set out specific action for recovering more money.

Meg Hillier, Labour and Co-operative MP and chairwoman of PAC, said: "The Government's failure to get a grip on recovering the costs of treating overseas visitors is depriving the NHS of vital funds.

"Our committee has reported extensively on the financial pressures facing the health service and it is simply unacceptable that so much money owed should continue to go uncollected.

"This is a problem for the health service as a whole and work to put it right must be driven by central government.

"We are concerned that financial progress to date does not reflect meaningful progress with implementing the rules and the Department for Health and NHS have much to do if they are to meet their target for cost recovery."

In December, Freedom of Information responses from 104 trusts obtained by the Press Association revealed overseas patients have left the NHS with an unpaid bill of almost £30 million in just one year.

Patients who were not entitled to free treatment on the health service owed £29,530,378 in 2015/16.

Several NHS trusts provided figures for the past four years, showing they are now owed a backlog of millions of pounds.

In London, Barts is owed £10,340,322 from the past four years, while Imperial College Healthcare NHS Trust is owed £5,509,733.

Guy's & St Thomas' NHS Foundation Trust and London North West Healthcare NHS Trust are also owed around £5m each for the past four years.

Press Association

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