Health chiefs must take urgent action to recover more money from NHS patients visiting from overseas.
That’s the view of a Public Accounts Committee report, which calls on the Department of Health to improve systems for cost recovery.
Whether patients are supposed to pay for NHS treatment depends on whether they are resident in the UK and on the type of treatment.
Some treatments, including GP appointments and accident and emergency care, are currently free to all patients; and some patients, such as refugees and those applying for asylum, are exempt from charges.
In other cases, statutory regulations require hospital trusts to make and recover charges in respect of the cost of treating overseas visitors. Most hospital care is chargeable.
The report states: “If the NHS does not recover the cost of treating patients who are not entitled to free care, then there is less money available to treat other people and even more pressure on NHS finances.”
The Committee is not confident the Department is taking effective action to recover more of the costs of treating overseas visitors and concludes progress “is hampered because the NHS is not effectively identifying chargeable patients”.
The extent of unexplained variation between hospital trusts suggests that some have scope to make substantial improvement, says the Committee.
It also concludes other parts of the health system—such as NHS England and clinical commissioning groups—have an important role to play and are not yet doing enough to support cost recovery.
Among its recommendations the Committee urges the Department to publish by June an action plan “setting out specific actions, milestones and performance measures for increasing the amount recovered from overseas visitors.”
Meg Hillier MP, Chair of the 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.”
Since the Department launched its overseas visitor and migrant cost recovery programme in 2014, the amount charged has increased—from £97 million in 2013-14 to £289 million in 2015-16—but most of that progress has resulted from changes in the charging rules, rather than from trusts implementing the existing rules more effectively.
The Department and the NHS are still a long way from meeting the target to recover up to £500 million a year by 2017-18.
Dr Mark Porter, BMA council chair, said: “It is important that those accessing NHS service are eligible to do so and that we recover the costs for treating overseas visitors. The systems to do this need to be practical, economic and efficient and must not jeopardise access to healthcare for those who need it.
“Any charging systems should not prevent sick and vulnerable patients receiving necessary care, otherwise there may be serious consequences for their health and that of the public in general.”