Hospitals write off £112m in foreign patient bills

London hospitals person written disconnected much than £112m successful unpaid attraction bills from overseas patients betwixt 2018 and 2023, according to figures obtained by the BBC.

Under existent NHS regulations, infirmary trusts successful England indispensable complaint patients who are not "ordinarily resident" successful the UK for non-urgent treatment.

Critics reason that the existent strategy for recouping these costs is unfair and ineffective.

The Department of Health and Social Care (DHSC) said it expected each NHS trusts to retrieve immoderate charges not paid successful beforehand wherever possible.

The BBC contacted each 32 of London's acute infirmary trusts astir their overseas diligent billing.

The responding NHS trusts invoiced a full of £223m for specified treatments implicit the five-year period, but £112m was subsequently written disconnected arsenic atrocious debt.

Though exigency and GP services stay escaped for everyone, trusts are required to measure for different types of non-urgent attraction for patients who bash not ordinarily reside successful the UK and complaint astatine 150% of modular NHS rates.

This premium is meant to screen the administrative load of identifying patients and pursuing payment.

While aimed astatine tackling "health tourism", the charging strategy has exemptions for susceptible groups including asylum seekers and trafficking victims.

But hospitals often conflict to retrieve costs, peculiarly erstwhile patients instrumentality overseas.

Trusts equilibrium their ineligible work to retrieve costs and the realities of treating patients successful need, galore of whom person constricted means oregon look different barriers to payment.

Barts Health, serving a ample colonisation successful eastbound London, wrote disconnected £35m successful unpaid bills implicit the 5 years - the highest among each responding London trusts.

A spokesperson said: "Where appropriate, we marque each effort to retrieve outgo from patients who are liable for the outgo of their treatment.

"However, galore patients whitethorn person constricted funds disposable and immoderate volition not beryllium nonmigratory successful the UK, which means recovering outgo tin beryllium difficult."

King's College Hospital abandoned £17m, portion 10 different trusts each wrote disconnected much than £1m successful unrecovered fees.

A spokesperson for King's College Hospital said: "We instrumentality earnestly our ineligible work to place patients presenting astatine our hospitals who are not eligible for escaped NHS treatment."

The spokesperson added that the spot works "to guarantee we embed fairness and proportionality principles into our income betterment processes".

Lewisham and Greenwich Trust, which wrote disconnected £11m, said it would "never deter anyone from seeking treatment, particularly arsenic galore of these patients are utilizing our maternity services".

A spokesperson emphasised that they "work closely" with diligent groups and partners connected charging arrangements, "always ensuring we enactment successful an empathetic, compassionate and supportive mode towards each patients".

The British Medical Association (BMA) has been consistently captious of the charging policy, arguing that it deters susceptible groups from accessing indispensable healthcare portion diverting NHS unit clip distant from diligent care.

Patients similar Beni, who asked the BBC to alteration his name, accidental it tin beryllium devastating.

A disabled antheral applying for UK residency, Beni was pursued for £495 aft attending 2 infirmary appointments for a prosthetic limb fitting by a London infirmary trust.

"It was a horrible acquisition oregon antagonistic acquisition due to the fact that the infirmary was precise rude with maine and much assertive with maine adjacent though I'm disabled and I needed immoderate help," helium told the BBC.

"I felt similar I'm a antagonistic idiosyncratic here, due to the fact that I cannot bash anything. Cannot work, I cannot bash nothing.

"They charged maine £495 conscionable for checking, and it was precise costly for maine due to the fact that astatine that clip I couldn't enactment and I didn't person immoderate income.

"So, I tried to wage it monthly for a agelong clip until I tin decorativeness it."

The BMA besides maintains that doctors should not person a relation successful assessing patients' eligibility for escaped NHS care.

Dr Omar Forge Risk, a campaigner against NHS charging for overseas patients, said the charging strategy was harmful to nationalist health.

"The world is that if [patients] were paying backmost immoderate more, it would propulsion them into destitution," helium said.

"Ultimately, if you're charging patients and pushing them much into sick wellness and into destitution, the costs from immoderate position volition beryllium greater successful the agelong run."

The BBC spoke to respective doctors who recounted their experiences with the charging system, though they did not privation to beryllium identified.

An exigency medicine practitioner who antecedently worked successful London said they had "multiple patients" who came to this state successful renal failure, from a assortment of antithetic countries, due to the fact that they could not get attraction oregon it was excessively costly to get dialysis successful their ain country.

A cardinal London oncologist argued that "health tourism is simply a monolithic problem, it's a immense problem".

"Everyone knows the NHS is escaped astatine the constituent of attraction and astir doctors volition accidental it's not their work to constabulary the system," they said.

"It's hard erstwhile a diligent is hopeless for care. Policing needs to hap astatine an earlier stage."

Government modelling published successful 2023 by the past wellness caput Jeremy Hunt estimated that much accordant charging of overseas patients could output an other £500m per twelvemonth for the NHS.

However, the existent grade of unpaid bills remains unclear, arsenic the £223m invoiced lone represents patients identified arsenic chargeable, portion galore others whitethorn person attraction without ever being billed.

The existent authorities has defended the charging strategy and said "tens of millions of pounds" were recovered each year.

A DHSC spokesperson added: "Overseas visitors - and those who are not lawfully settled present – should lend towards their attraction successful designation of the further outgo to the NHS.

"We are committed to getting maximum worth for taxpayers' money."