Henry Smith MP earlier today introduced a Bill to parliament entitled NHS Audit Requirements (Foreign National) Bill.

Commenting on the measure, Henry said:

“The 2011 figures showed that whilst the under the European Health Insurance Card Scheme alone, the UK paid out £1.7 billion for the treatment of British nationals abroad, we only claimed back £125 million from qualifying countries.   

“Freedom of Information Act requests have shown that most NHS trusts at best only cursorily audit the treatment of foreign nationals not entitled to automatic free healthcare and GP practices don’t record this information at all, despite in many other countries access to primary care having a nominal charge for all patients, including British visitors. This is the case in countries like France and Germany where an entry fee for primary care is required or in Spain where proof of insurance is needed.

“The purpose of the Bill isn’t to deny healthcare to foreign nationals, but to ensure that reciprocal arrangements we have with European Economic Area nations, and other countries, are properly used so the British health budget is not unfairly burdened. 

“Many hospitals do not even ask whether patients are foreign nationals, with one poll of NHS managers showing that a third of them did not routinely ask patients about their eligibility for free care.

“The issue of fairness is key. Fairness to the taxpayers that fund the system and fairness to those that use it.  

“Emergency medical treatment should of course always be provided to those who require it at the point of need without exception. Beyond that, entitlement to free healthcare is considerably more generous to visitors and short-term residents than is reciprocated for UK citizens abroad and our system is the most liberal, and lax, than anywhere else in the world.

“GPs may choose to register any person as an NHS patient and indeed are actively encouraged to register all those who approach them, even where an individual has no right to free NHS care. Thus many foreign nationals receive free primary care, including free prescriptions, and once registered with a GP have essentially unlimited access via referral throughout the NHS without charge. 

“Hospitals have a duty to enforce the regulations and screen all patients for eligibility, applying charges where appropriate, but most do not, struggle to do so, or do not bother at all.”

In March 2012, I sent Freedom of Information Act requests to 445 Health organisations comprising of Primary Care Trusts, Foundation Trusts, Acute Trusts and so on, enquiring as to whether they screen foreign patients for auditing purposes. Only 105 Trusts were able to respond with data at all. Information, therefore, was only supplied by less than a quarter of NHS organisations, and what data that did exist was patchy. 

Henry continued:

“In Crawley, UK Border Agency officials see on average 150 cases a year at Gatwick Airport of heavily pregnant passengers arriving with visitor visas and East Surrey Hospital had to write-off debts of £425,000 for the treatment of foreign nationals who avoided payment.  

“Even when overseas patients try to pay often they are unable because the cost of their care is not recorded. A US citizen who asked for a receipt after receiving medical care in order to claim it back on their health insurance was told that an invoice was unavailable.

“My proposed Bill would: 

·         Qualify residency criteria for free NHS care;

·         Extend current charging principles to primary care;

·         Create more effective and efficient processes to screen for eligibility; and

·         Establish more robust methods of securing recovery of treatment costs including options for requiring health insurance.

“These measures would save the NHS hundreds of millions of pounds each year.”