Feature Briefing

Passport to healthcare: NHS charges become the new normal for overseas patients

BMJ 2016; 355 doi: https://doi.org/10.1136/bmj.i6379 (Published 28 November 2016) Cite this as: BMJ 2016;355:i6379
  1. Anne Gulland, freelance journalist, London, UK
  1. agulland{at}bmj.com

Anne Gulland looks at government plans to improve identification of ineligible patients

Chris Wormald, permanent secretary at the Department of Health, told the public accounts committee earlier this week that the government is considering asking all patients to prove they are entitled to NHS care by showing a passport or some other form of identification.

How much money does the NHS spend on overseas patients?

According to a government commissioned report in 2013 the NHS spends around £2bn (€2.4bn; $2.5bn) a year treating overseas visitors.1 Broken down, these figures show that £1.75bn goes on patients from outside the European Economic Area (EEA); £261m is spent on patients from the EEA, £94m on expats, and £330m on irregular migrants. And despite the headlines about health tourism—that is, people coming to the UK deliberately to get free healthcare—the NHS spends just £60m-£80m on this.

Could all this money be recouped by the NHS?

No. Under current rules the NHS can potentially charge for acute and emergency care after admission to hospital, most elective hospital treatments, maternity care, and outpatient appointments. But emergency department care, primary care, treatment for infectious diseases such as tuberculosis or HIV that could pose a threat to the wider public, and some mental health services are all free to overseas patients.

However, it is difficult to know how much the NHS should be trying to claw back. A National Audit Office (NAO) report published in October warned, “Data are incomplete and unreliable, but the …

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