Health tourists have cost the NHS £252million in three years after failing to pay for their care

Health tourists have cost the NHS a quarter of a billion pounds in just three years after failing to pay for their care, a report reveals.

The £252million would be enough to pay the salaries of 3,200 more GPs or build 68 new GP surgeries, the Policy Exchange think tank says.

It found some trusts are recovering just £40 of every £1,000 they are owed by overseas patients despite Government pledges to crackdown on freeloaders.

And some doctors even admit to flouting NHS rules on checking people’s eligibility for free care because they say it creates a ‘hostile environment’ on the wards.

Writing the foreword for the report, Sir Sajid Javid, a former Conservative health secretary and chancellor, said the NHS is ‘not a charity or an international aid organisation’ and warns failing to recover these fees while British residents face long waits is ‘corroding confidence’ in the system.

Migration campaigners say the NHS has long been open to abuse and is now regarded as the ‘International Health Service’.

Overseas visitors can access some NHS services for free – including seeing a GP or A&E care – but people who are not ‘ordinary residents’ in the UK can be asked to pay for other services.

Guidance suggests that treatment must be paid for upfront unless doing so would delay urgent or immediately necessary care.

Policy Exchange sent Freedom of Information requests to 202 NHS trusts in England including hospitals, mental health trusts and community health services to ask about the amount of money collected by the trust 'for the provision of any episode of care for a foreign national (ie. any individual who is not entitled to that care free at the point of use)’.

It also asked about the amount of money written off or the money that remains uncollected by the trust in the last three financial years.

A total of 82 total responses were received along with five partial responses.

The report states that between 2021/22 and 2023/24, NHS trusts invoiced £384,245,201 to overseas patients.

Of that total, £131,843,335 was successfully collected; £167,911,874 remains outstanding and an additional £84,489,992 has been formally written off.

‘This results in a combined total of £252,401,866 in overseas charges that remain unrecovered, of which over £84 million is permanently lost,’ the authors wrote.

The true figure is likely to be significantly higher given the large number of trusts who failed to respond.

The average collection rate was 39 percent nationwide but 19 NHS trusts recovered less than 20 percent of the charges they issued.

The ten worst performing trusts accounted for £143.4 million, over half (56 per cent) of the national total unrecovered.

Sir Sajid, who was health secretary between June 2021 and July 2022, wrote: ‘Asking those who pay for the NHS to shoulder the cost for those who haven’t made the same contribution is fundamentally unfair.

‘When a taxpayer in Manchester or Birmingham is denied timely treatment, yet sees resources diverted to write off millions in unrecovered costs from overseas patients, confidence in the system is corroded.

'The NHS is not a charity. It is not an international aid organisation.

‘It is a public service – funded out of the hard-earned money of British taxpayers, for the benefit of British taxpayers.’

Alp Mehmet, chairman of the Migration Watch think tank, said: ‘The NHS is now regarded as the International Health Service.

‘It has long been open to abuse, and £250m may be a significant underestimate of the money owed by those not entitled to free treatment.

‘In reality, the NHS makes little effort to recover it. Aneurin Bevan will be turning in his grave.’

Daniel Elkeles, chief executive of NHS Providers, said: ‘This report is unfair.

‘Hospitals do check if patients are eligible for NHS care for planned procedures, and they try to ensure that where appropriate, payment is taken in advance.

‘The NHS uses debt collection agencies to pursue people but when they have left the country it is hard to enforce.’

An NHS spokesperson said: ‘The NHS is committed to delivering the best possible value for taxpayers’ money and, in line with regulations, providers of NHS-funded services must identify chargeable overseas visitors and take all reasonable steps to recover costs.

‘For non-urgent care, payment must be secured in advance; and urgent or immediately necessary treatment will be provided without delay, in line with the NHS’s commitment to patient care.

‘The NHS has recovered more money so far this year compared to previous years but we are determined to go further and are working on a variety of measures to achieve this.’

One of the highest profile cases of a foreign patient being unable to pay for their care was that of a Nigerian woman who was treated as an emergency case at St Mary’s A&E, in London, after her plane stopped at Heathrow.

The woman, only identified at Priscilla, needed care for her unborn quadruplets and by the time she was discharged her bill had reached £330,000.

The Conservative Party’s 2019 election manifesto said: 'We will clamp down on health tourism, ensuring that those from overseas who use NHS services pay their fair share.’

The issue was not mentioned in Labour’s manifesto for the 2024 General Election, although it said it would create an extra 40,000 appointments every week paid for by cracking down on tax avoidance and non-dom loopholes.