Not Saussure

October 1, 2006

Health Tourism?

Filed under: Medicine, Politics, UK — notsaussure @ 10:50 pm

The Telegraph reports:

More than a third of the money spent by the NHS on treating “health tourists” last year has not been repaid.

Tens of millions of pounds are outstanding because patients from outside the European Union, who are ineligible for free treatment, have not settled bills. The problem persists, despite an attempt to crack down on it by the Department of Health in 2004 […]

The figures, obtained by Andrew Lansley, the shadow health secretary, under the Freedom of Information Act, provide the first official, country-wide picture of the cost of health tourism

The article concludes

The NHS is obliged to treat any patient who requires urgent medical care. Patients from outside the EU should have to prove that they can pay for medical treatment in advance. [I think that’s a paraphrase of Mr Lansley’s view rather a statement of current practice, but it’s not clear]

“If the NHS is providing care to people who are not entitled, it should ensure that they pay up front,” said Mr Lansley. “I see no reason why the NHS should behave less commercially than a private hospital would do, where they would expect to be given payment or an insurer’s guarantee.”

A Department of Health spokesman said that the unpaid money had not been written off. “It can take some time to receive the money from the patient’s home country, so processes could still be ongoing,” he said.

I’m a bit unsure about this story for a couple of reasons. First, the term ‘health tourist’ suggests someone who comes here in order deliberately to obtain free medical treatment to which they’re not entitled. And second, if someone needs urgent treatment and doesn’t, for whatever reason, have the ability to pay, should the hospital turn them away?

Back in the early 1990s, I did a lot of business with the former Soviet Union. Once, my chum Sasha came over with his interpreter, Lena, who was about three months pregnant at the time, though she hadn’t told anyone. She suddenly started bleeding and, of course, we whisked her off to the nearest hospital. They gave her a scan; fortunately, it was nothing to worry about, but it was obviously very worrying for her at the time, and well done the NHS.

Then — don’t know about now — you couldn’t buy medical travel insurance in Russia; or, if you could, Sasha hadn’t been able to find any. This I know because he’d previously asked me to try to arrange some him and Lena here, when it had become clear they’d be making a lot of trips over, but I couldn’t find anyone who’d sell a policy to someone coming here from abroad.

Anyway, despite a very concerned Sasha producing his wallet and offering to have money wired over from St Petersburg if necessary, the hospital told him and Helen not to worry, since we apparently have a reciprocal medical agreement with Russia and the NHS would bill the Russian health system.

This had me and Sasha rather amused — the idea of the Russians, at the time, actually paying hard currency over to UCH for Lena’s scan seemed a bit fanciful — and I rather imagine that the debt ended up being written off. Or, more likely, set against the notional cost of emergency treatment to any Brits who needed treatment in Russia.

But, whatever happened, I don’t think it would be fair to describe Lena as a ‘health tourist’ — she certainly hadn’t planned it — and what on earth would Mr Lansley have had the hospital do if neither Sasha nor I had been in a position to pay, especially if — God forbid — it had turned out to be more serious than it was? Let her lose the child? I’m not sure I’d want to be treated in a hospital that turned someone away in those circumstances — this is Britain, damn it, not the USA.

Strikes me that this the sort of thing that makes a good headline but needs rather more careful thinking through if the Tories are to lose the image of ‘the nasty party’.

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