Births cost non-residents millions

New mums ineligible for free care have repaid $3.3m but some committing fraud by using others’ identities

Pregnant women considered “non-residents” have paid more than $3.3 million for births at New Zealand hospitals in the past five years. And in Auckland, where new mums have paid back at least $1.7m, there have been cases of fraud by non-resident women trying to get free care.

The figures were released to the Herald under the Official Information Act as Canada grappled with a “birth tourism” problem.

Here, Auckland’s three district health boards — Auckland, Waitemata and Counties Manukau — were the only DHBs of 20 surveyed that confirmed cases of non-residents using another person’s identity to get a free birth or access free care elsewhere in the DHB.

In total there were 4682 births to non-resident women across the country between 2013 and 2018. But some were eligible for free health care because they qualified or their partner did.

At least $649,184 is currently outstanding from the births and the DHB with the highest number of births was Counties Manukau with 730.

Counties Manukau DHB said it could not break down invoices solely for deliveries but the total amount invoiced for maternity services provided to nonresidents during the past five years was $3.1m.

The most expensive birth was $56,533 at Bay of Plenty District Health Board and the least expensive was $1401 at Waikato DHB. In the Bay of Plenty case the mother had so far paid back $49,053 and payments were still being received.

Some births cost more than others because of complications involving extra clinicians such as theatre staff or the need for a baby to have neonatal care after delivery. The highest amount paid back to any one DHB by 254 patients was $948,869 at Waitemata DHB, where $209,763 was still owing.

Women were allowed to pay off their deliveries in instalments and DHBs said they did not take legal action if women failed to pay. Instead, they sold the debt to debt collectors who kept up to 25 per cent of the amount recovered.

DHBs never turned away an expectant mum at the point of labour.

“We have a duty to treat and provide care — and then to determine/confirm eligibility,” said the then Counties Manukau DHB acting chief executive, Gloria Johnson.

At Waikato District Health Board 73 non-resident births cost the DHB $582,496 with more than $216,000 outstanding. The most expensive birth there, $25,654, had not been paid and was handed to a debt collection agency.

Capital and Coast DHB in Wellington had collected $365,275 for 92 non-resident births and there was $145,252 still to be paid.

Canterbury DHB registered 2484 non-resident births in the timeframe but only 89 were not eligible and so far 47 had paid back $220,294, with $17,938 outstanding.

DHBs said there was no issue of “birth tourism” here, where mothers give birth to claim citizenship for their child, a rising phenomenon in other countries.

That’s because you are born a citizen only if at least one parent is already a citizen or permanent resident. Kiwis born here before 2006 automatically became citizens.

No fraud hot lines have been set up to catch non-resident health care cheats though a Ministry of Health “integrity line” allows anonymous tips

relating to health care fraud to be reported.

People eligible for free public health care include citizens, permanent residents, Australian citizens and work visa holders who have been here two years, young people in the care of an eligible person, interim visa holders, NZ Aid Programme and Commonwealth scholarship students, foreign language teaching assistants and refugees.