Births cost non-res­i­dents mil­lions

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

The New Zealand Herald - - News - Natalie Akoorie

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.

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