NHS boards owed £3.2m from foreign patients

Holyrood report finds NHS missing out on vital funds

Scottish health boards are owed more than £3.2 million by patients from outwith the European Economic Area who have not paid for treatment over the last five years, a Holyrood committee has found.

Health boards could also recoup more than £700,000 a year if they participated in a scheme to report usage of the NHS by holders of the European Health Insurance Card (EHIC), according to a report.

The Scottish Parliament’s health and sport committee has raised concerns that NHS boards are missing out on “vital sums of money” because they cannot identify those entitled to NHS care.

Only those people who are not “ordinarily resident” in the UK are charged for using NHS services, however it is currently not necessary for a GP to establish a person’s country of origin before treating them.

The committee is calling on the Scottish Government to establish a standardised approach to identifying those not eligible for free NHS treatment, warning that boards are potentially losing out on “significant revenue”.

Committee convener Lewis Macdonald said: “The committee support the principle that anybody in Scotland can access GP services or A&E departments free of charge.

“However, we are concerned that NHS boards are missing out on vital sums of money to which they are due by not being able to identify those entitled to NHS care.”

The report identified a varied and inconsistent approach from NHS boards in Scotland, with some not reclaiming costs from those not entitled to free care.

The Scottish Parliament Information Centre has calculated that individuals who are not from the European Economic Area (EEA) owe more than £3.2 million for treatment which has not been paid for over the past five years.

Evidence gathered by the committee also showed that not all health boards are participating in the EHIC Incentive Scheme, whereby NHS boards can claim back 25% of EHIC card holders’ treatment costs.

NHS figures provided in December 2018 showed that £5 million worth of treatment, relating to 4,841 individuals, had been reported to the Department for Work and Pensions by participating boards since the scheme was set up in 2014, which resulted in £1.25 million being reimbursed to those boards.

The committee estimated that if all boards participated in the scheme the average amount coming back to them could be £710,000 a year.

Mr Macdonald said: “We believe the Scottish Government should begin a review of the situation immediately and have asked them to adopt a clearer and more unified approach to ensure access to NHS treatment is applied fairly.”

A Scottish Government spokeswoman said: “We will study the committee’s report and respond once we have clarity around new arrangements.”