SCOURGE COSTS US BILLIONS A YEAR

HeAlTH tourism is the scourge of the NHS. At a time when the service is under severe financial pressures, it not only costs the Government a fortune but also undermines healthcare for British patients who have contributed to the system through their taxes.

The full expensive absurdity of this problem has been highlighted in this week’s brilliant investigative reports. Yesterday the Mail revealed how an undercover reporter living in Hungary easily acquired a european Health Insurance Card (eHIC), thereby ensuring the NHS would pay for her medical treatment anywhere in europe; today it discloses how the NHS is ‘haemorrhaging’ money to health tourists – and how the problem is being ignored at best, or covered up.

The founding principle of the NHS was that its care should be ‘free at the point of use’, but that noble ethos is now systematically abused on an epic scale.

Health tourists are defined as people who come to Britain with a pre-existing illness and whose motive is to receive free treatment on the NHS.

Contrary to the scaremongering from the politically correct brigade, the term ‘health tourism’ does not apply to overseas visitors who suffer an accidental injury or suddenly become ill. Nor is it applicable to asylum seekers or disadvantaged migrants who are generally entitled to NHS care.

What we are talking about is cynical exploitation of the service by ineligible foreigners. I became aware of the seriousness of this issue through my work in the NHS as a surgeon, specialising in the treatment of cancer. I kept coming across cases that showed both the increasing prevalence of health tourism and the indifference of the authorities towards tackling it.

In one typical example, a Greek resident – whose son lived in the UK – arrived with CT and MRI scans that had been recently performed in Athens.

Since these scans had been carried out under medical supervision in Greece, I wondered why the patient was being treated here rather than in his home country. Despite expressing my concerns, he was accepted for free NHS care.

I was so outraged at the catalogue of abuse that in 2013 I went public with my concerns through articles in this newspaper and other publications. The massive response – particularly from staff working in the NHS – demonstrated that the problem was even worse than I had imagined.

One doctor claimed every week he saw people who had been flown in from all over the world with a variety of serious health problems, many of whom had been ‘wheel- chaired’ onto the plane because they were too ill to walk.

THe most powerful testimony came from the NHS hospitals’ Overseas Visitor Officers (OVOs), many of whose shocking revelations are contained in the Mail today. These are people who have the difficult job of identifying and charging ineligible patients for treatment they have received – and in this capacity they witness the exploitation and mismanagement at first hand.

One told me how a heavily pregnant Nigerian woman referred herself to the hospital’s maternity service. She had had IVF in Nigeria and came to Britain on a visitor’s visa to give birth to her triplets. Because she had visited the UK regularly for 15 years, she believed was entitled to free care.

Many of these NHS workers complained to me bitterly about the reluctance of politicians or senior managers to tackle the problem. Indeed, at times the authorities almost seem to collude with it.

The refusal to face up to reality is illustrated by the Government’s instinct to downplay the financial burden of health tourism.

earlier this year the Health Secretary Jeremy Hunt put the total cost at just £200million a year. But Mr Hunt’s figure seems to me absurdly low. From my own analysis, I believe that the true sum is about £3billion a year.

How did I come to my figure? Well, for a start, it is based on the fact that the entire culture of the NHS militates against a robust charging system. Rather than billing foreign patients, hospitals usually find it easier, quicker and more reliable just to recover their costs from the NHS Clinical Commissioning Groups which authorise the treatment.

In practice, given that the Groups are funded entirely by the State, this means that British taxpayers are picking up the tab. even when invoices are sent to foreigners, little effort is made to chase up payment. Moreover, the invoices that are paid grossly understate the real costs to the NHS. They are based on a financial measurement called the ‘NHS tariff ’, which is a minimal, heavily subsidised amount covering the bare bones of each treatment.

So, for instance, a recent NHS tariff for an uncomplicated obstetrical delivery (childbirth) was £2,820. An equivalent package in the private sector would cost £12,000. Similarly, the NHS tariff for complex abdominal surgery is about £ 7,000 but would cost £40,000 in the private sector.

Add to this the fact that – as yesterday’s investigation reveals – the NHS pays not only for treatment in Britain but also for healthcare across europe, and you begin to realise why the official figure is a woeful underestimate.

There is a fashionable belief, sedulously cultivated by some pro-european ideologues, that health treatment is free throughout the member states of the eU, as long as a patient possesses a european Health Insurance Card (eHIC). But this is a myth. Mainland europeans are only entitled to such a card in their own countries if they or their employers contribute to their native national insurance scheme.

even then, a valid card may be issued for only weeks or months, and some nations – including Belgium, France and Germany – insist that patients from other countries still pay 20 to 30 per cent of their medical costs.

The contrast with Britain could hardly be greater. Any european national who claims to be resident in the UK simply needs to provide an address and an NHS or National Insurance number to apply for a British eHIC.The card, valid for five years, will be sent in the post within days, entitling the applicant – who may only be temporarily resident – to free health treatment anywhere in europe.

OUR politicians need to take their heads out of the sand. Health tourism is almost uniquely a British phenomenon because other countries with comparable health services have a strict method of personalised patient identification to determine entitlement to free care.

We need the same in Britain. Hospitals and GPs should be obliged to insist on payment from patients who cannot prove their eligibility. To this end, it would be perfectly reasonable to ask patients, when registering for their first hospital or GP appointment, to provide some photo ID, together with a recent utility bill.

exactly as is required to access any financial service, open a bank account or even get a bus pass.

The administrative costs would be minimal, but what is required is the political will. Our taxes should be paying for the National Health Service – not the International Health Service.