HL Deb 22 October 2003 vol 653 cc1605-6

Baroness Boothroyd asked Her Majesty's Government:

What action is being taken to recover the amount owing to the National Health Service by overseas visitors, known as National Health Service tourists, who have unlawfully obtained free medical treatment.

The Parliamentary Under-Secretary of State, Department of Health (Lord Warner)

My Lords, the National Health Service (Charges to Overseas Visitors) Regulations 1989 place a duty on NHS trusts to establish whether a patient is eligible for free NHS hospital treatment and, if not, to levy a charge for any treatment provided. The Government are consulting on proposals to strengthen the charging regulations.

Baroness Boothroyd

My Lords, is the Minister aware of the concern in the National Health Service at the amount owed to it by illegal overseas patients? Can he give an indication of that debt and say how much has been recovered by overseas patient officers and debt collectors? Am I to understand that we can look forward to new regulations that may well be brought in to help to tighten up what can only be described as exploitation of the National Health Service?

Lord Warner

My Lords, under this and the previous government, it has been down to local hospitals to collect charges in accordance with the regulations. We do not collect information on the issue at the centre. As the House knows, devolution is the world that we live in, and we do not want to increase bureaucratic demands on the frontline National Health Service.

In 2001–02, £1.2 million was written off by local health trusts for uncollected debts in the area. However, it is not possible to qualify the total costs that may be lost.

Baroness Thomas of Walliswood

My Lords, as a former member of a hospital trust board, I am astonished that that important information is not among the millions of pieces of information that the board must yield to the central authorities. How did that oversight occur? Do the Government intend to use a future policy on identity cards to check whether people are liable to pay for healthcare? If so, what sort of identity card are we talking about—the Home Secretary's or the Foreign Secretary's?

Lord Warner

My Lords, as the noble Baroness knows, the Cabinet is still discussing the matter. It would be wrong to pre-empt the outcome of that discussion.

Earl Howe

My Lords, what methods are currently in place in the NHS for checking someone's entitlement to free NHS services?

Lord Warner

My Lords, where there are concerns about whether someone is required to pay charges in those circumstances, the usual arrangement is that an overseas visitor manager will arbitrate, taking account of the requirements in the charging regulations.

Lord Rotherwick

My Lords, who decides whether there is such a concern about someone who comes to a hospital? Surely, that is a difficult task, since some overseas visitors speak extremely good English. Who is responsible for deciding whether a person should have healthcare?

Lord Warner

My Lords, as I thought I made clear, under the charging regulations it is down to the local hospital. I have explained the local system to the noble Earl.

Lord Mackie of Benshie

My Lords, how much money do we owe French and other authorities for treatment in those countries?

Lord Warner

My Lords, I have no idea, but I will be happy to inquire and to write to the noble Lord.

Lord Walton of Detchant

My Lords, does the noble Lord agree that, if overseas visitors come to this country without any intention of seeking medical care but happen to fall ill during their visit, they are entitled to the services of the National Health Service? We are referring to those who come specifically for medical treatment and who must carry the cost of that treatment.

Lord Warner

My Lords, I am grateful to the noble Lord for expressing that point of view. We have made clear all along to the NHS that urgent treatment needed to save life or to prevent a condition becoming immediately life-threatening should not be withheld. The NHS remains a humanitarian service.

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