§ Mr. Rookerasked the Secretary of State for Social Services how many pay bed patients have been transferred to National Health Service facilities following failure to pay for pay bed facilities in the past 12 months.
§ Dr. OwenUnder present arrangements failure by a private patient to settle their account does not itself justify a reversion to NHS status. Regular accounts continue to be raised for the whole duration of the patient's occupying of a pay bed and it is for the health authority to pursue recovery of the debt in accordance with normal practice.
Patients in pay beds may revert to NHS status during the same course of treatment only where some bona fide change of circumstances can be shown —e.g., where exceptionally the length of stay became longer than could reasonably have been foreseen. The decision whether these circumstances have occurred is for local management. I regret that information about the number, or circumstances, of such cases is not available centrally.
§ Mr. Rookerasked the Secretary of State for Social Services if, in view of the bad debts by pay bed patients in National Health Service hospitals, he will make a statement on the accounting system used for such patients.
§ Dr. OwenBad debts arising from pay bed patients are not separately identified in accounts submitted to my Department by health authorities but they are known to amount to well below 1 per cent. of the total income from private patients. Patients admitted to NHS hospitals seeking private treatment are required to give, or be the subject of, an undertaking to pay hospital charges.102W Accounts are normally rendered weekly and patients are expected to settle their accounts before they are discharged. It is within the discretion of local management to ask paying patients for a deposit before their admission which may cover any part or the whole of the cost of their expected duration of stay.
Where accounts are not settled it is the responsibility of the health authority concerned to ensure that all practicable steps are taken to recover debts including, where appropriate, action through the courts. The system used to establish, collect and record the amounts due will depend upon local circumstances, but will always be under the control of the health authority's treasurer, and its operation in each authority is subject to audit by, and the accounts so produced are certified annually by, statutory auditors.
§ Mr. Rookerasked the Secretary of State for Social Services what is the amount of bad debts by pay bed patients which have been recovered by each regional hospital authority following legal action or formal notice of legal action in the last year for which figures are available.
§ Dr. OwenThe accounts submitted to my Department by health authorities do not separately identify pay bed income recovered as a result of the institution of legal action, but I am arranging to obtain this information from the regional health authorities and I will write to my hon. Friend.
§ Mr. Rookerasked the Secretary of State for Social Services whether Treasury approval has been obtained for writing off bad debts to the National Health Service pay bed patients.
§ Dr. OwenTreasury approval has been obtained for writing off all bad debts in excess of a delegated limit, currently of £500 per case.
§ Mr. Rookerasked the Secretary of State for Social Services what is the total amount of bad debts due to the National Health Service caused by non-payment by pay-beds patients written off for each of the last 10 years.
§ Dr. OwenThe total amount of bad debts in respect of pay bed income is not separately identified in the accounts submitted 103W to my Department by health authorities.
§ Mr. Rookerasked the Secretary of State for Social Services if he will introduce legislation to require hospital consultants to indemnify the National Health Service for the cost of services provided to pay bed patients.
§ Mr. Rookerasked the Secretary of State for Social Services how many pay bed patients have had their bad debts to the National Health Service written off in each of past 10 years; and how many of these were not United Kingdom citizens.
§ Dr. OwenThe number of bad debts in respect of pay bed income is not separately identified in the accounts submitted to my Department by health authorities.
§ Mr. Leeasked the Secretary of State for Social Services how many law suits have been instituted since 1974 by the West Midlands Regional Hospital Board to recover fees from patients who have occupied pay beds in the region; how much money is outstanding; how much has been recovered; and if he will make a statement.
§ Dr. OwenSince April 1974 about 200 pay bed cases have been the subject of legal proceedings resulting in the recovery of about £13,500. Figures relating to current pay bed debtors are not specifically identified, but health authorities are required to pursue all outstanding debts, seeking the aid of the regional health authority's legal department as necessary.