English
Foreign Use of the NHS Costing Two Billion Pounds Every Year?
Posted on Oct 29, 2013 by Ailee Slater (G+)
In the United Kingdom, the National Health Service (NHS) ensures that every English citizen has access to free, government-run medical care. It’s a system with obvious benefits for those who live in Britain, but what happens when a tourist or undocumented migrant experiences an illness or injury in Britain? Of course, that person will go to the hospital where they will receive the necessary treatment, and the bill will be sent to the NHS – whether that patient is a tax-paying citizen or not. Money might be recovered from the patient’s insurance policy or home country, but often, the NHS simply absorbs that expenditure – and according to a new report, funding the medical care of migrants and foreign tourists may be costing Britain £2 billion every year.
The report, released on October 3, 2013, was commissioned by the U.K. Department of Health. Authors of the study divided their research into three different groups: regular visitors and migrants, making use of British health care services as necessary and expected; so-called irregular migrants, meaning illegal immigrants, failed asylum seekers and those who have overstayed a visa; and health tourists who have come to England with the express purpose of seeking medical care or prescription drugs.
Of these three groups, researchers estimate that regular visitors and migrants account for around £1.4 billion in NHS spending every year. However, the report notes that this spending is considered normal – the NHS expects lawful visitors and migrants to use its medical services, as necessary, while in the country. Many of these costs are also recoverable. Countries such as Spain, France, the United States, Australia and others have a reimbursement agreement with Britain – if a French citizen is injured in the U.K. and must be hospitalized, France will repay the NHS for the cost of that care.
The second group of non-citizen NHS users are irregular migrants, and authors of the report admit that it is difficult to accurately calculate how much the NHS spends every year on care for these illegal or over-stayed migrants. Based on statistics from the U.K. Home Office, however, researchers estimate that irregular migrants account for around £330 million in NHS annual spending.
Health tourists, the third group of non-citizen NHS users, are likewise difficult to accurately calculate, as their use of the U.K. health system is irregular and more difficult to document. Report authors did find that health tourists could be using as much as £300 million in NHS health services.
Although it is not possible to recover the entire £2 billion spent every year on getting medical care to these three non-citizen groups, health ministers have said that it might be possible to avoid some of that spending. Firstly, the U.K. government has already instituted an annual £200 levy on any non-European Economic Area migrant. If a migrant from outside of that economic area stays in Britain for six months to five years, he or she will pay £200 pounds toward the NHS, which could raise around £200 million every year and help to deflect the cost of giving care to migrants who aren’t paying into the National Health Service.
On top of that levy, the U.K. government is also considering setting up cost recovery units to help hospitals get back the money they are owed from the home countries of foreign tourists. By making better contact with other governments, Britain could get recover some financial expenditures and put that money back into the NHS. Such recovery efforts do happen already, but most research shows that just over £73 million is reclaimed, while the U.K. government is owed closer to the sum of £460 million. With dedicated cost recovery units, the NHS could save a good deal more money every year.
Following this October report, some government officials have also suggested that the U.K. make a bigger effort to discourage what researchers termed the third groups of non-citizen NHS users: medical tourists, or foreigners who purposefully enter Britain in order to use health services for free. Health tourism can take the form of emergency inpatient care, maternity services, or prescription drug access from a general practitioner. The U.K. government has said that in coming weeks, it will reveal more information about what laws and policies could be implemented to discourage medical tourists from coming to Britain, and how the U.K. could recoup more costs from these NHS users.
At the same time, health officials have said that they do not want to rush into large scale legislation until better estimates of migrant NHS use or misuse can be confirmed. The October report has been criticized for its varying quality of data and use of assumptions as opposed to hard facts and figures. Report authors themselves have been quick to note areas of the research that are still unconfirmed. Critics of the government response to the report also fear that doctors may be asked to police their patients; examining citizenship or eligibility before providing care, which advocates and GPs agree should not be a responsibility tasked to doctors. Migrant advocates also want to be sure that foreign nationals in the U.K. are not discouraged from seeking necessary medical care.
However, despite the uncertainty in the October report and concerns about hospital policy and policing, U.K. health officials and government workers are largely in agreement that non-citizen use of the NHS is costing the nation money, and should be better examined and legislated. In the coming months, it is likely that we will hear more proposals from all sides on how to recoup NHS funds, discourage illegal medical tourism, and adjust the current migrant health care system so that supporting a healthy populace doesn’t come at an exorbitant cost to the few who pay the bills.