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Commissioners are not doing enough to support the NHS in recovering costs from overseas patients


1 February 2017

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Clinical commissioning groups and NHS England need to support trusts in identifying and charging overseas visitors, a House of Commons select committee report has concluded.

The report has said that the NHS in general is not effectively recovering costs.  The target for recovery was set at £500m a year by 2017-2018. However, the forecast suggests that only £346m will be charged, according to the Public Accounts Committee (PAC).

Clinical commissioning groups and NHS England need to support trusts in identifying and charging overseas visitors, a House of Commons select committee report has concluded.

The report has said that the NHS in general is not effectively recovering costs.  The target for recovery was set at £500m a year by 2017-2018. However, the forecast suggests that only £346m will be charged, according to the Public Accounts Committee (PAC).

The report states: "If the NHS does not recover the cost of treating patients who are not entitled to free care, then there is less money available to treat other people and even more pressure on NHS finances."

Only 65% of visitors outside the EEA&S were charged and only 16% of those within the EEA&S.

The committee noted that there is an unexplained variation between the amounts charged at different hospital trusts, which indicates that there is room for improvement. Although the statutory obligation for charging overseas patients lies with trusts, the committee recommends that commissioners also aid the process by auditing debt recovery.

At St George’s Hospital in London, for example, more stringent tests for eligibility for maternity care were put in place as a response to the CCG’s refusal to pay for overseas patients, the report has said. According to the committee, this is an example of the progress that can be made if trusts are penalised. But it added: “There are no clear, consistently applied sanctions when trusts do badly.”

The committee also noted that the amount that is charged to patients is not the same as the amount that is recovered. So although the amount charged has increased from £89m in 2012-2013 to £289m in 2015–16, the amount recovered will be less than £289m because trusts do not get back all of the amounts that they invoice to patients directly.

Chair of the PAC, Meg Hillier MP, said:

'The Government's failure to get a grip on recovering the costs of treating overseas visitors is depriving the NHS of vital funds.

'Our Committee has reported extensively on the financial pressures facing the health service and it is simply unacceptable that so much money owed should continue to go uncollected.

'This is a problem for the health service as a whole and work to put it right must be driven by central government.'

The Committee has urged the Health Department to publish an action plan 'setting out specific actions, milestones and performance measures for increasing the amount recovered from overseas visitors' by June. 

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