Health tourism

It seems to be a big drain on the economy. I've read that it costs between 100-300 million pounds each year for the NHS to treat non-residents who come on purpose for medical treatment. In other countries with universal health care, ie Australia and Canada, only permanent residents can access free health care . People with chronic illness who want to immigrate to those countries, may be rejected all together or have to guarantee to pay their own health expenses for their lifetime. Visitors who have accidents or medical emergencies have to pay up front unless they have travel insurance. I think that this attitude is more appropriate - no country can afford to pay the health care needs for people who are just coming for that purpose ! The UK needs to toughen up on this issue, in my humble opinion.

Actually I agree with you, it’s just that I’ve been told by others that health tourism is a drop in the ocean compared to the overall cost of the NHS, and whilst it very well may be only a drop in the ocean, I feel that people who come here should only have access to any immediate health care they need, and not to go on to have heart operations or whatever. For that I think they should be sent home.

Health tourism is wrong, it is fraud, just the same as not paying tax but there is such a small number of people involved, it's nothing in the NHS budget. I did come across it where I used to work.

In the 80's and 90's when HIV was at its peak, many people came to London from other countries specifically for free treatment and ended up in ITU for many weeks costing thousands of pounds. I agree, it is fraud at our expense. I do not care if the money is a drop in the ocean- it should not happen.

Health tourism works both ways. At New Year when the NHS was in crisis. I bundled up DH, who was down with the lurgy big time, put him in the car and we went over to our house in France because I decided that if he needed to be taken to A&E, which was possible, he would not survive a journey of over two hours to our local A&E [allowing an hour for roadworks and another hour for finding a parking place. Official hospital advice] and 5 hours sitting on a hard narrow chair.

In France A&E is under stress, but at least provides more humane service and care for those waiting to be seen than the UK system does. Fortunately, no visit to A&E was required.

Health tourism is wrong, but I think it is a London centric problem. This is where the cheats fly in, so should be resolvable with a bit of thought, but remember there are also people like me and others using our EU rights to seek medical treatment outside the UK because of failings in our own country.

I am about to visit my daughter in Australia.
I have taken out insurance.
If I can afford the travel costs then I should be prepared to pay for that insurance. So IMO should everyone else.
The fact is that some don’t . I don’t condone it but am afraid that if I were a medic I would find it very difficult to turn away from someone in need. Apart from the fact that I should imagine that reatment will already have been started before it is found that the patient isn’t entitled to NHS care.

At the moment, as we are in the EU, we are entitled to health care in other EU countries, as I understand it. Therefore going to France to get health care if you already have a house there anyway, doesn’t seem to me to be health tourism. I do think it’s immoral for people to arrive here and get health care such as coronary heart bypass (which I saw on a documentary, and yes, it really happens) which costs thousands of pounds, and then simply return home, without paying. Where else would this happen? Without insurance you simply wouldn’t get that kind of care in most other countries. However I do think we should provide emergency care in A+E for anyone in the country, but that wouldn’t include admission and a coronary heart bypass, it would be emergency treatment to ensure stability and then discharge unless the patient can pay. We can’t be a World Health Service.

We would get a bill for part of our care in France. last time DH went to the Urgences in France we had a bill for 30 Euros.

And I expect you paid your bill Monica, but as far as I understand it, many health tourists in Britain don’t pay their bill even when presented with it. The UK is able to charge and should charge apparently, but often the bill is ignored and the person simply leaves the country saying they can’t pay. Other times apparently a bill is never even presented as staff say it’s too much trouble to do one, and of course medical staff should never be expected to deal with billing, that’s the job of administration. In many other countries, visitors are required to present their credit card before they even see a medic, assuming of course, the patient is conscious.

maddy I believe I heard/read recently that it is onerous to chase up these unpaid bills, maybe the NHS simply doesn't consider it worth the expenditure of time and money, given that the treatment is a small proportion of their costs. It's a great pity that some kind of screening isn't done before people are admitted (except, of course, to A&E), or evidence of sufficient insurance being a requirement at the point of entry to the country. Doesn't seem like rocket science...?

I am not defending health tourism, but I think it is very much London based and that it is easily resolved if government and hospitals put their minds to it. Other countries manage.

The question is: why don't they?

Good question Monica, I’d like to know that too. They don’t seem to have any real will be sort it out. I know the figures are quite small overall, but as you say, other countries seem to manage to do to it, but the biggest reason to do it in my opinion, is that many people who pay tax on their really quite small incomes, should not have to support others who come here to abuse the system.
I still would advocate providing emergency care for anyone in the country, at the point of need, and obviously try to get the country reimbursed if possible. If it’s not possible, we’d have to suck that one up, but no care other than immediate emergency care should be provided unless it is paid for, in my humble opinion.

I'm told that about two thirds of patients being treated for HIV/AIDS in this area are non-UK/non-EU citizens. That seems a lot but when you weight up the cost of them otherwise spreading HIV through the community, I guess it's worth the cost.

Yes, that’s a good point Sue, something I hadn’t thought of. But I still think we shouldn’t be doing triple by passes on non residents of the UK, unless they can pay.

An American visitor to one of my neighbours recently broke her arm in a fall. She was treated / plastered at A and E. She asked - “how do I pay? I have insurance”’ , she was told “no need to pay we don’t ask for payment”. She was quite shocked, but did make a donation to one of the hospital charities. Surely if someone is willing and able to pay for straightforward treatment there should be some mechanism to collect the money?

That's also true, Maddyone. It's not possible to treat everyone.

My son, who is now US-based, developed shingles when he was visiting us. He paid £40 to see a doctor and get a prescription. That seems a fair price, really.

Monica if you need medical treatment in France - or a prescription - you should be given a brown form - feuille de soins - if you fill it in putting your EHIC number on it and send it to Newcastle you should be reimbursed.
Things such as road accidents or a life threatening event such as a stroke or heart attack will be treated free in France I believe - so says our insurance broker.

How very odd Gerispringer and others. I was watching an episode of the documentary Hospial a couple of months ago and it was quite clear that people are chased up for payments incurred, even those without insurance. There was a designated person in the hospital whose job it was and they managed to recover costs in 80% of cases.

That’s the problem with hearsay and those kind of ‘visitor to one of my neighbours’ scenarios.

Yes, found this

“From October 2017, those resident outside Britain will need to pay for non-urgent care, in a bid to clamp down on “health tourism”. NHS trusts have been instructed to ask patients for detailed evidence to establish their right to free healthcare, if there is any doubt about their entitlement.

Every NHS trust has been issued with guidance, with a list of questions to be asked, and documents to be required, if the residence status of a patient is not immediately clear.

Some hospitals - especially in urban areas with high ethnic populations are expected to ask questions of every patient, in a bid to reduce the risk of being accused of discrimation.

Accident & Emergency departments and access to GPs will remain free for all, and asylum seekers will be exempt.

The move means anyone flying to the UK for non-urgent treatment such as a hip operation or cataract removal could now be turned away unless they agree to pay the NHS bill.

A number of hospitals had introduced upfront charges for overseas patients already, with some requiring provision of a passport and utility bill, to help officials establish entitlement.”

How could you contemplate driving to France M0nica for “emergency”health care?
On another thread I think you said you live in a village outside Oxford, or am I mistaken?
Even I, living halfway between Oxford and Cambridge could be at the JR Infirmirary in less than the 2 hours you describe even allowing for the traffic chaos around that area and frequently was .
And in an emergency I would have a choice of at least 3 A&E departments all considerably closer. Plus on the many occasions Paw was rushed to A&E, whether by ambulance or car, he was seen in considerably less than 5 hours. Parking? You can generally drop off at the door and then find a space.
Let’s not denigrate our A&E departments out of hand.

www.theweek.co.uk/brexit/65461/brexit-news

Better get your emergency healthcare in early, then, Monica, as it may not be avaiable after we leave.
I agree with Maw. Driving to France seems a bit excessive if you think h could not cope with a drive to an Oxford hospital.
I bet you feel really sorry for us in the sticks up North.

The French health care system is struggling as well so don't look at it through rose tinted glasses. However their Carte Vitale system is excellent with all your details available electronically. A system similar to that would be good for the NHS but expensive to implement.
I agree with Maw let's not knock the NHS all the time, we should be proud of the service and look for ways to help. It seems to me that if we want more from the NHS then we have to pay more.