Updated: Friday, 20th April 2018 @ 11:35am

Investigation: Health tourists exploit Manchester NHS and leave taxpayers to foot £580,000 of unpaid bills

Investigation: Health tourists exploit Manchester NHS and leave taxpayers to foot £580,000 of unpaid bills

By Lucy Kenderdine

For thousands of years people have travelled far and wide to get medical treatment for various illnesses, injuries and infirmities.

From the ancient Greek pilgrims who travelled over the Mediterranean in search of healing god Asklepios to the patients seeking the health-giving mineral waters of Victorian England spa towns, medical tourism is nothing new.

But in recent years medical and health tourism, the practice of travelling to seek medical treatment, has garnered more interest, particularly within the UK and the National Health Service.

A Panorama investigation last year showed that the NHS had lost at least £40million over a period of four years after it failed to identify ‘health tourists’ who were not entitled to free health care.

With a legal duty to establish if a person is entitled to free care, exempt from charges or liable to pay costs for their treatment, the exposé damaged the reputation of the NHS.

But even when an overseas patient is required to pay for treatment, a new problem emerges as hospitals can struggle to recover payment.

Following this, MM investigated the situation across Manchester hospitals, and examined how much each Foundation Trust in the region is owed by foreign nationals who have yet to fully pay for their treatment.

Freedom of Information requests sent to the NHS Trusts in the area discovered that the region is not immune to the problem, with some trusts recording substantial debts.

Between October 2011 and October 2012, Central Manchester University Hospital NHS Foundation Trust treated 155 patients who were required to pay for their treatments, with a total value of £358,906.

But significantly the Trust was still owed £268,072 at the end of this period.

A Trust spokeswoman said: “The current level of outstanding debt represents a small proportion of overall trust income (less than 0.1%).”

The Trust, which includes several hospitals including Manchester Royal Infirmary, Royal Manchester Children's Hospital, Saint Mary's Hospital, and Trafford Hospitals, has the highest level of outstanding debt, but as one of the largest, this is not surprising.

She added: “The Trust’s policies and procedures for assessing patients’ eligibility for free treatment reflect Department of Health guidelines.”

NHS Foundation Trust

Number of Patients treated

Amount Owed

Central Manchester University Hospitals



Pennine Acute



University Hospital of South Manchester






Salford Royal



Wrightington, Wigan and Leigh







Central Manchester was not alone in their problem with others across the region reporting that they are still owed money following treatment given to non-exempt foreign nationals.

Alongside Central Manchester, Pennine Acute Trust recorded a similarly high outstanding debt figure, and was awaiting £264,117 following the treatment of 202 patients up to October 2012.

A Trust spokesman said: “We have systems in place to both identify and collect overseas visitors’ payment for treatment in accordance with government guidance.”

He added that the Trust tries to combat the issue by sharing non-medical information with the UK Borders Agency.

“The majority of outstanding debt still owed to the Trust relates to urgent care cases where all avenues to recover these monies have been exhausted.”

So what is being done about this problem across the country?

Speaking about the issue Andrew Gwynne, Shadow Health Minister and MP for Denton and Reddish, said: “This is a serious issue and Ministers need to urgently investigate how hospitals have been left in this position.”

The MP highlighted that the previous Labour government proposed a series of further safeguards including amending immigration rules so that anyone with substantial medical debts is not allowed back into the country.

Mr Gwynne added: “Hospitals have a legal duty to recover any charges made to overseas patients and to be frank some hospitals need to be much better at it.

“Sometimes it can be as simple as improving the recording of contact details so the patient can be pursued for payment but we do accept the rules and procedures could be improved.”

The government has certainly taken notice of the issue in recent months as more issues with the system become apparent.

A Department of Health spokesman told MM: “The NHS is essentially a humanitarian service and no-one in need of immediate treatment will ever be left to suffer just because they cannot pay.”

He added that the government has recently completed a detailed look into this problem and will be examining if the charges to overseas visitors need to be reviewed.

“The government believes that measures are needed to provide a balance of fairness and affordability in the provision of NHS treatment for overseas visitors,” they added.

“The existing system is too complex, generous and inconsistently applied.”

The government and MP’s are not alone in believing that this is a problem that needs to be fixed as members of the public have begun an e-petition calling on changes to be made.

However, with only 27 signatures so far, there is a long way to go however influential think tanks are also suggesting reform is needed.

Vice Chairman of Migration Watch UK Alp Mehmet said: “Very few hospitals are dedicated to identifying foreign nationals who should be paying for treatment and recovering the money after treatment is given.

“We believe that this is of real significance to Britain’s taxpayers and they should not be footing the bill.”

Mr Mehmet added: “It is a matter of fairness and it is an area of the law that needs to be looked into more.”

Picture courtesy of Labour, with thanks

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