BMA vote not to charge "health tourists"

[IrmaFayLear]

Quite cross about this.

Different of course if someone has a heart attack/car accident, but to turn up specifically to access expensive maternity/cancer etc treatment is not only unacceptable but unsustainable.

Particularly annoyed because the pil's dementia care which they had to self-fund ran into many hundreds of thousands (at a humdrum establishment, too).

It sticks in one's craw to be told constantly that the NHS is crumbling but that an extra couple of billion per year is ok for health tourists.

@DGRossetti

*What I don’t understand is, when people say ‘it’s not a big deal, it’s only 0.3% of the budget’ - how do you we KNOW it’s only 0.3% of the budget?

How do we know anything ?*

Very metaphysical question

My point is that clearly, use of the NHS by those not entitled to use it isn’t tracked. So it’s just really unclear to me how anyone can say with any authority that ‘health tourism’ only amounts to x percent or y percent.

Also, any figure given for ‘health tourism’ is meaningless unless we know how ‘health tourist’ has been defined and how the figure’s been reached. It’s unclear what it means because it’s a nasty phrase made up by the tabloids. I assume it refers to people who come to the country for the sole purpose of receiving healthcare. But how can a hospital possibly know what someone’s motives are for coming to the country are? How are these motives recorded?

Also, presumably any figure given for ‘health tourism’ doesn’t include visitors from (for example) the US who are insured and able to pay, but aren’t asked to? Or visitors from the EU where the NHS is able to claim back the cost of their care from other EU governments, but doesn’t?

I’m absolutely prepared to accept it’s not a big strain on the budget - I don’t work for the NHS, I’m not a medical professional, I have no idea. But the stats seem open to challenge. And it seems contradictory to admit on the one hand that we don’t track improper use of the health service and on the other assert that it’s definitely, absolutely not a large expenditure.

@DGRossetti

I’d like to see the publicly funded resources paid to private companies to administrate the complex processes of assessing claims for disability based benefits to be reallocated to assessing & chasing up the ‘tax evaded, avoided & uncollected’.

If there is political will to save the UK tax payer monies by chasing down fraudulent claims on the state then recouping unpaid tax gives more bounce per ounce.

My point is that clearly, use of the NHS by those not entitled to use it isn’t tracked. So it’s just really unclear to me how anyone can say with any authority that ‘health tourism’ only amounts to x percent or y percent.

I can say with 100% confidence that the amount the NHS "loses" to health tourism is not 100%. We can work back from there.

Also, I don't really care about investing millions of pounds into calculating to within +/-0.000001% whether it's 0.1% or 0.3% - although I know that there are many that would happily spend the rest of their lives - and your money - to do so.

Remember, we are discussing all this against a backdrop of a government which has immediately found £10 billion for a deal with the DUP, spunk hundreds of millions of money (from where ?) on cancelled no-deal Brexit contracts, and by the Chancellors own admission has £26 billion squirrelled away for a Rainy Brexit.

So against all that backdrop, do you really think there's enough of a difference between 0.1 and 0.3 % to give a shit about ? I haven't even started to add the countless (literally) billions the government pisses away in having to bail out dodgy firms (G4S anyone ?) left right and centre. As well as having to pay over budget for those pet projects now behind schedule.

Discussing health tourism as a problem for the UK economy is a bodybuilder worrying about split ends. Maybe it is a problem. But I doubt it will hurt their Olympic chances. See also: benefit fraud.

,

If there is political will to save the UK tax payer monies by chasing down fraudulent claims on the state then recouping unpaid tax gives more bounce per ounce.

There isn't at the moment. The only political will is to send a clear message to all that if you are ill: you are a waste. If you can't work: you are a waste. If you can't service the country: you are a waste.

And waste has to be eliminated. As efficiently as possible. Which is why we don't shoot the poor. It would cost too much.

Hyperbole ? Well, both contenders for our Next Great Leader are all about "da tax cuts" for the top taxpayers, so I think I'm starting on safe ground here.

Mother What happened to speculate to accumulate? Yes, you would have to invest in some technical infrastructure, but that is doable. When I go to UZL, I rock up, take a ticket, get my details confirmed by the admin lady, get my parking ticket capped, and off I toddle to my appointment. Takes 10 minutes tops.

Given that one has to check into outpatients say, in a UK hospital and give your details, how long would it take to add a health card check (provided by the state to prove your entitlement to use the NHS)?

If it wasn't worth billing people who aren't entitled, then why would the other European countries do it?

Remember, we are discussing all this against a backdrop of a government which has immediately found £10 billion for a deal with the DUP

10 billion?

Posted too soon.

I've only ever seen that £10 billion figure on here. I understood it was £1 billion. Am I hopelessly out of touch with (reasonably) current events?

The U.K. could have a social insurance system, like in France and Belgium and Germany.

But it would have to pay to employ the administrators to run it, and the IT professionals to develop and manage the computer systems.

Based on recent big government IT projects this would be extremely expensive and would take decades.

Here in France, it's not doctors and nurses who check your rights to healthcare but office workers. The BMA is absolutely right that doctors should not act as accountants or gatekeepers. For a start, it could mean doctors breaching their professional ethics and obligations.

If the U.K. wants an insurance based scheme then it will need to pay for the extra layers of bureaucracy required to run such a system.

10 billion?

Apologies - it's stated as £1 billion ...

A friend (wealthy banker) with family in India flew his aunt to the UK to have an operation. They costed it up and the flights were much cheaper than paying for the op. in her home country, and she could stay with her sister and see family whilst she recuperated.

He thought it was crazy she could do this, but as she could - why not.

please I think he was wrong to do this particularly when he is wealthy and it is dishonest

Plus it pushes others living here further down the list.

she said that the have Nigerian women arriving every day in labour

No they don't. For this to be true, the women would have to time their flights to coincide with the time they were going to go into labour. No airline would allow them to board already in early labour, and even if they did, the fastest flight from Lagos to Gatwick is about 6 hours. Many labours are shorter than 6 hours so it would be commonplace for Nigerian babies to be born en route, which it isn't.
So, either they're all psychic and know when they're going to give birth, or they all start an induction of labour just before boarding, and hope that active labour had kicked in 6-8 hours later. But as many women on MN can attest, inductions just aren't that predictable - so there'd still be plenty of babies being born mid-air.
This is clearly one of the many anecdotes that get circulated about health tourism, that if people just used their brains for 30 seconds, they would figure out that they can't possibly be true 🙄

This is clearly one of the many anecdotes that get circulated about health tourism, that if people just used their brains for 30 seconds

30 seconds ? As long as that ?

JonnyPocket and yet upthread, I posted a link to a report quoting staff at St Thomas's in Tooting, who apparently do find this to be an issue

I don't pretend to know the truth either way, but unless the whole thing was made up - in which case the hospital would surely have refuted it - I'm inclined to accept the word of those who work in this field

Perhaps there is a place for a system where to travel into or through the UK you have to have a visa and travel insurance to cover medical issues and, as part of the visa application, you have to lodge details of your insurance.

Presumably there is a system that could corroborate there is valid insurance against those details (in the way they can check if a car is insured). That way if you need treatment the claim could be made direct to the insurers. Yes sometimes they may not be covered (non-disclosed pre-existing condition for example) but hopefully that could cover most.

It is not just people coming into the country - it is also those passing through. I remember in a news story on it last year, one of the large debts was from a woman travelling I believe to America but with a change in the UK who went into labour during the stopover and had a bill of around £500k outstanding.

To enter Russia from the UK one needs proof of health insurance.

There will always be those who deliberately seek to take advantage, but it definitely seems wrong to advocate having a policy never to charge people.

Tell you what, first bar British people from leaving the country without health insurance and travel insurance. With Brexit as well, the queues at airports will be something to behold.

I heartily agree that British people should take out travel insurance too. The cheek of crowdfunding to cover the medical bills of skydiving or wotnot in Brazil. Actually I think a lot of older people duck out of insurance because of existing conditions etc and they don't want to miss out on their cruises...

The problem is "insurance" isn't a 1:1 replacement for the NHS - both ways. Insurers won't cover a whole host of situations and conditions.

So what happens to someone who uses the NHS, has insurance but the insurers refuse to pay ?

one of the large debts was from a woman travelling I believe to America but with a change in the UK who went into labour during the stopover and had a bill of around £500k outstanding.

If this is the woman I'm thinking of, I encountered her very briefly in person, as our paths crossed in the hospital. She was pregnant with IVF quads, and was on her way from America to Nigeria, when she went into prem labour at about 24 weeks. As I recall, one baby died at birth, one died shortly afterwards, and the other two died after a few weeks in NICU. She was not a health tourist, and did not intend to give birth at 24 weeks during her short layover at Heathrow. And she was fully aware of all the media coverage accusing her of ripping off Britain's hardworking taxpayers, while she grieved for her dead babies, in a foreign country, alone.

Obviously we cannot expand the coverage of the NHS to everyone from everywhere on Earth, and make the growth in costs effectively infinite while keeping the contributions to the UK's tax paying public, which it already can't come close to adequately servicing.

The fact that it's bad and sad when people are sick or vulnerable and nice and heroic when we treat them doesn't really change that, it's a sentimental and silly argument.

one baby died at birth, one died shortly afterwards, and the other two died after a few weeks in NICU

That poor woman.

How does someone get onto a flight when 24 weeks pregnant with quads? I would assume that you would be refused permission to board.