Comment

Vantage point: halting health tourism

Inappropriate use of the NHS by people who pay no taxes in the UK is unfair and expensive
Health_tourism

Inappropriate use of the NHS by people who pay no taxes in the UK is unfair and expensive

The Lagos shuttle its called. Every week several passengers arrive at Gatwick or Heathrow from Nigeria in the late stages of pregnancy.

Although Africa is commonly perceived as pervasively poor, these are generally women of means, from the richest country on the continent. Yet despite its oil bounty, Nigeria has a substandard health service and a high mortality rate.

Women want safe births. But the NHS is funded by UK taxpayers for British patients. Emergency care is always provided to foreign visitors, not least because it is a requirement of the Human Rights Act, but travelling to the UK simply to take advantage of free treatment is not permissible.

Chasing payment

Charges should be made to patients or their countries

...

Inappropriate use of the NHS by people who pay no taxes in the UK is unfair and expensive

Health_tourism
Picture: Getty Images

The Lagos shuttle it’s called. Every week several passengers arrive at Gatwick or Heathrow from Nigeria in the late stages of pregnancy. 

Although Africa is commonly perceived as pervasively poor, these are generally women of means, from the richest country on the continent. Yet despite its oil bounty, Nigeria has a substandard health service and a high mortality rate. 

Women want safe births. But the NHS is funded by UK taxpayers for British patients. Emergency care is always provided to foreign visitors, not least because it is a requirement of the Human Rights Act, but travelling to the UK simply to take advantage of free treatment is not permissible. 

Chasing payment

Charges should be made to patients or their countries of origin, but hospitals have been lax in controlling access and chasing payment. In one case, quintuplets were delivered at an unrecovered cost of £200,000; that’s a few midwives’ salaries. 

One in 14 births in NHS maternity units are to visitors, exacerbating a crisis of escalating demand and shortage of midwives. When capacity is exceeded, local women may be sent to distant hospital because beds have been taken by outsiders. 

Criticism of health tourism is controversial, having connotations with racism. Mark Porter of the British Medical Association asserted that doctors’ duty is to treat patients, not to act as ‘border guards’. However, this apparently virtuous stance dismisses the public’s sense of fairness and inhibits service planning.

In 2012-2013, hospital administrators pursued £49 million of a chargeable £367 million. 

Media attention

Despite media attention, a survey suggested that 42% of doctors and 55% of nurses do not know that visitors may be ineligible for free NHS care. 

In 2014, the government pledged to recoup £500 million every year for treating visitors, and last year, £289 million was collected. This is progress, but everyone in the NHS should be vigilant.

Nursing managers have an important role in ensuring that public resources are not abused.  


About the author

Niall_McCrae

Niall McCrae is a lecturer at the Florence Nightingale Faculty of Nursing and Midwifery, King's College London and a member of the Nursing Management editorial board

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