The NHS will always provide immediately necessary and urgent care to any patient who needs it. However, hospital trusts have had a statutory duty for over 30 years to recover the cost of treating overseas visitors who are not eligible for free care. It is clear that the NHS has been recovering much less than it should, and only in the last few years has the cost of treating overseas visitors become a priority for the Department of Health (the Department). Since the Department launched its overseas visitor and migrant cost recovery programme in 2014, the amount charged has increased (from £97 million in 2013–14 to £289 million in 2015–16) but most of that progress has resulted from changes in the charging rules, rather than from trusts implementing the existing rules more effectively. The Department and the NHS are still a long way from meeting the target to recover up to £500 million a year by 2017–18.
The systems for cost recovery appear chaotic. The Department told us it was planning further changes relating to policy and regulation, good practice and IT, but we are not convinced that enough is being done to identify and charge overseas patients. 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. The Department and the NHS need to do more to promote public confidence that the money due to the NHS is being recovered, and that the system is fair to taxpayers and to patients who are entitled to free care.
30 January 2017