Health tourism

[DonPeffers]

http://www.express.co.uk/news/uk/849324/nhs-health-tourism-2bn-year-Dr-Meirion-Thomas

"Dr Meirion Thomas said the number of health tourists was “grossly underrated” and estimated the true cost of ineligible foreign patients using the NHS to be £2 billion a year".

How is it possible for health tourists to get NHS treatment (seemingly by turning up) when it can take me about a week to get a GP appointment and I waited over 18 weeks to see a consultant to chat about possible double hip replacement (and that appointment only came about when I received a telephone call to say there had been a cancellation and could I attend the next day, which I did)?

What if the UK introduced a tourist chargeable entry visa system and checked that tourists had their own health insurance to cover any medical costs which occurred on their holiday/trip to UK?

What are the collectives thoughts on this or any other money saving initiatives to assist the NHS?

[Blatman]

Health tourism is one of those things we hope Brexit will be able to get a handle on.

BUT... I also believe the hospitals already have rules governing this. The issues are that doctors/nurses are going to be unwilling to turn away people with genuine need and secondly, who is going to be arbitrating whether a patient has arrived with the requisite documentation to prove entitlement to free treatment?

I am as annoyed as anyone about this issue but it's a really tough nut to crack. The very first time the rules are applied and the patient outcome is less than favourable you can bet the tabloids shouting for this to stop (The Express and The Mail if I'm any judge) will almost certainly turn on the NHS 'cos remember the truth won't get in the way of a good story. And it'll be even worse if an entitled person is refused treatment. Then nothing will get checked, ever.

[jeff oakley]

My daughter is a Dr who see's this a lot. It is easy to sort but the will is not there. Every person in the UK, like abroad needs an identity card, which they produce to access services like the NHS. Every person who comes by train boat or plane from abroad is charged for travel insurance by the company who brings them, or provides proof they have it otherwise they pay for any treatment. Companies would police that if it was to cost them.

She has had people turn up in A&E with a set of x rays from another country showing growths and things needing attention and they get very angry, to the point of  her calling security to eject them, when told this is not an emergency.

Also families will fly in Grannie to stay with them who then gets ill so they get treatment as they get registered with the local GP as a visitor.

In Bristol the Union who runs the reception desks in the main hospitals, have instructed members not to ask for status of patients as they are not to do a cut price immigration job for the government.

Ask anyone who works in the NHS will be able to relate to the tales of Women getting off planes heavily pregnant and being taken straight to hospital being a common one. The Nigerian woman who had 4 babies delivered here was sent a bill but has said there is no way she could or will pay.

Even when they do identify those and send a bill to other countries the reluctance to pay makes recovery hard. Even when it is an agreed system. We pay when asked by other countries in the EU and try getting treatment in none reciprocal countries if you cannot pay.

A friend of mine came over from the states, fully insured and twisted his ankle badly. He went to A&E was seen and told them he was insured, they had no idea on the front desk how to deal with this so told him not to bother!

The Dr is right, it is a massive problem and a lot is swept under the carpet, HIV sufferers from Africa for another example can get here legally, IIRC a Somalian can get Portuguese papers and then travel legally through the EU. We should send a bill to the Portuguese but the success of claiming the money is very low indeed.

Will Brexit stop this, doubtful until all realise we do need to have some identity control of people already here, many find that unacceptable. Also until those on the front line are willing to ask questions as to if they have cover then we will still do nothing. 

Emergency treatment for life threatening events should always be done, it is the right thing regardless of legitimacy all others we need to grow a pair. 

[John K]

7 hours ago, jeff oakley said:

all others we need to grow a pair.

100% agreed with all your comments, but unfortunately we are governed by the weak and feeble who only care which way the twatesphere is trending.

And any attempt to close down the health tourism gravy train is met with rampant and slavering screams of Evil, Evil, EVIL...

[DonPeffers]

1 hour ago, John K said:

100% agreed with all your comments, but unfortunately we are governed by the weak and feeble who only care which way the twatesphere is trending.

And any attempt to close down the health tourism gravy train is met with rampant and slavering screams of Evil, Evil, EVIL...

Or are the Government running down the NHS to the point where they can claim some form of private health insurance is mandatory (making billions for their mates)?

Painful to read of cancer operations cancelled at the last minute and by the time they are rescheduled it's too late and the patient is terminal and can only be given pain relief.

[jeff oakley]

2 hours ago, DonPeffers said:

Or are the Government running down the NHS to the point where they can claim some form of private health insurance is mandatory (making billions for their mates)?

Painful to read of cancer operations cancelled at the last minute and by the time they are rescheduled it's too late and the patient is terminal and can only be given pain relief.

To be honest Don some of it needs privatising. My wife works as a Finance Director in the NHS and there is no agenda to make the service an insurance based one, but they do need to get a grip on other things. Take finance, each CSU or CCG has their own systems, this is then collated and sent to the DOH in one format. So you would think a good idea would be to have one system for all but that would be too easy and would mean that there would be less number crunching to do and as seniority comes with a big teams, there is no appetite to change.

Procurement, IT projects are never fully worked out and too many times they do not work as promised, but the spec and contracts are poorly written so the supplying company is never out of pocket, even if it is scrapped. A central purchasing/ negotiating hub would do better deals, but they all like to control their own areas as once again, this would mean less staff needed in the back office functions so we have multiple buyers all doing individual deals on many things.

HR is another area that has no idea. In companies HR works first for the owners and when they have a bad egg get rid. In the NHS it appears they work for both sides at the same time really bizarre.

Even some medical work can be privatised. You mention cancelled operations. In an acute hospital if someone comes in with a massive heart attack, they take priority so regardless of who a theatre was promised to it goes on need. If they use private facilities, like Spire Nuffield Circle etc. then they know that they will not get an emergency so they can better plan and they get paid the same as an NHS hospital would. The difference is they don't have to employ diversity officers, green transport  coordinators and other none jobs so make money.

Waste is biblical, the new Hospital in Bristol, built with PFI funding spent £250k on a clock which then had to run training courses for staff to teach staff how to tell the time, I kid you not.

The truth is the NHS has some harsh choices to make as we age as a population. We need to decide what is essential and what is not. Should IVF or gender reassignment be funded for example? To my mind no but I have a staff member who is having treatment for gender reassignment and it is hard not to have sympathy with his, to be her, plight. But against drugs for kids who have cancer no argument.

To make the NHS better it needs to be taken out of the political football game where it has become the ball. Get it run by a select cross party group with a clear objective for the next 20 years and then you might make progress, but every government change for the last 50 years has wreaked havoc with changes for political purpose. The one constant has been the work of the frontline medical staff who strive everyday to do their best with an increasing workload and demands

[SootySport]

It's not in our nature to turn away anyone who needs medical help in this country, were just too nice.    Some hospitals do have a dept. that will chase up the costs retrospectively and with some success it seems, perhaps they all should.   

 

[jeff oakley]

10 hours ago, SootySport said:

It's not in our nature to turn away anyone who needs medical help in this country, were just too nice.    Some hospitals do have a dept. that will chase up the costs retrospectively and with some success it seems, perhaps they all should.   

 

You are correct, we are too nice and I for one would never want to get to where we fish for a wallet to treat someone having a heart attack. for example, but when someone rocks up with a set of x rays that is taking our generosity too far.

All hospitals have departments to recover monies, if they know who to bill and there is the problem. False names, false addresses etc. I read one article in a US magazine which said many Americans do not bother getting insurance to come here as health care is free so why bother adding to their home policy? Some try harder than others but getting a third party to pay sometimes costs more than any money recovered. It also depends on the area Birmingham and around Bradford has a low success possibly due to where the visitors using the NHS come from not having reciprocal measures in place. 

The NHS this winter is in for a rough ride that is for sure and anything we can do, self medication flu jabs etc. will all help.

[DonPeffers]

19 hours ago, jeff oakley said:

 

To make the NHS better it needs to be taken out of the political football game where it has become the ball. Get it run by a select cross party group with a clear objective for the next 20 years and then you might make progress, but every government change for the last 50 years has wreaked havoc with changes for political purpose. The one constant has been the work of the frontline medical staff who strive everyday to do their best with an increasing workload and demands

Totally agree Jeff with taking the NHS out of party politics and it's time the public demanded it.

[CraigHew]

People say the NHS is under-funded.  I think people's healthcare expectations expand as time progresses

Treatment is, and should be, free at source.  This means it's gonna be open to abuse.

Having departments set up to chase overseas money, actually costs money to administer.  Best to write the debt off.

There are huge huge bureaucratic overheads. Too many chiefs, not enough Indians (apart from Doctors of course).

The NHS is widely accepted as the best model worlwide.   It isn't going to change anytime soon.

[jim_l]

Whether it is underfunded or not depends which way you are kicking the political football that the NHS is.  In fact it is a victim of it's own HUGE success,  there are 2 million more people alive over the age of 65 now than there were 10 years ago, hundreds of thousands in their 80's and 90's,  more people being treated successfully for heart disease, cancers, everything. 

Doesn't look much like a Government running down the NHS to me, looks like the most successful organisation of its size on the planet.

Now those older people need more looking after, much more, and that costs.   So how much do we spend on the NHS?  what we spend now ?  our entire GDP?  it will always be the case that the NHS faces tough decisions,  can we spend the contributions of 100 people keeping one person alive for another month or so, just because it is medically possible?

Private provision of health care to date is quite limited, and is not the province of any political party in particular,  unfortunately it mostly takes place in such a way that provides low paid jobs and profits for the providers.   We need some private provision but quite simply it should only be allowed on the condition that it provides quality jobs with decent pay, not minimum wages and maximum profits.

 

 

 

[John K]

I don't think the NHS is underfunded, I think its trying to do too much.

IMHO they are trying to fix/treat too many 'lifestyle' issues. Tattoo removal, cosmetic procedures because folk are suffering psychological stress, gastric bands etc. This sort of stuff should be paid for leaving the funds free for the urgent stuff or the elderly (but that is another issue, because social care for the elderly is in a state, how any folk are in hospital purely because there is no other way to look after them)

[jeff oakley]

As with all things it depends on what you are measuring. Funds for the NHS have gone up year on year, but when you take wages (even those capped) increases for seniority, building costs, PFI, rates etc. they have suffered a real cut. On top of that there is the increase in number of patients seen and increased life expectancy and it is clear ther is not enough money.

But like the MOD, central government, the waste is insane. Yesterday was a great example. A highly respected award winning surgeon was suspended on full pay after allegations of bullying were made. The investigation and disciplinary took three full years to complete. He has appealed and the Hospital involved decided they were going to lose and made a 6 figure settlement, with a confidentiality clause. 

This guy lost his career as he is now unable to practice due to the length of time involved, so three years at £95k plus a settlement. What in gods name would take so long, but that is the NHS HR for you.

Also today Cambridge, where IVF was perfected, have announced they will no longer fund any IVF treatment and I expect others will do the same to join the three so far. I expect other treatments will curtailed as well.

We need sensible discussions with facts and without the hysteria we are getting at the moment

 

[DonPeffers]

On 9/4/2017 at 07:58, jeff oakley said:

Every person who comes by train boat or plane from abroad is charged for travel insurance by the company who brings them, or provides proof they have it otherwise they pay for any treatment. Companies would police that if it was to cost them.

 

I now recall our cycletouring group flying London to Geneva decades ago then cycling into France to cycle the French Alps.

As part of the flight ticket there was a mandatory addition to cover your first nights accommodation in a Youth Hostel, so you weren't left stranded without a roof over your head.

The connection to health tourism ties in with Jeff's point above about making the transportation company responsible, when doing online booking, for ensuring that the traveller has valid insurance to cover health problems during their trip.

If a tourist made a false declaration which later invalidated their health insurance they would be refused UK entry visa in future until the medical bill was paid.

This would NOT apply to countries with reciprocal health arrangements with the UK.

If the tourist needed NHS healthcare and is found to have no valid insurance then the airline etc must pay the medical bill. Of course it involves legislation but cannot be that difficult and hopefully our industrious MPs can find the energy after their 7 week Summer holiday.

 

 

 

[Howsafe Workwear and Safety Equipment]

On 04/09/2017 at 07:58, jeff oakley said:

My daughter is a Dr who see's this a lot.

The first lady Dr Who hey!