NHS needs to recover hundreds of millions from overseas patients

Of this sum, some £84 million has been "permanently lost", according to a Policy Exchange report.

Writing the foreword for the report, Sir Sajid Javid said the NHS is "not a charity (or) an international aid organisation".

The former health secretary said that sum would be enough to pay the salaries of "3,200 more GPs or build 70 new GP surgeries".

Overseas visitors can access some NHS services for free – including seeing a GP or A&E care – but people who are not "ordinary residents" in the UK can be asked to pay for other services.

Guidance suggests that treatment must be paid for upfront unless doing so would delay urgent or immediately necessary care.

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It goes on to say that this care must never be withheld or delayed, even if the patient is unable or unwilling to pay, though these patients remain liable for the charges.

The UK has healthcare arrangements with several countries, which means patients from these countries will be able to get some services without being charged.

But hospitals are still urged to document these cases as the UK may still be able to claim back the cost of the patient’s care from the country responsible for their healthcare.

Policy Exchange sent FOI requests to 202 NHS trusts in England including hospitals, mental health trusts and community health services to ask about the amount of money collected by the trust "for the provision of any episode of care for a foreign national (ie. any individual who is not entitled to that care free at the point of use)".

It also asked about the amount of money written off or the money that remains uncollected by the trust in the last three calendar years.

A total of 82 total responses were received along with five partial responses.

The report states that between 2021 and 2024, NHS trusts invoiced £384,245,201 to overseas patients.

Of that total, £131,843,335 was successfully collected; £167,911,874 remains outstanding and an additional £84,489,992 has been formally written off.

"This results in a combined total of £252,401,866 in overseas charges that remain unrecovered, of which over £84 million is permanently lost," the authors wrote.

The majority of trusts with the most uncollected overseas health costs were in London.

Sir Sajid, who was health secretary between June 2021 and July 2022, wrote: "NHS trusts in England failed to recover more than a quarter of a billion pounds over three years from overseas visitors. That’s enough to pay the salaries of 3,200 more GPs, or build almost 70 new GP surgeries.

"Asking those who pay for the NHS to shoulder the cost for those who haven’t made the same contribution is fundamentally unfair.

"When a taxpayer in Manchester or Birmingham is denied timely treatment, yet sees resources diverted to write off millions in unrecovered costs from overseas patients, confidence in the system is corroded.

"Many of those who are cared for by the NHS without paying for it do, in fact, have the means to pay.

"Some will have insurance policies that would cover the cost of their treatment. By failing to collect what is owed, NHS trusts are effectively boosting the profits of private insurers while passing the bill to British taxpayers."

He added: “The NHS is not a charity. It is not an international aid organisation. It is a public service – funded out of the hard-earned money of British taxpayers, for the benefit of British taxpayers."

An NHS spokesperson said: "The NHS is committed to delivering the best possible value for taxpayers’ money and, in line with regulations, providers of NHS-funded services must identify chargeable overseas visitors and take all reasonable steps to recover costs.

"For non-urgent care, payment must be secured in advance; and urgent or immediately necessary treatment will be provided without delay, in line with the NHS’s commitment to patient care.

"The NHS has recovered more money so far this year compared to previous years but we are determined to go further and are working on a variety of measures to achieve this."