According to data obtained by the BBC, London hospitals have written off more than £112m in unpaid treatment bills from overseas patients between 2018 and 2023. Hospital trusts in England are required to charge patients who are not “ordinarily resident” in the UK for non-urgent treatment. The trust must bill at 150% of standard NHS rates, intended to cover administrative burdens associated with identifying patients and pursuing payment.
Critics argue that the current system for recouping fees is unfair and ineffective. While aimed at tackling “health tourism”, exemptions are made for vulnerable groups, including asylum seekers and trafficking victims. Hospitals often struggle to recover costs, particularly when patients return overseas.
Barts Health wrote off £35m in unpaid bills over the five years, the highest among all responding London trusts, which serve a large population in east London. A spokesperson said, “Where appropriate, we make every effort to recover payment from patients who are liable for the cost of their treatment. However, many patients may have limited funds available and some will not be resident in the UK, which means recovering payment can be difficult.”
King’s College Hospital abandoned £17m of unpaid fees, while 10 other trusts each wrote off more than £1m in unrecovered fees. A spokesperson emphasised that the trust works “to ensure we embed fairness and proportionality principles into our income recovery processes”.
The British Medical Association (BMA) has maintained that charging policies deter vulnerable groups from accessing necessary healthcare. Dr Omar Forge Risk, a campaigner against NHS charging for overseas patients, said the charging system was harmful to public health, while doctors reported patients arriving from abroad seeking treatment
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