Hospital Treatment Tourism

[mercalia]

No wonder that a lot goes on - watched a programme called "Hospital" the other day at a friends dealing seeing a particular hospital dealing with this. And the dialogue when the admin or whoever chatted to the patient was some thing like this - " the operation will cost £xxxxxx are you happy to sign this form. <concerned look from patient> well dont worry the operation will go ahead regardless dependant on medical need......" " are you able to make a small payment? < relative resident in UK - oh I am retired and have a mortgage .....> "well dont worry the operation will go ahead regardless dependant on medical need......" so there is collusion going on? Maybe visitors at immigration control need to be asked if they have any current medical issues and not allowed in if they have? Hospitals shouldnt be put in that position? Some thing needs to be done? Atleast any unpaid debts are recorded against their passport and any future re entering the UK may not be allowed.

[kwackers]

No wonder that a lot goes on - watched a programme called "Hospital" the other day at a friends dealing seeing a particular hospital dealing with this. And the dialogue when the admin or whoever chatted to the patient was some thing like this - " the operation will cost £xxxxxx are you happy to sign this form. <concerned look from patient> well dont worry the operation will go ahead regardless dependant on medical need......" so there is collusion going on?

Isn't that the same everywhere? If you have an emergency you sign a form and get the treatment, not many countries have a policy of turning folk away needing urgent treatment - and surely that's what "dependant on medical need" actually means?

Recovering the money - that's the real trick. I'll be there's more than a few UK citizens that haven't paid up when it happens to them abroad.

[roubaixtuesday]

Demonising and fear of immigrants is very popular at the moment. As it's driven by emotional appeals rather than rational analysis, facts rarely make any difference to the "debate".

So these facts are unlikely to influence anyone:

‘health tourism’, where people come to the United Kingdom with the express intent of using health services to which they were not entitled, was estimated to cost between £60 million and £80 million per year. This compares to the annual NHS budget of £113 billion.

(that's roughly 0.06%)

and

The average use of health services by immigrants and visitors appears to be lower than that of people born in the United Kingdom, which may be partly due to the fact immigrants and visitors are, on average, younger.

https://www.kingsfund.org.uk/projects/v ... ration-nhs

On the other hand, the NHS could not operate without immigration:

11% of all staff and 26% of doctors are non-British

https://www.theguardian.com/society/201 ... th-service

The idea that immigration is a drain on the NHS is totally counterfactual.

[mercalia]

The tv programme in question mentioned not £60m but £400+m

immigrant workers is another issue

[kwackers]

The tv programme in question mentioned not £60m but £400+m

immigrant workers is another issue

Everything I've ever seen suggests that it's very difficult to cost but that £400m is right at the top of the estimate.
But I understand that it's important though to pick the high estimate if you're trying to show how damaging it is.

In other news, evaded taxes by corporations runs into tens of billions. Again difficult to get absolute numbers but if I was in charge of public accounting I'd go for the low hanging fruit with the most gains.
A handful of easy to find folk owing billions, or tens of thousands of individuals spread around the globe. Tricky choice.

[bovlomov]

Two weeks ago, our local A&E had ten ambulances waiting outside, for three to five hours. How much kit is that, sitting out there doing nothing? Two or three million quid? Then two highly trained staff on board each ambulance. I believe the targets for A&E waiting times are partly to blame.

The ambulance drivers can't get tea and coffee from the A&E department, as it's not their budget. They have to go up to the Costa franchise in the main foyer.

I could write a book about the wasted resources I have seen in the NHS. If that's typical, then immigrants are the least of the problem.

[blackbike]

There are savings to be made in refusing free at the point of delivery treatment to those not eligible for it.

But the NHS could also save money in other ways.

It could end non-essential treatment like tattoo removal and breast enlargement/reduction, and for abortion which treats a normal bodily condition, not an illness.

But by far the biggest savings would be achieved by privatisation of services by giving NHS work to private contractors.

Public sector staff are very expensive to employ as they are given well above average terms and conditions of employment.

We could save billions by getting nearly all NHS staff off the public payroll and employing them through private companies which give market related terms and conditions to employees.

This process has started, but we need to speed it up to ensure that we get the best value for the money we give to the NHS.

Private provision of services to the NHS has been in place ever since 1948, and has worked well. GPs, dentists and opticians declined direct NHS employment and operate as private contractors, and patient satisfaction is generally high.

[bovlomov]

This process has started, but we need to speed it up to ensure that we get the best value for the money we give to the NHS.

Private provision of services to the NHS has been in place ever since 1948, and has worked well. GPs, dentists and opticians declined direct NHS employment and operate as private contractors, and patient satisfaction is generally high.

It may or may not save money. As you must know, governments have a patchy record regarding outsourcing. There's lots of opportunity for cock-ups, conflicts of interest and other assorted corruption.

PFI, for example, has been very bad value for money, and we are going to be paying for it for years to come.

[irc]

Health tourism is a problem. Whether the amount as a percentage is big or small is not the issue. The NHS is a national health service not an international health service. It is about fairness. It isn't fair for anyone to fly here from anywhere in the world to use it.

Every health tourist is preventing those resources going to someone entitled to them.

http://www.spectator.co.uk/2013/04/inte ... h-service/

[blackbike]

This process has started, but we need to speed it up to ensure that we get the best value for the money we give to the NHS.

Private provision of services to the NHS has been in place ever since 1948, and has worked well. GPs, dentists and opticians declined direct NHS employment and operate as private contractors, and patient satisfaction is generally high.

It may or may not save money. As you must know, governments have a patchy record regarding outsourcing. There's lots of opportunity for cock-ups, conflicts of interest and other assorted corruption.

PFI, for example, has been very bad value for money, and we are going to be paying for it for years to come.

Outsourcing is a very popular way for organisations to reduce employee costs.

There is no reason to suppose it won't work for the NHS, an organisation which has traditionally given its staff very expensive terms and conditions, far better than those enjoyed by the majority of workers whose taxes fund the service.

The process was started by Labour, as even they recognised that money is being wasted by direct employment of NHS staff.

It continues, but not fast enough. We should accelerate the process to save money quickly.

[roubaixtuesday]

But by far the biggest savings would be achieved by privatisation of services by giving NHS work to private contractors.

An assertion with no facts to back it up. No surprise there.

The facts are, of course, rather inconvenient to your case: the NHS is one of the poorest funded healthcare systems in the OECD but in comparison studies almost invariably comes at, or near, the top in terms of value for money. It has the highest proportion of government work.

So, entirely counterfactual to your point, the evidence shows that the more government run, the better value the system.

See, just for instance:

https://www.kingsfund.org.uk/blog/2016/ ... nationally
http://www.commonwealthfund.org/publica ... ror-mirror

[roubaixtuesday]

Health tourism is a problem. Whether the amount as a percentage is big or small is not the issue.

Of course it matters whether it's big or small.

When the issue is so small as to be insignificant (0.06%...), money spent combating it is wasted. We should focus on real issues, not demonise foreigners as an excuse for not solving our own problems. Especially when the NHS relies on foreigners to function at all!

I understand there are a few health trusts where it's a bigger issue, and they correspondingly are proposing ways to tackle it.

[irc]

Health tourism is a problem. Whether the amount as a percentage is big or small is not the issue.

Of course it matters whether it's big or small.

When the issue is so small as to be insignificant (0.06%...), money spent combating it is wasted. We should focus on real issues, not demonise foreigners as an excuse for not solving our own problems.

Nothing wrong with criticising health cheats. They are stealing from the UK. I don't recognise your 0.06% figure. By it's nature most health tourism is not recorded and the true figure is unknown.

Dealing with it and dealing with other issues is the way to go. It isn't either/or.

[roubaixtuesday]

I don't recognise your 0.06% figure

In which case, why not read the reference for where it came from which I helpfully provided?

And there is, in my opinion, something wrong with criticising health cheats when it is used as a pretext for avoiding solving the real issues with the NHS but deflecting blame onto outsiders, for an issue which is actually entirely insignificant.

A good parallel would be the way that moaning loudly about the lawlessness of cyclists on our roads deflects from the real issue of deaths and injuries caused by motorists.

[axel_knutt]

if I was in charge of public accounting I'd go for the low hanging fruit with the most gains.

For those who want to stir up a rabble, blaming foreigners is the low hanging fruit with the most gains.