A National Health Service, not a Global Health Service


       Today sees the government publish details of just how much extra UK taxpayers have to pay to support an NHS which gives free treatment to people who do not pay taxes in the UK. They think we could be spending as much as £2000 m a year.

           Those of you who write in and say ideas from this site and like minded MPs are ignored should note that this is a case where the government has listened. It also shows that the government is trying to find economies and ways of offsetting public sector costs which do not harm UK voters and taxpayers.


  1. REPay
    October 22, 2013

    This is welcome news…I have had a family member and a friend treated by the NHS in recent years, both US citizens. They both wanted to pay, but there was no mechanism at St Thomas to do so!

    By contrast, when my father, a UK citizen and taxpayer, got an infection after an operation in a private hospital, he was sent a bill for 16,000 pounds for his care at the hands of the same people who had treated him in the private hospital! This nearly sent him into relapse…luckily the insurance company paid. He stopped private insurance when Gordon Brown removed tax relief. I don’t think public sector workers should get private healthcare, but many senior people seem to.

    1. Hope
      October 22, 2013

      No the government has not listened. Hunt made it clear today that he only intends to recover 25 percent of such costs. Why such a low target? When asked how he would collect from people who returned to Europe and beyond because there is not the capability or capacity to collect he had no proper answer. The man and policy is useless and a scam as suggested by Labour.

  2. Demetrius
    October 22, 2013

    The problem is more complex than many people think. There probably are a good many “tourists” as such who are essentially visitors. There is another area of those from other states who come not just as illegal migrants or “students” but legal ones doing real work. From what I see is that while they are here many seem to have with them a changing number of family over a period of time, again quite legally. What we forget is that in many countries the extended family is real and individuals feel a responsibility for their closer relations. So their helping them is a duty and as they work here they will feel that they indeed have a right to exercise that duty. This is a moral and ethical matter which is difficult to criticise in the context of the idea of a family. My anecdotal evidence from what I see around me is that if you have one million of such persons then you must allow for three or four million extra customers for the NHS.

  3. Brian Tomkinson
    October 22, 2013

    Talking about it won’t resolve the problem. When is the government going to publish how they are going to recoup that money and get on with it? We want action not words.

  4. lojolondon
    October 22, 2013

    The worst part of the story is that they only want to claim back 25% of the fees – meaning that 75% is actually planned and accepted!! Hippocratic oath aside, NO-ONE should get free health services unless they have an NI Number.

    And the government should immediately, with the cash saved, begin treating British people for cancer and other serious illnesses that are denied them in Britain but free on the NHS in Scotland for example.

    1. alan jutson
      October 22, 2013



      Why doctors cannot understand that the more we spend to treat overseas patients for free, the more it reduces the budget they have to spend on those at home, I do not know.


      So the public were right, the government eventually listened and found out their own estimate was 100 times wrong.

      Now they need to do another calculation for the other things the public KNOW ARE WRONG .

      Cost of the EU
      Simplification of the Tax system
      Benefits claimants.
      The non working of the so called job Centres.
      Borrowing and waste.
      So called cuts in expenditure.

      etc etc.

    2. Iain Gill
      October 22, 2013

      having a valid NI number doesnt prove you are entiled to to free NHS

  5. Iain Gill
    October 22, 2013

    OK then can you get them to stop giving free schooling to the children of work and student visa holders where nobody in the family has indefinite leave to remain in the UK? where they are from countries which would not provide free schooling to equivalent British children in their schools? especially given the massive tax and national insurance dispensations handed out to work visa holders in this country? make them pay for their childrens education like we would have to in their country or dont let them into the country in the first place.

    Indeed if you could get them to charge work visa holders at least as much tax and national insurance as Brits that would help too…

    Good luck

  6. David Cee
    October 22, 2013


    Yes, but this is another example of ministers thinking that in making a speech or statement, something has happened.

    And, just as I can guarantee that the cost of Hinkley (and HS2) will be significantly over budget (and late) so I will happily wager that in 5 years time the number of NHS tourists and the costs will be higher than they are now.

    John, do you seriously, really believe that anything significant will actually be done?

  7. Denis Cooper
    October 22, 2013

    It has always rather stretched some people’s altruism that they were expected to help fund a National Health Service just for their own countrymen, and it goes well beyond breaking point for most when it starts becoming a Global Health Service.

  8. Nick
    October 22, 2013

    A two billion fraud, and the Doctors are looking the other way.

    Here are some suggestions.

    1. Offer a cut of money recovered. Say 10% to people who shop the fraudsters. I suspect lots will refuse, but enough won’t.

    2. You have to have health insurance to come to the UK. 2.1K a year would cover it.

    Just two starters.

    1. Mark B
      October 22, 2013


      I very much agree with number two. BEFORE you are allowed into the UK from non-EU/EFTA member states, you must have FULL medical insurance with a legitimate UK based insurer. So even if they do a runner, the NHS Trust can recover the monies.

      Also, whatever NHS Trust money is defrauded from them by health tourists, this must come from the workforce salary as a percentage. Harsh I know, but if everyone is going to lose out, it is more likely that those health tourists will find people working in the NHS Trust less sympathetic as the health tourist will be defrauding them personally and not the tax payer. Personal responsibility is key.

      1. uanime5
        October 23, 2013

        If you punish NHS workers for treating health tourists then they’ll have no incentive to be honest about how many health tourists they treat. All your plan will do is make it easier for health tourists to get treatment as no one will report them.

  9. Bazman
    October 22, 2013

    You would all agree with Home Secretary Theresa May is speaking for “most people” then with her new immigration bill? Most people want a “hostile environment” for illegal migrants and those coming over here on the make, taking all our vital services.
    What, for example, if a woman manages to flee the horrors of a bloody conflict in the Congo? By some incredible route, she gets to Britain, illegally. She is confused, scared but her child is ill.
    She goes to the doctor. Do we condemn her for taking services that we’ve paid for but she hasn’t? Do we want the doctor to say sorry, can’t help, you’re not showing up on official databases, so you’re illegal? Is this really what “most people” want?
    This is not a party political issue. This is about the sort of people and nation we are. This is so fundamental that we all need to take a stand, to say we, “most people”, are not having that. Ram it.

    Reply The new scheme still offers free emergency care and care for transmittable diseases to all who are here.

    1. Denis Cooper
      October 23, 2013

      I hope that we’re the sort of people who can do simple arithmetic and use common sense.

      You imagine the case of one woman and her child fleeing the horrors of the Congo; but you do not go on to recall that the population of the Congo is large, in fact over 75 million, and that potentially every one of that 75 million plus could be seen as an individual hard case deserving sanctuary and assistance in our country.

      So do you have any idea how many Congolese you would admit before even you began to think that it was too many?

      And that is only the Congo: as pointed out recently, the population of Africa has increased almost tenfold over the past century, and is now above a billion; so do you have any view on how many of those billion plus Africans the 60-odd million people of this already overcrowded country should welcome?

      Of course it could be said that certain people in the developed countries have been indirectly responsible for the population explosion in Africa, by concentrating on help to reduce death rates while doing very little to get parallel reductions in birth rates; by “certain people” I especially mean those who are soft-headed as well as soft-hearted, never a good combination.

    2. a-tracy
      October 23, 2013

      I’d be interested to know what Spain, France or Germany do with healthcare provision for the example you use? I know a young girl who went to Spain without insurance and her parents had to bankroll her care for life threatening meningitis, should the Spanish authorities have treated her and provided full care for her, I thought they were obliged to but apparently she needed a special card, how come its one rule for us Brits when we travel to Europe and another for our visitors from Europe?
      If we went to India, just as one example, without medical insurance – what emergency treatment would we be offered?
      When emergency treatment is going to be very expensive and long in duration do we pay to repatriate people to their Country of origin or pay for them to be treated in a much lower health cost country as soon as they can travel?
      When I hear friends talking about elderly people in this country who are told they can’t have their hernia operations or cataracts done through cost cutting measures after years of working and paying their NHS medical insurance this sort of thing infuriates me.

    3. Edward2
      October 23, 2013

      Indeed Baz it certainly is an incredible route for this poor woman to take.
      Instead of stopping at a dozen other countries that could have provided her with a safe haven she ploughed on and on until she got to the UK.

  10. DrJohnGalan
    October 22, 2013

    As long as this “discovery” leads to action, fine.

    However, the whole ethos of the NHS: “good healthcare should be available to all, regardless of wealth” is cultural. Anyone who has worked in business knows that it takes between 10 and 20 years to change an organisation’s culture effectively. Businesses solve this problem by dismantling organisations completely and then rebuilding them. I cannot see any government being brave enough to do this with the NHS.

    Thus, my prediction is that things will stay very much the same and the NHS will remain a service providing free health care to anyone (apart from, perhaps, a British subject who has contributed a lifetime’s-worth of tax and National Insurance, but who now lives abroad).

    1. alan jutson
      October 23, 2013

      DR Galan.

      Perhaps you would like to volunteer to treat all of these people without pay, given your feelings are so strong.

      Indeed why not take time off (use your holiday entitlement even), go to those countries direct, and work on a charitable basis.

      If you already do the above, then well done, you are a man of principle.

      Ps: I do charity work for the largest voluntary organisation in the world without any financial reward (indeed it costs me money), but I do not agree with treating anyone and everyone who turns up here for free. because it is not for free of cost is it.

  11. Old Albion
    October 22, 2013

    Gawd! you and your chums in Westminster make me furious John. This issue is nothing to do with ‘THE NHS’ It’s entirely Englands NHS. It’s about money owed to NHS England not UK. Got it yet?
    If only we had an English Parliament to oversee the running of Englands NHS!!!!!!!!!!

    Reply Not so. Some of the money is owed to the NHS in Scotland, Wales and NI.

    1. Old Alcbion
      October 23, 2013

      Not true.
      It was reported by the BBC as 2 billion pounds owed to NHS England.
      If the England hating BBC make the distinction it must be the case.

      Reply Foreign nationals can turn up in an NHS treatment centre otuside England and get free treatment just as they can in England. This was all explained in the debate in the Commons.

      1. Old Albion
        October 23, 2013

        I’m not disputing that. However, the 2Billion owed and suggestion for the recovery of £500M pertains exclusively to England. But politicians don’t recognise England and continue to pretend England is the UK.

        Reply NO it does not. The S of S made clear to the Commons this is a UK issue. I heard the statement and the Q and A!

        1. Old Albion
          October 23, 2013

          Well i don’t accept that.
          NHS services are devolved to Scotland, Wales and N.Ireland. How those services run are the resposibilty of the devolved bodies, not Westminster.
          I suggest the S of S is either mistaken or disingenous.

          Reply Just try and follow what they are doing. Health tourism affects all parts of the Uk. Ministers made this clear and said they will estimate the amounts owing to each part of the UK and make the necessary credits in the accounts.

  12. peter davies
    October 22, 2013

    I don’t know if this is true – but I read somewhere that stats for health tourism are not collated by the NHS so Ministers are only guessing the size of the problem.

    1. Denis Cooper
      October 23, 2013

      I also read that.

    2. alan jutson
      October 24, 2013


      Which guess ?

      The one that was 100 times wrong, or the figure now being suggested.

  13. Anonymous
    October 22, 2013

    A few weeks ago the BBC were blaming all NHS shortages on old aged British people ‘bed blocking’ as they chose to call it.

    Can the BBC be prosecuted for hate crime ?

    Of course, we’ve all known health tourism is rife and has been going on for years – the press have been banging on about it for decades. We all know nurses, ambulance crew and some of us know doctors who tell us the score.

    Why has it taken so long for politicians to catch on ? Why have they been ignoring it for so long ?

    1. Anonymous
      October 22, 2013

      PS, We all know those predictably ineffective “Illegal immigrants, go home now” vans were not to send a message to the illegal immigrants but to con the British public into thinking that something was being done.

      1. Bob
        October 23, 2013

        No no no!
        David Cameron really believed it would compel illegal immigrants to return home, otherwise he would not have agreed to do it.

        He also believes that he can reduce the deficit by increase foreign aid donations and spending thousands of millions of pounds on a new railway line.

        Not only that, but he believes that he can prevent climate change by pushing our industrial production overseas.

        Such a clever chap, he must have been a rocket scientist before entering politics.

  14. lifelogic
    October 23, 2013

    Indeed but all, other than those who really cannot, should pay something at the point of use. That way the money follows the patient and the hospitals and doctors no longer have an inventive to deter users with large delays, huge waiting times or inconvenient appointment systems, as they so often do now. After all they pay for food, water, heat and hair cuts why not medical care?

    We cannot have both uncontrolled EU immigration, free health care and a generous benefit system it is one or the other.

    1. Denis Cooper
      October 23, 2013

      So because we are in the EU we can no longer continue with a system of free health care for our own people; the best answer to that problem is obvious.

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