The Department of Health will not meet its 2017/18 ambition of recovering costs on treatment for overseas patients under the current charging rules, the National Audit Office (NAO) has said.
In a report, NAO has said that if “current trends continue and the charging rules remain the same” the Government will not reach its aim of recovering £500 million a year by 2017/18.
The ambition to recover up to £500 million a year represents a substantial increase on the estimated £73 million recovered in 2012-13.
However, NAO estimates that within the existing cost recovery rules, the amount charged is forecasted to be £346 million in 2017/18.
After concerns that the NHS was “overly generous” to overseas patients, the Government launched a programme in 2014 intended to extend the scope of charging and implement existing regulations more effectively.
NAO said that the cost recovery programme “demonstrates many elements of good practice”, however it adds that the charging regulations are complex and relies on staff judgement in determining whether a patients is chargeable.
The report also found variation in the amount of overseas visitor income that trusts identify, suggesting scope for improvement.
According to the NAO, the Department does not have a good understanding of why some trusts do better than others.
In 2015/16, just ten trusts, all in London, accounted for half of the total amount charged to visitors from outside the European Economic Area.
The number of overseas patients treated is said to be affected by the location and size of the trust, and the cost for each patient varies depending on the nature and complexity of treatment provided.
Overseas visitors were charged £97 million in total in 2013/14 and £289 million in 2015/16.
Approximately £164 million of the 2015/16 revenue was generated by a new immigration health surcharge for students and temporary migrants from outside the European Economic Area.
Sir Amyas Morse, head of the National Audit Office, said: “Hospital trusts remain some way from complying in full with the requirement to charge and recover the cost of treating overseas visitors.
“In the past two years, the amounts charged and amounts actually recovered have increased. Much of this increase is the result of changes to the charging rules.
“If current trends continue and the charging rules remain the same, the Department will not achieve its ambition of recovering up to £500 million of overseas visitor income a year by 2017-18 and faces a potential shortfall in the region of £150 million.”
However, Dr Mark Porter, BMA chair of council, said it is not the doctor’s job to “act as a border guard” and charging systems should be “practical, economic and efficient and must not jeopardise access to healthcare for those who need it”.
He said: “It’s vitally important that any charging systems do not prevent patients receiving necessary care. Sick and vulnerable patients must not be deterred from seeking necessary treatment, otherwise there may be serious consequences for their health and that of the public in general.”