Free riding foreigners: the next NHS scandal

A fundamental and enduring principle of the NHS is that it is ‘free at the point of use’. All major political parties subscribe to this mantra and none dare challenge it. Herein lies the problem. The consequence of such altruism — all at the UK taxpayer’s expense — is health tourism and abuse of the NHS by ineligible patients. The general public seem unaware of this deception despite being rightly exercised about other examples of similar abuse, such as benefit fraud. How is this any different?

The rules and regulations laid down by the Department of Health governing eligibility for free NHS care are so porous, ineffective and difficult to enforce that they can be easily breached by would-be patients motivated enough to try. Those patients don’t come for the trivial stuff; the usual reason is a serious illness recently diagnosed in a country with poor or unreliable medical services — or where the best care is expensive and has to be paid for. The illness will probably require lengthy and resource-intensive treatment. Any health tourist planning to breach the rules of entitlement will find that the Department of Health’s online guide — ‘Eligibility for free hospital treatment under the NHS’ — provides the essential information and identifies the loopholes.

It must be explained why the NHS is more vulnerable to exploitation than comparable health systems which are as good as ours, such as those in Scandinavia, Germany, Holland and France. These countries have an insurance or employer-based service: patients have personal identification to prove entitlement, which acts as a barrier to abuse. Proof of entitlement is deemed unnecessary in the UK because NHS services are ‘free at the point of use’. This deficiency is compounded by the fact that many, if not most, transgressors are invisible to our feeble screening systems.