Tonight:
5°c
American healthcare providers are notoriously hardhearted towards would-be patients without the ability to pay. Now British hospitals may become a little tougher on those who come here to exploit the health service, if they follow the lead of the West Middlesex University Hospital. It obviously provides emergency treatment to all-comers but offers a more limited service to foreign would-be patients whose lives are not in danger - sufficient to stabilise their condition but not a full course of treatment. For that they have to pay. The spectacle of the NHS requiring cash, Visa or Mastercard upfront before giving HIV and cancer treatment to foreigners may seem incongruous but it is an acknowledgment of reality.
Health tourism is a particular problem in London and hospitals have been heavily burdened by the arrival of patients within hours of giving birth and those needing life-saving operations or dying of HIV/Aids. They often leave after treatment without paying their bills. As individuals they inspire sympathy but collectively they impose a considerable cost on the NHS - £7 million in the past year. By changing its approach, the West Middlesex has saved £700,000 in the last year. Other hospitals have the same problem: Guy's and St Thomas' is owed £1.6 million in unrecovered bills, University College Hospital, £656,000. Plainly, it would be difficult to levy charges on women about to give birth but for serious longer-term conditions, an upfront payment should be required.
The problem of the exploitation of the NHS by individuals from outside the EU may well extend beyond hospitals. GP surgeries, for instance, require only minimal evidence that patients are resident in the area, not proof that they are entitled to be here in the first place. At a time when the NHS faces unprecedented demands from an ageing population, it will have to become considerably more stringent in dealing with the problem of health tourism.
Misguided missiles
THERE are several reasons why the US is right to abandon its plans for a missile defence system in Poland and the Czech Republic. The official reason, that Iran's long-range missile programme is less advanced than experts predicted, is one good reason. Another is that the putative threat from rogue states such as Iran or North Korea is less grave than the real alarm that the plans caused to Russia and, less vociferously, China. The third, unspoken, reason is that it is prohibitively expensive.
Any defence strategy has to be based on a balance between risks and rewards. And the reality is that alienating Russia is not worth the gains for European security that the new defence was meant to deliver. Russia intimated that it was not so much the system that was proposed that was a problem but what would happen if the US expanded it; Moscow duly moved its own ballistic missile system to Kalingrad in the west and promised to jam the anti-missile system electronically.
In the new world order, Russia should be an ally of the US in combating global terrorism. The US, and indeed Nato, have enough fights on their hands without alienating an old enemy, still a nuclear power, that they should be seeking to work with. Mr Obama is right.
Big tent for design
THE tent-like Commonwealth Institute may not be a thing of beauty but it is, nonetheless, an interesting Sixties building. For years it has languished in a corner of Holland Park. Tonight, Kensington and Chelsea council will consider permission for a scheme for the building to house the Design Museum, and for adjoining flats to fund the redevelopment.The council should approve, though with an eye to the objections raised by English Heritage. The Design Museum needs a strong, visible presence in London and the distinctive Commonwealth building would be a worthy home.
Reader views (2)
You say that "[a]s individuals they inspire sympathy". Why? People who pop over to the UK to steal medical treatment that is paid for by hard-pressed British taxpayers do not deserve sympathy. Why should British people pay for the medical needs of foreigners? Have you seen St. Mary's in Paddington? It's patients are majority foreign.
- Anthony, London, 18/09/2009 14:12
Report abuse
Re health tourism and the NHS, it is not generally known that the qualification for NHS treatment is not UK citizenship but residence in the UK. Anybody, whether or not a UK citizen, is entitled to NHS treatment after 3 months residence in the UK. This is an open invitation to health tourism at taxpayers' expense. The extent of this and the cost are questions to which the answers need to be known.
- Richard Shaw, Pinner, UK, 17/09/2009 17:28
Report abuse
