Health tourism ..

[CrgT16]

Very sad case.
Maybe the story is genuine as it is presented to us or not. We will never know.
It is not impossible to have symptoms whilst here although I understand doubts. What I don't understand is that being found with cancer they did not exhaust all options to treat. One of them was to go back to Jamaica. Sure, maybe their health system is not good but that would have been something.

Without trying to be harsh what would they realistic expect? Particularly when health tourism does happen. We should be kind, compassionate and all that and perhaps she should have been treated but where does it stop?

I would not expect free treatment overseas and I would take travel/health insurance if travelling. The fact this woman had some money for a flight, a 6 month tourist VISA that expired and "discovered" had cancer after arriving can raise some suspiction.

In the end, I will say, they should probably treat her but perhaps requesting valid travel insurance before issueing a VISA could avoid this problems in the future. The NHS cannot look after all the people that live and work in the UK. Overseas people demandng/needing more than emergency treatment should not be allowed free. The cancer treatment was important but it seems not as urgent as say an acute apendicitis.

Sad story and sad times.

[shed driver]

The Trust that I work for has an Overseas Patient Officer who ensures that all patients admitted have the entitlement to treatment. Sadly, when the previous post holder left the vacancy was never filled following a recruitment freeze on all but essential administrative staff. This was at the time of newspaper headlines shouting about "sack all the admin staff and employ more doctors and nurses."

Also, some cases must by law be treated. Infectious diseases is one case where turning away a single patient could have catastrophic consequences in the wider population.

SD.

[2Btoo]

Daughter in article said:

“They didn’t care, that don’t matter. The fact that she is overseas, she’s a foreigner, that took priority over everything. As far as I’m concerned, they tell me she’s not entitled to nothing, she just needs to go back and die. That’s how I saw it.”

Massive sense of entitlement and self-centred view of the NHS. Does she really see the NHS as being a system to treat anyone, no matter whether they are British of not? They told the daughter that the mother was entitled to nothing because that was the case.

The clue is in the name - National Health Service.

[Matthen]

CrgT16 said:

Very sad case.
Maybe the story is genuine as it is presented to us or not. We will never know.
It is not impossible to have symptoms whilst here although I understand doubts. What I don't understand is that being found with cancer they did not exhaust all options to treat. One of them was to go back to Jamaica. Sure, maybe their health system is not good but that would have been something.

Without trying to be harsh what would they realistic expect? Particularly when health tourism does happen. We should be kind, compassionate and all that and perhaps she should have been treated but where does it stop?

I would not expect free treatment overseas and I would take travel/health insurance if travelling. The fact this woman had some money for a flight, a 6 month tourist VISA that expired and "discovered" had cancer after arriving can raise some suspiction.

In the end, I will say, they should probably treat her but perhaps requesting valid travel insurance before issueing a VISA could avoid this problems in the future. The NHS cannot look after all the people that live and work in the UK. Overseas people demandng/needing more than emergency treatment should not be allowed free. The cancer treatment was important but it seems not as urgent as say an acute apendicitis.

Sad story and sad times.

Would travel insurance cover cancer treatments? At best, it'd pay for a flight back I'd guess. Seems mad to go abroad without it.

2Btoo said:

Daughter in article said:

“They didn’t care, that don’t matter. The fact that she is overseas, she’s a foreigner, that took priority over everything. As far as I’m concerned, they tell me she’s not entitled to nothing, she just needs to go back and die. That’s how I saw it.”

Massive sense of entitlement and self-centred view of the NHS. Does she really see the NHS as being a system to treat anyone, no matter whether they are British of not? They told the daughter that the mother was entitled to nothing because that was the case.

The clue is in the name - National Health Service.

I think it's a pretty widely held belief tbh - The topic came up in the pub recently, half the group I was with didn't realise that foreign nationals have to pay, sometimes up front. Perhaps an ad-campaign on national television would help.

Edited by Matthen on Wednesday 14th November 11:21

[bloomen]

Matthen said:

Would travel insurance cover cancer treatments? At best, it'd pay for a flight back I'd guess. Seems mad to go abroad without it.

I would be amazed if it did. It's travel insurance, not health insurance.

The only circumstances where it might apply is if you were physically incapable of being transported back in which case you'll have had cancer for months or years and they won't cough up anyway unless you'd declared it, even then they'll go all out not to pay.

[Du1point8]

bloomen said:

Matthen said:

Would travel insurance cover cancer treatments? At best, it'd pay for a flight back I'd guess. Seems mad to go abroad without it.

I would be amazed if it did. It's travel insurance, not health insurance.

The only circumstances where it might apply is if you were physically incapable of being transported back in which case you'll have had cancer for months or years and they won't cough up anyway unless you'd declared it, even then they'll go all out not to pay.

You can get travel insurance to cover it... anyone who has had cancer can get travel insurance when abroad that will cover remissions, etc.

However... travel insurance for those that have pre-existing conditions or have had cancer is not cheap at all. My folks are paying a lot to be covered for their ailments when abroad so they can get treatment for any of the following and not pay:

Cancer remission
diabetes complications
excessive bleeding from taking blood thinners
(the list goes on)

They see it as a necessity rather than risk being stuck in a county that give them a 6 figure bill for a hospital stay.

[Johnnytheboy]

Du1point8 said:

Johnnytheboy said:

It's funny how the health unions fight against any attempts to impose eligibility checks on patients, yet never stop going on about inadequate resources.

Wonder why no-one in the NHS has the balls to do something like this, surely it would be a massive crowd pleaser and show that the NHS is starting to do stuff other than whine every year they dont have the funding?

Someone high up from NHS and the government meet and discuss a plan, then try and get it through parliament and lets see who opposes trying to clean up the NHS trying to be the WHS instead of just for the UK and its citizens.

Problem is, getting the Civil Service and NHS to introduce a system whereby they save money by excluding un-entitled patients would end up costing more than it saved.

[Enricogto]

bloomen said:

Enricogto said:

In many EU countries to start with, France or Italy for example. Their local NHS equivalent would have then tried to recover the cost from Jamaican authorities, in this case....

That might be the case for a broken arm. Would it be the same for months of cancer treatment?

Yes, or for any other "short term" treatment where you'd rack up a considerable cost in a short time (i.e. an urgent operation with several surgeons involved, etc..)

[Du1point8]

Johnnytheboy said:

Du1point8 said:

Johnnytheboy said:

It's funny how the health unions fight against any attempts to impose eligibility checks on patients, yet never stop going on about inadequate resources.

Wonder why no-one in the NHS has the balls to do something like this, surely it would be a massive crowd pleaser and show that the NHS is starting to do stuff other than whine every year they dont have the funding?

Someone high up from NHS and the government meet and discuss a plan, then try and get it through parliament and lets see who opposes trying to clean up the NHS trying to be the WHS instead of just for the UK and its citizens.

Problem is, getting the Civil Service and NHS to introduce a system whereby they save money by excluding un-entitled patients would end up costing more than it saved.

Really... how much would it cost?

Are you going to tell me that to implement a system of not allowing people to travel to/transit through the UK without valid health cover will cost the UK hundreds of millions a year, so why bother?

Is that what you are suggesting?

[superlightr]

People don't like saying no to others. I think the NHS is a good example as to be a nurse or doctor you would naturally be on the more caring end of human nature I would wager. They don't want to say no and turn people away as its against their nature.
Politicians want to get re-elected. They want to appear nice and fluffy and friendly. A helpful person. Self-serving mostly.

Now people that run their own businesses are used to saying no, used to making unpopular choices for the benefit of the client or their business. They have skin in the game. Myself being an ex solicitor and current letting agency owner are quite happy to say no to people, not to take a risk, to make someone unhappy if its the right thing to do. It costs me if I get it wrong.

If I worked in the Govt or NHS I would have no hesitation in setting up rules and requirements to implement a "no health tourism rule". I would enforce it too with no hesitation. I may not be liked by those that are affected or by the Doctors/nurses and you can bet the politicos would wring their hands and make sympathy sounds but behind closed doors they would be pleased. If its the right thing to do for this country and I got paid by results then that's fine by me.

[Countdown]

Vandenberg said:

From what I saw, the local NHS trust isnt geared up for either accepting payment or claiming on patients travel insurance.

US relative broke his arm, NHS fixed him up and he offered his Insurance details and credit card for any immediate payments.
The Drs weren't interested they said it wasn't their job and wouldn't know what to charge anyway and the admin people didnt have a clue. Also it was never followed up.

I have to say that's substantially different to our experience when my Father in Law fell ill on his last trip to the UK. He had a minor heart attack and had to be admitted to A&E and then the Cardiac Unit at MRI. The hospital staff were proactive in asking us to confirm that we would pay, then issuing an invoice for the first part of the treatment (c £5k). They also recommended the insertion of stents for an additional £5k but pointed out that they wouldn't carry out this treatment unless we paid in advance.

I doubt they would have refused the initial treatment if we hadn't shown willing but, throughout the process, they were quite clear on what the costs were and what their expectations were in terms of payment.

[Countdown]

Johnnytheboy said:

Problem is, getting the Civil Service and NHS to introduce a system whereby they save money by excluding un-entitled patients would end up costing more than it saved.

It really wouldn't (I used to work in the NHS). The only problem is "where do you draw the line?". People are only going to be health tourists where the illness is significant and potentially life-threatening. I doubt even the most hard-hearted PHer would turn away a mother about to give birth, or a person who had just been involved in a car accident. And the people who work in the NHS aren't the type to be uncompassionate.

[superlightr]

Countdown said:

It really wouldn't (I used to work in the NHS). The only problem is "where do you draw the line?". People are only going to be health tourists where the illness is significant and potentially life-threatening. I doubt even the most hard-hearted PHer would turn away a mother about to give birth, or a person who had just been involved in a car accident. And the people who work in the NHS aren't the type to be uncompassionate.

how many times has it been said? Emergency life-threatening treatment wont be refused.

Im happy to draw the line. I would get a big long list of every possible medical treatment going and class them into "emergency free treatment for all" "or pay the bill types"

Its not that hard. Some may be on the line or marginal types but it would limit health tourism Im sure.

Edited by superlightr on Wednesday 14th November 12:10

Edited by superlightr on Wednesday 14th November 12:12

[rxe]

esxste said:

It never ceases to amaze me how people live in a world filled with uncertainty and unknowns, and yet insist that everything is absolute.

Is showing compassion in the circumstances described in the article incompatible with general policies to insist non-nationals pay their way?

The UK is far from an easy target. Getting a VISA to visit, to work here, to do business here is expensive and complicated, and laborious since the UK has sold off and downsized its embassies.

The cost to the NHS of treating non-nationals is near insignificant percentage of its annual budget. It could and should be lower; but it certainly is not an indication that we're an easy target being taken for a ride by the hordes of the world.

I have a GP friend and this is actually remarkably common. She works near Heathrow, so it may be very common there rather than all over the country. It typically goes like this:

1)Bloke makes an appointment for his mum who is over from another country and is staying with him
2) Bloke and mum appear in the surgery, mum has a cough, bloke is concerned
3) Mum does not have a cold, so is sent for a chest x-ray
4) x-ray comes back, mum has lung cancer. Mum is not surprised in the slightest by this diagnosis, she already knows
5) Mum gets treated (surgery or chemo)
6) Mum might get billed, but has returned to other country

Her rough estimate is that 10% of people who walk in with serious condition have no right to be there.

[Rovinghawk]

Countdown said:

I doubt even the most hard-hearted PHer would turn away a mother about to give birth,

It could be argued that the mother has had ample time to plan ahead for this eventuality and either arrange insurance or be in the right country at/around the due date.

[williamp]

Countdown said:

Johnnytheboy said:

Problem is, getting the Civil Service and NHS to introduce a system whereby they save money by excluding un-entitled patients would end up costing more than it saved.

It really wouldn't (I used to work in the NHS). The only problem is "where do you draw the line?". People are only going to be health tourists where the illness is significant and potentially life-threatening. I doubt even the most hard-hearted PHer would turn away a mother about to give birth, or a person who had just been involved in a car accident. And the people who work in the NHS aren't the type to be uncompassionate.

Surely the line is to insist- as part of the visa process- that adequate health insurance is in place. Then any person who presents themselves at a hospital can be seen and treated. Those who have not paid NI will have a bill which their insurance company will pay.

Its compassionate, straightforward and fair. Whats not to like?

[Roofless Toothless]

esxste said:

The cost to the NHS of treating non-nationals is near insignificant percentage of its annual budget.

This may well be true but the availability of spaces for this kind of treatment are limited.

I have experience of turning up at hospital for what was described to me as 'life altering' cancer surgery and being turned away as another patient was put in front of me. It is not an easy thing to deal with.

For all my sympathy for this lady and her family, I don't think I would have been very happy to discover that the person I was bumped for had no right to treatment in this country and hadn't any insurance.

Compassion is one thing, but people die of awful things all over the world every moment and we never hear of them or give them much of a thought. After a lifetime of paying my tax in this country, is it too much to ask that when limited places on chemotherapy, radiotherapy or surgery programmes become vacant they should go to me in preference?

[2Btoo]

rxe said:

I have a GP friend and this is actually remarkably common. She works near Heathrow, so it may be very common there rather than all over the country. It typically goes like this:

1)Bloke makes an appointment for his mum who is over from another country and is staying with him
2) Bloke and mum appear in the surgery, mum has a cough, bloke is concerned
3) Mum does not have a cold, so is sent for a chest x-ray
4) x-ray comes back, mum has lung cancer. Mum is not surprised in the slightest by this diagnosis, she already knows
5) Mum gets treated (surgery or chemo)
6) Mum might get billed, but has returned to other country

Her rough estimate is that 10% of people who walk in with serious condition have no right to be there.

My wife is a specialist doctor in a West London hospital and her specialism requires people to have very long-term care. She puts the percentage of people who are getting treatment with no right to it as being nearer 25%.

Yes, the figures in rural backwatersville weill be a lot lower but the amount of medical care going to people who have paid no UK taxes or NI is high, and it's expensive. Mandatory health insurance before entry is a sensible and easy solution.

[Matthen]

Countdown said:

Vandenberg said:

From what I saw, the local NHS trust isnt geared up for either accepting payment or claiming on patients travel insurance.

US relative broke his arm, NHS fixed him up and he offered his Insurance details and credit card for any immediate payments.
The Drs weren't interested they said it wasn't their job and wouldn't know what to charge anyway and the admin people didnt have a clue. Also it was never followed up.

I have to say that's substantially different to our experience when my Father in Law fell ill on his last trip to the UK. He had a minor heart attack and had to be admitted to A&E and then the Cardiac Unit at MRI. The hospital staff were proactive in asking us to confirm that we would pay, then issuing an invoice for the first part of the treatment (c £5k). They also recommended the insertion of stents for an additional £5k but pointed out that they wouldn't carry out this treatment unless we paid in advance.

I doubt they would have refused the initial treatment if we hadn't shown willing but, throughout the process, they were quite clear on what the costs were and what their expectations were in terms of payment.

A and E treatment is free for all, you only get charged when you get admitted.

source

[esxste]

Roofless Toothless said:

This may well be true but the availability of spaces for this kind of treatment are limited.

I have experience of turning up at hospital for what was described to me as 'life altering' cancer surgery and being turned away as another patient was put in front of me. It is not an easy thing to deal with.

For all my sympathy for this lady and her family, I don't think I would have been very happy to discover that the person I was bumped for had no right to treatment in this country and hadn't any insurance.

Compassion is one thing, but people die of awful things all over the world every moment and we never hear of them or give them much of a thought. After a lifetime of paying my tax in this country, is it too much to ask that when limited places on chemotherapy, radiotherapy or surgery programmes become vacant they should go to me in preference?

With every sympathy to your situation, you're introducing factors other than medical need to the decision on who gets priority for treatment, and that opens a huge can of worms. For example, what if you found that the person in front of you had committed some crime 30 years earlier, or perhaps had spent the last 20 years on benefits? What if they were a wealthy person who'd paid in more taxes to the system than you?