Between 2018 and 2023, London hospitals wrote off more than £112 million in unpaid bills for overseas patients. This staggering sum highlights a growing problem that strikes at the heart of the NHS. While the NHS remains free at the point of care for UK residents, the burden of unpaid foreign patient bills underscores the failures of current policies and practices.
A System in Crisis
Under NHS regulations, hospitals must charge non-residents for non-urgent care at 150% of standard NHS rates, a premium designed to offset administrative costs. Yet, the Department of Health and Social Care (DHSC) reports that over £223 million was invoiced during these five years, with half of this sum written off as irrecoverable debt. These figures only account for patients identified as chargeable, meaning the true scale of the problem could be far greater.
Doctors on the frontline report witnessing health tourism firsthand. An emergency medicine practitioner recalled treating multiple patients arriving in the UK with advanced renal failure, seeking dialysis unavailable or unaffordable in their home countries. A central London oncologist described health tourism as “a massive problem” and stressed that doctors are not equipped to police the system, urging earlier intervention.
NHS Resources Diverted
Broader strains on the NHS compound the scale of unpaid bills. Recent findings shared by Rupert Lowe of Reform reveal a shocking disparity in resource allocation at a GP practice in London:
- Only 8% of appointments are used by British citizens.
- 51% of patients require an interpreter, doubling the time and cost of consultations.
- 72% of all sick notes are issued to patients who do not speak English as their first language.
- Foreign nationals take 92% of appointments.
This data reveals an unsustainable system that prioritises non-residents at the expense of British taxpayers. Native Britons face mounting challenges in accessing GP and dental services, further eroding public confidence in the NHS.
A National, Not International, Health Service
The NHS was established to serve the British public and was funded by taxpayers who rightly expected equitable access to healthcare. While exemptions exist for vulnerable groups, such as asylum seekers and trafficking victims, it is clear that the system is being overwhelmed by unchecked immigration and health tourism. Hospitals struggle to recover costs, particularly from patients who leave the country after receiving treatment, leaving taxpayers to foot the bill.
Time for Urgent Reform
The current system is not fit for purpose. As a National Health Service, not an international one, the NHS must prioritise British citizens while maintaining compassionate care for genuine emergencies.
Immigration policy has failed to protect public institutions from undue strain. Without decisive action, the NHS risks further degradation, leaving future generations with a system unable to meet their needs. The time to act is now. British taxpayers deserve nothing less than a healthcare system that prioritises them and upholds the founding principles of the NHS.
