Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what proportion of NHS costs provided to EHIC and GHIC holders is not recovered from the patients’ country of residence; and what steps he is taking to reduce that proportion.

The National Health Service recovers the costs of treatments provided to overseas visitors through a range of routes, including Immigration Health Surcharge, direct cost recovery from chargeable patients, and reciprocal healthcare arrangements.

Under the European Health Insurance Card (EHIC) scheme, visitors, students, and certain workers from the European Economic Area (EEA) and Switzerland are entitled to necessary healthcare during their temporary stay in the United Kingdom. The Global Health Insurance Card is issued by the UK to cover costs incurred abroad, so is not used to recover NHS costs.

NHS providers request an EHIC from the patient and record details of the care provided. These costs are then submitted to the NHS Business Services Authority (NHSBSA) who coordinate recovery of costs from the EEA and Switzerland in line with the rules set out in international agreements. Under these agreements, participating countries are obliged to reimburse eligible costs where a valid EHIC card has been presented for state funded medically necessary healthcare.

The vast majority of costs submitted under the EHIC scheme are successfully recovered from patients’ country of residence. However, a small number of rejections can occur for a range of reasons, including incomplete or inaccurate details being submitted by the NHS facilities. Digitisation of systems for reporting EHIC claims has helped reduced the incidence of these types of clerical errors. The NHSBSA monitors rejected claims and works closely with NHS providers to improve data quality and maximise recovery.

The Department continues to work with NHS to ensure that the NHS recovers all costs it is entitled to under our international agreements.