Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what information her Department holds on how many people not legally resident in the UK were charged for healthcare in (a) NHS hospitals and (b) doctors surgeries in (i) 2021, (ii) 2022 and (iii) 2023.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

The Department does not collect or hold the requested information.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what estimate he has made of the potential cost to the public purse of foreign nationals accessing NHS services in each of the last five years.

Answered by Will Quince

This information is not collected in the format requested.

The Department publishes data on the income recognised from overseas visitors, who may or may not be foreign nationals, accessing the National Health Service in its annual reports and accounts, as well as the NHS consolidated provider accounts.

The information from the annual accounts is shown in the below table.

The annual reports and accounts are available at the following links:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1135637/dhsc-annual-report-and-accounts-2021-2022_web-accessible.pdf

https://www.england.nhs.uk/wp-content/uploads/2023/01/consolidated-provider-accounts-21-22-final.pdf

Question to the Home Office:

To ask the Secretary of State for the Home Department, what steps her Department are taking to re-coup costs from unpaid medical treatment provided to non-entitled persons.

Answered by Robert Jenrick

The Home Office is not responsible for recouping NHS debts. This is solely within the remit of each NHS trust. Migrants who are not entitled to free NHS healthcare are charged at 150% of the cost of treatment where charges apply.

The NHS debtor rule acts as an immigration sanction which is imposed on migrants who accrue debts to the NHS exceeding £500. Migrants with outstanding NHS debts are notified to the Home Office once the debt has been outstanding for a period exceeding two months from date of invoice. An NHS debt may lead to further immigration applications being refused.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if he will publish the (a) number of foreign nationals who have received NHS treatment in the last year and (b) the proportion of that figure who have paid back the NHS for their treatment.

Answered by Will Quince

The information requested is not held centrally. Those seeking asylum or temporary or humanitarian protection are exempt from paying for National Health Service treatment in England, where they have made a valid application, until their application is finally determined. Devolved Administrations are responsible for NHS charging in their areas.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how much foreign nationals paid for the treatment they have received on the NHS via the visitors charging regime in each of the last five years.

Answered by Will Quince

We have taken foreign national to mean an overseas visitor. The following table shows that over the last five years the National Health Service has received £150 million from overseas visitors.

Source: Consolidated NHS provider accounts

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many foreign nationals received treatment on the NHS via the visitors charging regime in each of the last five years.

Answered by Will Quince

We have taken foreign national to mean an overseas visitor. The following table shows that over the last five years the National Health Service has received £150 million from overseas visitors.

Source: Consolidated NHS provider accounts

Question to the Department of Health and Social Care:

To ask Her Majesty's Government what assessment they have made of the extent to which the Immigration Health Surcharge has reduced the impact of non-British citizens using the National Health Service; and how they have made this assessment.

Answered by Lord Kamall

The Immigration Health Surcharge (IHS) raised £480.82 million in 2020/21; and £1,423 million in 2021/22. This relates to income collected by the Home Office through visa applications for the United Kingdom. The information requested on the distribution of this income specifically for the National Health Service in England, other Departments and public bodies is not held in the format requested. A proportion of net IHS income is allocated to the Department of Health and Social Care with other income sources for expenditure on health services by NHS England and other organisations, such as local authorities. However, there is no central record of the proportion of IHS income received by NHS and non-NHS organisations.

No specific assessment of the impact of the IHS on non-British citizens’ use of the NHS has been made. Those who pay the IHS have the same entitlement to NHS care as those ordinally resident in the United Kingdom, with the exception of assisted conception services.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether his Department's assessment of the NHS (Charges to Overseas Visitors) Regulations 2020 includes consideration of those Regulations' impact on (a) all equalities groups and (b) the health access and outcomes of Black Asian and minority ethnic pregnant women and new mothers; and if he will make a statement.

Answered by Edward Argar - Minister of State (Ministry of Justice)

There are currently no plans to publish a report relating to the internal policy assessment on these Regulations. The Department is considering the emerging evidence to ensure that the policy continues to protect National Health Service resources, while maintaining a humanitarian approach to the provision of healthcare. This assessment considers the effect on the most vulnerable migrants and overseas visitors, pregnant women and new mothers, as well as destitute migrants. It also focussed on ensuring that we continue to meet our obligations under the Equality Act 2010 with regards to individuals or groups with protected characteristics, including but not limited to race, disability, sex and gender and maternity.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, when he plans to publish the report on the Policy Assessment on the NHS (Charges to Overseas Visitors) Regulations.

Answered by Edward Argar - Minister of State (Ministry of Justice)

There are currently no plans to publish a report relating to the internal policy assessment on these Regulations. The Department is considering the emerging evidence to ensure that the policy continues to protect National Health Service resources, while maintaining a humanitarian approach to the provision of healthcare. This assessment considers the effect on the most vulnerable migrants and overseas visitors, pregnant women and new mothers, as well as destitute migrants. It also focussed on ensuring that we continue to meet our obligations under the Equality Act 2010 with regards to individuals or groups with protected characteristics, including but not limited to race, disability, sex and gender and maternity.

Question to the Department of Health and Social Care:

To ask Her Majesty's Government what assessment they have made of the report by the Institute for Public Policy Research Towards True Universal Care: Reforming the NHS Charging System, published on 23 November; and what plans they have to set up an independent body to (1) receive complaints about the charging system, and (2) review decisions by providers.

Answered by Lord Kamall

The Department has reviewed the report and has no plans to set up an independent body to receive complaints or review decisions on charging by providers. It is the legal duty of providers of relevant NHS services to make and recover charges from overseas visitors and to do so fairly and consistently.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to pages 16 to 28 of the report entitled Towards True Universal Care: Reforming the NHS Charging System Report, published by the Institute for Public Policy Research on 22 November 2021, what steps he plans to take to tackle the issues noted in that report.

Answered by Edward Argar - Minister of State (Ministry of Justice)

The Government believes that it is right that people who do not live in the United Kingdom on a lawful, settled basis help contribute towards treatment costs. Therefore, we have implemented a system of charging overseas visitors that is fair and proportionate, working with NHS England and NHS Improvement to ensure that the Charging Regulations are properly applied.

The Department regularly reviews the Charging Regulations, with consideration for their equity and impact on vulnerable groups, using a range of evidence and reports by organisations such as the Institute for Public Policy Research (IPPR). We are committed to improving the support, guidance, and advice provided to trusts on the issues raised by the IPPR’s report. We are taking steps to further protect vulnerable groups by raising awareness of exemptions from charge and improving guidance and training for the National Health Service on identifying patients who are genuinely without funds.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to the report entitled Towards True Universal Care: Reforming the NHS Charging System published by the Institute for Public Policy Research on 22 November 2021, what recent assessment he has made of the equity of the NHS charging system.

Answered by Edward Argar - Minister of State (Ministry of Justice)

The Government believes that it is right that people who do not live in the United Kingdom on a lawful, settled basis help contribute towards treatment costs. Therefore, we have implemented a system of charging overseas visitors that is fair and proportionate, working with NHS England and NHS Improvement to ensure that the Charging Regulations are properly applied.

The Department regularly reviews the Charging Regulations, with consideration for their equity and impact on vulnerable groups, using a range of evidence and reports by organisations such as the Institute for Public Policy Research (IPPR). We are committed to improving the support, guidance, and advice provided to trusts on the issues raised by the IPPR’s report. We are taking steps to further protect vulnerable groups by raising awareness of exemptions from charge and improving guidance and training for the National Health Service on identifying patients who are genuinely without funds.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to the report entitled Towards True Universal Care: Reforming the NHS Charging System, published by the Institute for Public Policy Research on 22 November 2021, if he will make an assessment of the potential merits of implementing the (a) options for reform on page 38 and (b) recommendations on 39 of that report.

Answered by Edward Argar - Minister of State (Ministry of Justice)

The Government believes that it is right that people who do not live in the United Kingdom on a lawful, settled basis help contribute towards treatment costs. Therefore, we have implemented a system of charging overseas visitors that is fair and proportionate, working with NHS England and NHS Improvement to ensure that the Charging Regulations are properly applied.

The Department regularly reviews the Charging Regulations, with consideration for their equity and impact on vulnerable groups, using a range of evidence and reports by organisations such as the Institute for Public Policy Research (IPPR). We are committed to improving the support, guidance, and advice provided to trusts on the issues raised by the IPPR’s report. We are taking steps to further protect vulnerable groups by raising awareness of exemptions from charge and improving guidance and training for the National Health Service on identifying patients who are genuinely without funds.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether he has plans to increase the amount of money recovered from foreign nationals using the NHS.

Answered by Edward Argar - Minister of State (Ministry of Justice)

The Department has no current plans to increase the rates charged to overseas visitors for National Health Service care. However, we continue to work with NHS England and NHS Improvement to help trusts improve overseas charging processes and increase debt recovery.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if he will make an assessment of the potential merits of a Government inquiry into the (a) economic and (b) social impact of the application of the NHS overseas visitors charging regulations during the covid-19 outbreak.

Answered by Edward Argar - Minister of State (Ministry of Justice)

The Government has no plans to suspend the NHS (Charges to Overseas Visitors) Regulations 2015, nor hold an inquiry into their impact during the pandemic.

The Regulations include important exemptions designed to protect the vulnerable or public health and no charge can be made to an overseas visitor for the diagnosis or, if positive, treatment of COVID-19. Exemptions from charge also apply to any National Health Service care received by asylum seekers, refugees and victims of modern slavery.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether his Department has made an assessment of the potential merits of suspending NHS overseas visitors charging regulations during the covid-19 outbreak.

Answered by Edward Argar - Minister of State (Ministry of Justice)

The Government has no plans to suspend the NHS (Charges to Overseas Visitors) Regulations 2015, nor hold an inquiry into their impact during the pandemic.

The Regulations include important exemptions designed to protect the vulnerable or public health and no charge can be made to an overseas visitor for the diagnosis or, if positive, treatment of COVID-19. Exemptions from charge also apply to any National Health Service care received by asylum seekers, refugees and victims of modern slavery.