Anne Milton, the Health Minister, has let the cat out of the bag in a Parliamentary written answer on the amount of money collected by the NHS from foreign nationals for treatment, and the value of debt written off in 2009/2010. Against £17m collected, £7m has been written-off. Now those of you who have run businesses will recognise this disguises an even more horrendous situation; as long as you treat a debt as 'live' it remains an asset, but sooner or later you're going to have to bite the bullet and write it off. What the parliamentary answer doesn't show is the age of the debts written off - they could well be two, three or even more years old. Some hospitals seem never to write off bad debts. But I'd guess that if you're writing off more than 10% of your sales figure each year you're in deep trouble; writing off over 40% is criminal incompetence. What we need to get a true picture is the value of uncollected debt over 60 days held as 'live' by each hospital - and I'll bet this will expose a can of worms.
Our NHS staff are a compassionate lot, ever ready to spend our money in a humanitarian cause. You'll bet they won't be keen on demanding payment in advance from a heavily pregnant Nigerian village girl. Or advise her to return to Lagos to have her baby. But you can bet the figures reveal only a fraction of the value of 'free' treatment enjoyed by foreign nationals not covered by reciprocal arrangements; if the NHS can't manage it themselves, we need to appoint some hard-nosed Almoners to our hospitals who will turn away anyone who can't pay (unless they have a disease that poses a risk to us - multi drug resistant TB, for example). If Parliament has decided that a whole class of people shouldn't be treated at public expense, it's simply wrong of local NHS administrators to ignore or subvert this.