Tuesday, 22 November 2016

There's still plenty of fat on the NHS

Although the NHS has had a gastric band fitted, it is still morbidly obese. It's daily money intake is still too great - and the risks of diabetic scleroticism, enervation and the gangrenous loss of unmanaged outlying parts is great. Without further weight loss, the prognosis is not good. 

I have written before about how my local south London hospital's maternity unit became dominated by Nigerian mothers. They were, I was told, the partners of the Nigerian fathers here on student visas on courses at the commercial universities. A very high proportion of Nigerian business studies students are married, it seems, and take advantage of being allowed to bring spouses to the UK. The hospital should have charged for all this maternity care but in practice didn't recover a penny; a culture in the NHS of free treatment for all, and a misplaced sense by NHS staff that they own the health service rather than are employed by it has always killed any effort at cost recovery. 

The suggestion made to MPs yesterday by a senior Department of Health mandarin that hospitals should check ID before treatment is nothing new. The statutory duty of hospitals to check eligibility of patients already exists - it is simply ignored by NHS staff. I received the following from my local hospital in response to an FOI request;

 
In fact they were collecting bugger-all revenue from overseas patients. In the few instances where invoices were raised, no action was taken to secure payment. Unpaid bills were written off after three years as bad debts. So how will yesterday's announcement change anything?

Not at all. Staff are entrenched in non-co-operation and will simply continue to ignore whatever instructions come from the DoH. The only way to secure change is to withhold a part of the budget equivalent to the estimated amount each hospital should be recovering in charges - and to pay it out only on evidence of income secured on a pound for pound basis. 

Sometimes you really need the stick as well as the carrot. 

Update: Professor J Meirion Thomas explains why ID won't stop our Nigerian maternity bed blockers, on R4 Today - 2:10 to 2:12 

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Note: Where a story is carried by more than one broadsheet I will generally offer a link to the Guardian. This is to encourage the maximun use of that newspaper's bandwidth at the greatest cost by as many people as possible. 

24 comments:

DeeDee99 said...

Pay the Hospital Trusts' CEOs and other executives by results.

If they don't recover payment from international health tourists, their exorbitant salaries should be cut by the same percentage that failure has reduced the available funds for "their" hospitals.

Robert said...

Has anyone done a similar investigation into student finance and loans of overseas students and rheir repayments, particularly those from the EU?

wiggiatlarge said...

True story, visiting my late mother in St Mary's hospital Paddington a couple of years back.
Spoke to senior nurse about the huge amount of non english patients seen in A&E etc, and managed to ask about heaalth tourism as they get a lot direct from Heathrow and the train link to Paddington station.
She quoted a Nigerian woman who was pregnant rocking up to give birth and subsequently had treatment for complications, they did actually present a bill for a large amount on the last visit, the woman laughed and walked out never to be seen again.
And many NHS health professionals think this is just fine !

mikebravo said...

A story told to me by my sister - she knows the American chap.

American in Channel on a cruise was taken ill and helicoptered off to Southampton Hospital as emergency. Routine checks showed nothing serious but he had been through a rigorous checking regime (doesn't sound like the NHS I know!). Stayed in a couple of days and released to return to his cruise.

He asked where he should present his insurance credentials for payment and was told by staff that there was no facility to take such payment and everything was free. He was incredulous.

Mrs Bravo worked for NHS and said that every hospital has a department to deal with invoicing and payments.

What the hell is going on? It has to be the staff. Like you say - they think it is their baby to act as they wish.

They have enough managers - they should set a couple aside to profile every patient that comes through the doors!

mikebravo said...

Counterpoint.

On a skiing trip a couple of years ago, a Russian chap staying in our chalet broke his leg on first day. He had been living in England for 5 yrs plus, had booked his holiday through a British company and had accident insurance. The French kept him for 4 days with a broken leg (drugged) until they could verify fully that the insurance was valid and they would be paid. His son was staying in the chalet with us and passed on this info.

That is the way we should be. My experience of living in London is that it would cut hospital costs by at least 10%.

decnine said...

The proposal to demand Passport and Utility bills before giving treatment will harm people who are entitled to NHS care.

More true stories.

I had to act as Attorney for both my mother and mother-in-law. Neither of them, being elderly and in poor health, had any use for a Passport or a driving licence. Neither of them, being in residential care, had Utility bills or Council Tax bills.

In my own case, all of my utility bills and bank accounts are managed online only. The agencies that already demand Utility bills insist on seeing originals and refuse to accept my own print outs.

Anonymous said...

Many moons ago whilst in the NHS we saw a patient come on to the ward for emergency care. Didn't speak any English so relatives spoke for him, giving name and address details. As part of the care, the medical notes were ordered based on the name and address. A very thick set of medical notes arrived. Care followed as per usual.

Then there was a shift change for the doctors. Next doc comes along and brings himself up to speed with patients by reviewing all the notes. On this particular patient there was a bit of curious backwards and forwards with further rechecking of notes and checking patient name details with family.

Eventually the doc asked the family why the patient in the bed had both of his kidneys when the notes were very clear one had been removed at some point.

We never really got to the bottom of whether this was a one off abuse of the system of whether the thickness of the notes indicated widespread abuse by numerous folk.

Weekend Yachtsman said...

Canadian couple of my acquaintance, bought a holiday house in the village where I live and lived in it every winter after (a) she contracted lung cancer (due to smoking of course) and (b) he got MS and needed all sorts of help.

Their "justification"? They had no insurance and "couldn't afford it".

Needless to say, they both soon became regulars at the local NHS hospital, even up to the level of major lung surgery for her.

They never paid a penny of course, and their local friends were proud that this happened and that they never paid ("aren't we lucky..." etc etc). They were, of course, far better off than those who were being forced to subsidise them.

Bizarre, but it shows the mentality we're up against.

Poppa Bear said...

As far as I am aware all of us who are 'entitled' have a NHS number. It appears on my prescriptions, discharge notes, appointments etc. It only needs this to be quoted PRIOR to treatment to eliminate most of the fraud.

Anonymous said...

The same with me, on holiday in France with a friend, he had a minor off piste on piss skiing resort accident but the French hospital insisted on researching his ability to pay before, they assessed the damage - badly sprained ankle and pot was needed btw.

I had to cough up in Spain, in fact wherever I have needed medical assistance outside of the UK - you pay up front in some cases/regions.

We are soft and the SJW's, the virtue signallers in the NHS their writ is great, their citadels impregnable to common sense and good practice. NHS, the Soviet banner poster girls and requires them to heal the sick of the world irrespective of ability to pay.

And all the while, staff given to talking above the heads of elderly patients, ignoring the pleas of their own fellow countrymen - recall the thousands of neglect cases and dying patients - incredibly the mendacious, vicious abuse showered by NHS staff on the victims relatives - who had the temerity to complain FFS!

Honestly there are some seriously fucked up minds - running the NHS and most of them belong to the UNIONS and that's where the great NHS steam clean needs to begin.
Unison, Unite, RCN, BMA etc.

backofanenvelope said...

As far as pregnant Nigerians are concerned, why not go to the root cause? Stop people on student visas bringing their spouse into the country.

John Miller said...

Apologies if I've posted this before, but during a week of cabbing from Charing Cross to St Thomas's two cab drivers told me of foreigners, unable to speak any English at all, presented them with a scrap of paper with the words "St Thomas Hospital Dr X" scrawled on it.

They were obviously right wing Brexit supporting, UKIP voting, Trump supporting facist bastards, but still...

John Miller said...

Er, the cabbies that is...

English Pensioner said...

My wife has to have a fortnightly blood test and when we went to Australia we went to the hospital in Sydney. In reception there was a big sign which said words to the effect of "Please present your entitlement to free treatment or a credit card". She got free treatment as it was then available to British tourists who were in the country for up to three months. Real service, unlike the NHS! They offered to phone through the results to our hotel, just let them know when we would be there, you don't want to waste your holiday coming back here.
In Melbourne in due course, they just logged into their computer, located the Sydney records and did the test.
The NHS notifies you of your results by post and a couple of months ago managed to lose my wife's records between two local hospitals about 5 miles apart.
If a country like Australia, with it's huge distances can manage to control immigration, ensure correct payment for health treatment and other services, why can't we.
Why does officialdom claim that the Australian points based immigration system won't work here? Why can't we charge for health services? Because for some reason our officialdom seems to hate the British and love foreigners?

Anonymous said...

Raedwald said:

'I have written before about how my local south London hospital's maternity unit became dominated by Nigerian mothers.'

A former girlfriend and nurse at Southampton General Hospital was not amused by the Nigerian who dropped four sprogs in four years and returned home via Lagos after each one. The staff were furious, this was before political correctness (cultural Marxism) killed the goose, but even then no one had the nerve to call it for what it was: extortion.

Steve

RAC said...

If the NHS staff feel that verifying identity and confirming eligibility for free treatment somehow goes against their self assumed humanitarian ethos the answer is simple, take the decision out of their control.
Employ an outside security contractor,group 4 or some such,to check each patient in. They could be remunerated on a percentage of the money, say 10-20% of the money they save OUR NHS and they could also be responsible for chasing up non payers, cash up front though would be the preferable option.
Stationed before triage, before reception, before anyone even got access to the hospital building. Oh the outrage, oh the humanity, oh the hand wringing lefty tears.

Dave_G said...


This is typical of any Government-run institution. Waste and inefficiencies run rampant and no-one is taken to task over the fact. Ever.

We need a system where the massive wage packets paid to the management of ALL Government run departments is DIRECTLY linked to spending and savings.

The only incentive anyone has is money. Always has been. Hit them where it hurts, make them DIRECTLY RESPONSIBLE for their actions (inactions).

If it's good enough for the private sector it's good enough for anyone.

anon 2 said...

Dave G: "The only incentive anyone has is money. Always has been." Huh? Speak for yourself, and don't mistake logical fallacies (here of 'Generalisation') for truth or logic. One would, however, remind you of a general principle: "Radix malorum est cupiditas." This one, "Love of money/earthly things is the root of all evil", was most excellently illustrated by Chaucer, the 'Father of English poetry'.


On your advice: "Hit them where it hurts, make them DIRECTLY RESPONSIBLE for their actions (inactions)," I wouldn't disagree. I would add, nevertheless, that human beings generally have free will; though most may need to learn how to use it.

Anonymous said...

EP @ 11:39 - "Why can't we charge for health services? Because for some reason our officialdom seems to hate the British and love foreigners?" That it does!!!!

My experience, as a properly documented ex-pat re-patriating from USA, was horrendous. For example, unlike some euro aliens, I had paid my post-grad university fees in full for a couple of years. When I needed treatment for seriously poisonous spider bites to my face, however, I had to fight all the officials for my right to NHS treatment! They were horrible to me --- but when an 'Asian' walked in they couldn't stop falling over themselves from being 'luv'ing and sweet.

And as for the 'Asian/pretend Yorkshire' chemist who looked at my last name and sneered "What kind of country does that name come from?" --- well, she had to back off when I told her it was a good Yorkshire name that had been recorded over the last 1500 years. The other assistants had to admit that was true .......

John Brown said...

"Update: Professor J Meirion Thomas explains why ID won't stop our Nigerian maternity bed blockers, on R4 Today - 2:10 to 2:12"

We need to insist that no-one from a non-EU country arrives without at least one year of medical insurance and if they do not possess it then the airline that transported them to the UK is required to fly them back from where they came.

Just as is done when a visa is required and hence why the airlines check visas before flying (for instance to China).

Gordon the Fence Post Tortoise said...

It would be useful to get a measure of the scale of the issue.

No doubt records are kept?

WHY aren't they being used?

Dick the Prick said...

Don't worry folks - Jeremy will sort it out. Nurse, nurse quick!

Anonymous said...

Simple point about ID - We all need EHIC cards to claim medical assistance in the EU - simply issue EHIC's to everyone, no need for passports, utility bills, etc.

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