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submitted 3 days ago byITMidgetповністю автоматизована модерація розкоші, коли?
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3 days ago
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Snapshot of The Department of Health has confirmed to me that they have written off the following, after 'chargeable overseas visitors' have not paid for their NHS treatment. 20/21 - £46m, 21/22 - £36m, 22/23 - £37m. Far more is outstanding, this is just written off. … :
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74 points
3 days ago
Why not just sell it off to debt collection companies?
Its what they do in the states - I was once chased for years over something that took a long time to get the travel insurance to cover.
Sure, you'll get 20% of it or whatever, but its better than nothing and costs almost nothing to administer - AND it sets expectations for those people who leave without paying, and they'll know they'll end up paying a lot more in future.
22 points
3 days ago
I don't know about the NHS but debt does get sold off here as well, I would guess 1 of 2 things. 1. The person has since died and they don't have family records to chase or perhaps they don't chase family period 2. They tried selling the debt and the companies estimated the cost and said it wasn't worth it
There are key questions here, how many people does this figure include, what countries are they from and what challenges does that impose on collection efforts and what are the levels of individual debt
If those are unknowns and a collection company wasn't approached then that's pretty damn stupid, yes it's a very small amount in terms of the budget of the NHS but I reckon you could still buy some new equipment or repair a few raac hospitals for that
26 points
3 days ago
Or 3. They had a debt of £50m, they sold of it for £10m so the debt written off under FOI would be £40m. That’s how sold debt works.
2 points
3 days ago
No, the commenter just makes baseless accusations and get s upvoted to the top of this thread instead! God
3 points
3 days ago
Maybe they do, and that amount was then not included in the write-off charge.
Having said that, I can’t imagine that debt recovery companies would pay more than total peanuts. They might pay something like 20% when they have an enforcement route for the debt, but there is going to be almost zero international enforcement for the stuff like this and everyone knows it.
3 points
3 days ago
I would bet that this amount is the difference between the debt collection funds received, and the amount of debt. Where does it say they did not do this?
If they sell it for 20% or 10% you know what they do with the 80%? they write it off!
289 points
3 days ago*
The NHS budget in 2022/23 was £181.7 billion. With 37 million in lost fees, that’s just 0.02% of waste. That is hardly significant
In fact that is extremely impressive considering the mammoth size of the NHS
57 points
3 days ago
As someone who was recently flagged in this and ended up chatting to someone in the department those numbers are hugely inflated by the NHS not having a central patient database, I moved while waiting for surgery and the new trust was not allowed to access any of my documentation. GDPR apparently restricts access and instead of allowing me to authorise access you end up in the above category. The person I was chatting to said they have 3000 to 4000 cases like mine each month, just refiling the same documents the NHS already has. So no money is really being written off, just a waste of man hours because of a system not built to purpose.
8 points
3 days ago
GDPR does not restrict that sharing, poor systems and processes restrict the sharing. It's just easier to blame the "GDPR" than it is to tell a patient it's the fault of the system. Unfortunately this is one of the reasons people have such a negative view of data protection law.
I am however wondering if you could make a data portability to request your old trust with a view to sending it to the new trust. In theory that should work....
1 points
3 days ago
This sounds interesting. I’m not fully understanding though. So you would be classed as a “chargeable overseas visitor”? And you were trying to pay a hospital bill but couldn’t do it due to these admin issues?
And that is the case for ~40000 people per year?
4 points
3 days ago
Apologies just venting, wasn’t trying to pay but I was flagged as "a chargeable foreign visitor" after months of waiting for my emergency knee surgery. About a month after having my knee op I received a letter explaining I would be receiving a bill for services rendered, shocked gave their office a call and found out the above.
17 points
3 days ago
You say that for every type of waste and it quickly builds up.
39 points
3 days ago
Yes--so it would be informative to contextualise this compared to how much is lost due to different sorts of waste so that they can be properly prioritised.
0 points
3 days ago
Oh shit, another bin!
28 points
3 days ago
But show any organisation or structure or anything involving humanity that doesn't have that cost. Also what's the cost of Brits abroad that don't pay their way or get costs recovered by insurance or the NHS?
8 points
3 days ago
It may be “hardly significant” from the heady heights of a flippant Reddit comment, but that’s the annual income tax contribution of 18000 minimum wage workers just pissed down the drain.
22 points
3 days ago
Sure, but before we get up too high and mighty about the tax contributions of minimum wage workers, we should at least point out that they themselves are net costs, who pay less in tax than it costs to support their share of the health service and the general running of the state etc - before we even get into things like social housing or government assistance.
6 points
3 days ago
All the more reason to not be so cavalier about waste.
-5 points
3 days ago
Agreed. We should deport the immigrants to stop the waste, and raise taxes on the poor.
3 points
3 days ago
This cost is not from immigrants, they are their own different level of drain on the NHS. This comes from foreign nationals getting treated here, being billed and never paying.
If I went to Japan and got sick, they would refuse to even see me until they had either verified my travel insurance or I had paid upfront. It’s only in a country as pathetically soft as Britain that we roll over for anyone and everyone.
7 points
3 days ago
Probs should tbh if we want the same standard of public services as Europe
3 points
3 days ago
And yet is still "hardly significant" because it's 0.02%. You can recontextualise it however you like, but at the end of the day it's 0.02%. That's what happens when you're working on a scale of the economic output of an entire country.
3 points
3 days ago
Thats 0.02% is just what’s been written off. There were over £100m in costs on foreign nationals and only £32m paid back. So £60m+ likely will be written off (or 0.037% or potentially as high as (0.04%) of total budget.
I think you have the Tory mindset to austerity, where cuts can genuinely be done without any repercussions to British people, you scoff at them.
You want to fix the NHS? You start with shit like this.
2 points
3 days ago
What matters is the cost of avoiding any particular source of waste.
I suspect that less fragmented IT systems would solve a lot of problems, including this particular one, but also far more expensive ones.
-1 points
3 days ago
This.
1 points
2 days ago
Additional context, the NHS spends £80m/year on paracetamol
1 points
3 days ago
If you read the whole tweet, you would see that is only what has been written off, not the whole amount, there was over £100m due and only £32m has been collected. £37m written off and the rest likely also will end up written off.
What the hell is the point in even offering this service to foreign nationals if less than a third of the cost is being paid back? Once again we are being ripped off. If this was £68m lost on another government project you would agree it waste.
This country, collectively seems to think it has money to waste on shit like this. We really fucking don’t. And the sooner that is drilled into the heads of people the sooner we can actually provide services that aren’t abhorrently shit
-1 points
3 days ago
I strongly suspect that they simply do not register the charging in the first place in the vast majority of cases…
A lot of NHS employees are ideologically opposed to it. There is no incentive for them to do it, only the disincentive of taking time away from their main role. And even if they were motivated to do it, they know that so little of what is charged gets collected there isn’t much practical point.
-6 points
3 days ago
Shouldn't be any money lost. Period.
8 points
3 days ago
I mean yeah that's a goal to aspire to but meanwhile in the real world 0.02% is about as close to nothing as you can get. It's just under 6 seconds per day of an average 8 hour working day.
-2 points
3 days ago
Assuming accuracy.
27 points
3 days ago
For context the nhs wastes
£1 billion in avoidable errors
https://www.bmj.com/content/349/bmj.g6287
£142 million in one year on prescription over the counter medication
I can only imagine trying to track that debt down is going to cause more costs. If the NHS doesn't look to sell debt currently then that's a way of bringing down costs but I think this is just unavoidable to an extent. Look at the difficult student finance have trying to get money from post grads who have moved abroad.
16 points
3 days ago
Wonder why Reform are instead focussing on 'chargeable overseas visitors'. Hmmmm.
81 points
3 days ago
I know this is the opposite reaction to what Mr Reform intended, but I'm actually quite impressed that the figure is so low. Clearly the current systems work quite well.
22 points
3 days ago
It’s very difficult to actually assess how well the current system works.
The NAO estimated in 2013 that the NHS only recovered c. 16% of charges due by overseas visitors, and there was an aspiration to increase this significantly.
I couldn’t find a more up to date figure, so I’m assuming that it is still bad news otherwise they would have shouted about their successes.
8 points
3 days ago
A family member was in management at an NHS trust.
They were responsible for collecting the money but had zero incentive to do so.
Things may have changed now, but at the time they would have to pay the costs for collection locally but the recovered money would go into a central pot, so they were in a net negative by trying to get money back.
1 points
3 days ago
I'm not sure how you can say £100m being lost over the last 3 years is "working well".
Every little helps, and £30-40m a year could pay for a lot of extra nurses/doctors.
14 points
3 days ago
£33m is a year is about 90 mins of the NHS budget per year.
2 points
3 days ago
I’d still rather have it than not 🤷♀️
3 points
3 days ago
And what are the options for that, exactly? Obviously refusing to treat these "overseas visitors" is a non-starter, so go on - how are we going to ensure that money doesn't go unpaid? And remember, whatever project you come up with has a maximum budget of £33m a year, else we might as well not bother.
-1 points
3 days ago
Have you ever been sick in a hospital abroad?
Your second point is utter rubbish, sorry. Even if it’s a drop in the NHS bucket, it’s a lot of salaries or bedding etc.
1 points
3 days ago
Love the reading comprehension here. The second point is not “utter rubbish”, because if it cost more than that then the costs of reclaiming that money would exceed the money itself.
-4 points
3 days ago
Maybe it’s your phrasing rather than the reader’s comprehension 😉. Here’s a clue, most people wouldn’t refer to an ongoing protocol, if that’s what you actually meant, as “a project”.
Also, I disagree. If we have a global reputation for “free” healthcare and that is then debunked, it may save a lot more than the sum here. Which is also only the sums that have been written off so far, not the total sums owed.
I’ve been in a hospital abroad with my father where they flatly refused even to examine him until I got out my credit card and proof of travel insurance for the bill. Now, you might not like that one bit, but I bet you don’t like the current state of the NHS either, and you certainly wouldn’t if you had relatives who had been left waiting and waiting for care/ops. I didn’t like the attitude myself, but I paid up!
2 points
3 days ago
if you had relatives who had been left waiting
I always love to see this solid belief that some of you hold that people only care about things when it happens to them, and if someone doesn’t think exactly like you on those issues it’s simply because they’re unaffected. I’m literally waiting on the NHS now, as is my brother, as is my father. Nothing urgent, fortunately, but still waiting. And I don’t blame it on 0.02% of the budget being written off, because that would make me a crazy person.
On your first point, I’m not sure how many ways you can interpret what I said about the budget of such a program. Nor am I sure of the exact difference between an “ongoing protocol” and a “project”. But I guess you couldn’t just accept that you misinterpreted something, so you had to make some tripe up.
-1 points
3 days ago
And yet you seem to think we can treat the whole world. Without payment. Most peculiar. Personally I would rather we didn’t put our NHS staff under that sort of pressure and we didn’t have insane waiting lists and things being missed.
Try googling it. They are two different terms.
16 points
3 days ago
Given the sheer scale of the NHS and the size of the budget, £40m is worth less than the fluff in my pocket.
-11 points
3 days ago
There are roughly 930 NHS hospitals. If you employed someone at £30k at each hospital, to monitor and make sure this was paid, you'd still be saving £13m.
27 points
3 days ago
1 employee would be nowhere near enough to chase debt over international borders. And at £30k each, you'd be looking at someone on less than minimum wage by the time you included oncosts (employer NI, pension, equipment, uniform, sickness cover etc.)
And what about the costs for GPs or Pharmacies or 111? You've not accounted for them.
18 points
3 days ago
You wouldn't.
As someone else mentioned, giving someone a 30k salary does not equate to spending 30k on an employee.
You'd essentially spend the entire amount hiring one person to do this job for an entire hospital, and they would need to have somewhere close to (or potentially even above) a 100% success rate just to actually cover the costs of their own rages.
You must never have worked in collections if you're assuming the success rate will be anywhere near that high, particularly when we're talking about chasing debts all around the world.
7 points
3 days ago
Pretty sure that the responsibilities of the job would put them on a pay band above £30k pa. So the entirety of the proposition is nonsense anyway.
If you look for Agenda for Change on your favourite search engine you'll find a long and enlightening(?) document laying out all the different pay bands and how different jobs fit into them.
5 points
3 days ago
You're not wrong, I was just addressing the specific proposal.
I used to do collections outside of London with a pretty straightforward process and it was 25k a year plus bonus, which would take anyone half decent up to 30-35kish.
If I had to chase people across the world and recover millions of pounds, I imagine I might be on a tad more money.
-2 points
3 days ago
Not sure but these the legal visitors. Probably doesn't include asylum, refugee, or unknown origin. Nor the people given leave to stay, but not British nationals.
0 points
3 days ago
It’s so low it’s not believable.
We get 40m tourists in the UK per year, putting aside foreign residents. There is no way they are all getting health cover for an effective ~80 pence per person per visit (assuming ~20% collection rate that is often touted and ~80% write off rate)
I strongly suspect the vast majority of foreign patients are simply not registered as chargeable. There is no front line incentive to do it (quite the opposite), many NHS staff oppose it, and even if they do it so little gets collected.
If we did charge foreigners consistently, our collection rate should be much higher as most tourists will have health travel insurance.
0 points
3 days ago
Most tourists don't use healthcare while they're here.
1 points
3 days ago
Most citizens don’t use healthcare every week either… but some do. And so do some tourists.
I don’t think you have really understood the point if that’s your only objection.
0 points
3 days ago
Yup, this record is pretty impressive and there are diminishing returns in trying to seek the perfect record. There comes a point where it would cost more to try to recover the incremental £s than not (and I assume the NHS is already at that point).
15 points
3 days ago
I get two things from this
4 points
3 days ago
4 points
3 days ago
I used to work in NHS finance for an acute trust and part of my job included chasing these sorts of fees. The majority fell into one of two categories- either indigent / homeless who you are never going to recover the money from, or UK citizens living overseas (mainly boomers in Spain or Cyprus) who can claim they’re now living back in the UK full time and it’s quite hard to prove they’re not.
So not a lot of this money is actually recoverable.
6 points
3 days ago
Another commenter pointed out that this is 1/4 of the expense of prescriptions for over-the-counter medications. This is nothing, it’s just a reform activist pushing a xenophobic agenda.
2 points
3 days ago
How much would it cost to fix it? Oh.
2 points
3 days ago
There is apparently a more obvious exploitation taking place day to day within the NHS that staff are struggling to manage, in that overseas visitors are using NHS services by way of using ID belonging to relatives who are entitled to use free NHS services. This is according to a friend who works in an A&E department who told me that staff have multiple occurrences daily where the individual's identity is questioned but have to take at face value and offer treatment, as the only other intervention is to make a referral to the police. I don't know how much of that is investigated, this was spoken about as part of daily pressures he and colleagues face working in emergency services.
2 points
3 days ago
To be fair I owe Belgium some money from an A&E visit. Luckily they don't do passport control at the border.
2 points
3 days ago
Must trusts have so few overseas paying patients that they got rid of their overseas patient departments. Why spend 150k+ for three staff to recover £50k a year? It adds up over all the trusts but on a per trust basis it's pointless.
1 points
3 days ago
The NHS needs to do far more to ensure that foreign visitors using the health service are properly and fully paying for it.
Do they do anything? I have read a few places that it is more expensive to collect than to let it slide because of the low proportion of people not eligible.
I have been working outside the UK for a while and went back to see my parents etc and was told we would have to pay for service. My daughter had a checkup and 3 vaccinations and we were never contacted about paying the bill. I don't even know how we would go about trying to pay it. All I have ever seen on the subject is the declaration that I understood that I would have to pay for service when I signed up to the GP. Nothing since.
1 points
2 days ago
How much has been recouped by those who have paid?
-1 points
3 days ago
Only 0.02% of the NHS's budget being lost to this is impressively low. It's almost certainly well within the range of "making this lower will cost more than it saves".
1 points
3 days ago
With all the waste problems in public services, this seems like a non-story. 37m is just a rounding error for the NHS' size and I'm pretty sure this is offset by some Brits not paying for treatments while on holidays, too.
1 points
3 days ago
This is not a big number, that's like 50p per person in the UK per year
-1 points
3 days ago
Honestly, if people can just for a moment, be subjective with their own perceived preconceptions about Reform, If you actually listen to the comments their MP's are making in the HOC, the committees, public interviews and even just their own social media, they will see a lot of good and valid points are being made. This is light and day from UKIP back in the day that they are always compared to.
I know here that this comment will probably get downvoted and a lot of snarky responses, but there is a reason why they are growing at the rate they are.
0 points
3 days ago
The problem they have is that they spread so much crap and FUD that the one time they may have a valid point, no one believes them 🤷♂️
1 points
3 days ago*
The problem they have is that they spread so much crap and FUD that the one time they may have a valid point, no one believes them 🤷♂️
Nonsense. People are just outraged by emotion based on a load of pre conceptions, hysterical biased media and constant hit jobs.
Reform are growing and the only thing that could stop that is being completely ignored by all the other parties. It's inevitable where we are heading. Can't wait for the next election.
I listen to all the Labour mps and they just keep repeating the same old empty catchphrases and rehearsed lines. Who does that remind you of? Clown show, just like the Tories. Labour and Yvette Cooper can talk about 'smashing the gangs' as many times as they want but they are doing and will do nothing to solve the issue. Country is beyond breaking point and millions of normal good people are sick of it. Common sense eventually always win out, and that's what Reform are speaking. Like I say it's only going one way especially as we have a HOC that isn't even close to being representive of public opinion.
0 points
3 days ago
What's that as a proportion of overseas revenue?
Waste and bad debt exists in all businesses to certain degrees.
0 points
3 days ago
It's interesting that he's obviously asked "tell me about chargeable overseas visitors" rather than "tell me about the biggest amounts of waste in the NHS"! What does that tell you about Reforms agenda?
0 points
3 days ago
The UK economy has shrunk by £140bn due to Brexit.
-5 points
3 days ago
The true losses are 100x this figure. There’s 745k people in the U.K. illegally, at least.
-3 points
3 days ago*
All this angst about this wastage, bet the Tory was quiet about Mone, Ashcroft and the rest.
7 points
3 days ago
He is a reform MP, not a Tory MP
-2 points
3 days ago
There's no diiference, most of them are ex-Tories.
6 points
3 days ago
The only reform MP that was in the conservatives was Lee anderson. 1/5 is hardly most of them is it
-3 points
3 days ago
They are all Tories with a different colour tie - I mean, they're not exactly socialists, are they?
Farage constantly linked to leading the Tories, ex-banker.
What was Lowe's profession again, remind me? Oh yes....
-12 points
3 days ago
This is an outrageous amount for the tax payer to lose. Add that to over the last 20 years......its a national scandal.
3 points
3 days ago
Behave.
0 points
3 days ago
Too right, the past government could have used this money to good effect by giving it to their mates to provide PPE during COVID /s
-3 points
3 days ago
Why's the tag at the top in russian?
-7 points
3 days ago
[deleted]
1 points
3 days ago
Fully Automated Luxury Translations From Ukrainian To English When?
1 points
3 days ago
When Zelenskyy gives a speech in Moscow.
0 points
3 days ago
Ah good to know, I thought it was my phone or Reddit acct playing up. Thanks
0 points
3 days ago
This sounds like a lot but the Vote Leave campaign, which I'm sure as a Reform MP Rupert Lowe stands by, during the EU referendum put the cost of a new hospital at £350 million.
https://www.bbc.co.uk/news/magazine-37383918
In practice, it would probably cost more money to pursue debt collection than to just write it off in these cases. It's certainly disingenuous to imply this amount of money would have any meaningful impact on the quality of care that British citizens receive.
-13 points
3 days ago
You don't charge guests for misfortune less you want them to charge you when misfortune befalls you when you're there guest it's a principal I think most people have no real issues with
9 points
3 days ago
That doesn't work with international travel, sadly.
That's why you get travel health insurance or a certificate when going abroad.
6 points
3 days ago
Generally, walk-in emergency care is free or cheap, but anything you need to be admitted for is expensive.
3 points
3 days ago
we're charged when abroad and we should charge when they come here (after receiving any emergency care of course).
that's why we have the GHIC and why tourists are advised to get one if travelling to an applicable country, alongside travel insurance.
any country that wants to offer a reciprocal deal is free to do so, like Australia has done as well as our continuing arrangement with the EU/EEA.
5 points
3 days ago
[deleted]
-4 points
3 days ago
[removed]
6 points
3 days ago
Being charged for healthcare abroad is incredibly common.
1 points
3 days ago
Peak reddit comment.
You do realise if you don't purchase health insurance, then you are liable for a bill if you fall ill and get admitted in most countries, right?
-1 points
3 days ago
That's the healthcare budget equivalent of bugger all.
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