Overseas visitor charge for using A&E

Okell

I'm a retired NHS manager.

I'm pretty certain it is made clear to non-UK resident patients that while emergency treatment might be free at the point of delivery, they will end up being charged for it.

And as others have said, travel insurance will (or would have) covered it


[Edit:  I'm originally from the Isle of Man.  Although there is a reciprocal health agreement between the UK and IoM it doesn't extend beyond emergency care so I always make sure I have valid travel insurance when visiting friends and family]

Exodi

My wife works for Border Force and medical debt is absolutely something they check for and is one of the main reasons for refusal of entry.

It's naive to suggest that it's all bluster by the trust.

saajan_12

Voyager2002 said:

dan_starstream said:

My sister in law came to visit from Turkey.  She had severe pain and so my wife took her to A&E.  For some reason she was not triaged in A&E but sent straight to gastronomy department, where she had a blood test, a quick examination with a Doctor, and a pain killer.  We now have received a bill for over £1,000 because she is an overseas visitor.  I responded with a letter stating she wanted A&E and was never informed of potential costs or that she wasn't in A&E.  We received another letter informing us that she was chargeable and if unpaid it will effect her future VISA applications and the debt will be passed on to a debt agency.  We don't have that kind of money to splash about but I don't know where to turn.

None of the answers have addressed the essential point: she went for a service that is not chargeable, and without any explanation was transferred to a service that was not free. In law, for a contract to be formed it is essential that the "client" is made aware that they are receiving a service for which they will be charged, and this applies to NHS trusts just as much as it does to any private business. If the Trust were to take her to court, they would lose. 

Did the letter give details of the complaints procedure? I find it interesting that you received a reply that did not address the very valid point that you raised.

A. You don't know that she wasn't aware - havent been to A&E in a long time but there are often intake forms which list some caveats of sectors of  care / medication that would or wouldn't be free based on benefits and residence status. 

B. They aren't taking it to court. They are presenting a request for payment, which if not made then immigration may take into account. 

Okell

Voyager2002 said:

dan_starstream said:

My sister in law came to visit from Turkey.  She had severe pain and so my wife took her to A&E.  For some reason she was not triaged in A&E but sent straight to gastronomy department, where she had a blood test, a quick examination with a Doctor, and a pain killer.  We now have received a bill for over £1,000 because she is an overseas visitor.  I responded with a letter stating she wanted A&E and was never informed of potential costs or that she wasn't in A&E.  We received another letter informing us that she was chargeable and if unpaid it will effect her future VISA applications and the debt will be passed on to a debt agency.  We don't have that kind of money to splash about but I don't know where to turn.

None of the answers have addressed the essential point: she went for a service that is not chargeable, and without any explanation was transferred to a service that was not free. In law, for a contract to be formed it is essential that the "client" is made aware that they are receiving a service for which they will be charged, and this applies to NHS trusts just as much as it does to any private business. If the Trust were to take her to court, they would lose. 

Did the letter give details of the complaints procedure? I find it interesting that you received a reply that did not address the very valid point that you raised.

I doubt that any of that is relevant - even if the trust were to take it to court.

I suspect that this is a charge imposed under statute and nothing to do with entering into a contract.  Bit like the charges that trusts used (still?) to make under the Road Traffic Act.  Or council tax.  No consent or contract required.

If I were the OP's SiL and wanted to return to the UK in the future, I'd pay up.  And I'd also get travel insurance next time.

(There also seems to be an assumption by several posters that A&E is totally free and without charge for non-UK residents.  In the absence of a reciprocal agreement I'm not sure that is true)

Voyager2002

saajan_12 said:

Voyager2002 said:

dan_starstream said:

My sister in law came to visit from Turkey.  She had severe pain and so my wife took her to A&E.  For some reason she was not triaged in A&E but sent straight to gastronomy department, where she had a blood test, a quick examination with a Doctor, and a pain killer.  We now have received a bill for over £1,000 because she is an overseas visitor.  I responded with a letter stating she wanted A&E and was never informed of potential costs or that she wasn't in A&E.  We received another letter informing us that she was chargeable and if unpaid it will effect her future VISA applications and the debt will be passed on to a debt agency.  We don't have that kind of money to splash about but I don't know where to turn.

None of the answers have addressed the essential point: she went for a service that is not chargeable, and without any explanation was transferred to a service that was not free. In law, for a contract to be formed it is essential that the "client" is made aware that they are receiving a service for which they will be charged, and this applies to NHS trusts just as much as it does to any private business. If the Trust were to take her to court, they would lose. 

Did the letter give details of the complaints procedure? I find it interesting that you received a reply that did not address the very valid point that you raised.

A. You don't know that she wasn't aware - havent been to A&E in a long time but there are often intake forms which list some caveats of sectors of  care / medication that would or wouldn't be free based on benefits and residence status. 

B. They aren't taking it to court. They are presenting a request for payment, which if not made then immigration may take into account. 

I agree.

A. It seems clear from the start of this thread that the OP believes that she wasn't made aware. He was not present but his wife was, so clarification from her would be helpful.

B. Agreed: my comment was hypothetical, that if it were to go to court the action would fail. 

Brie

I'm a bit foggy about my last visit to A&E or any previous ones but despite having an obvious non British accent I was never asked about my residency status or saw anything to indicate that non UK residents would be charged for any treatment.  

I'm not saying that non UK residents shouldn't be charged but just that someone should have stated it outright that there would/might be a charge.  

As for the OP I might suggest that you discuss this further with the department that sent you a letter and perhaps agree that SiL would pay a small amount monthly.  This might come from your bank account but it would remain her debt - that may be sufficient to satisfy Border Control.   ( @Exodi -  your thoughts?  or your wife's??)

born_again

Usually when you register at A/E you get asked if you are resident as part of their process, & should have been advised about any charges at that point. But it would also be part of your duty of care, to make sure you are aware of any protentional charges.
Our local A/E's all have a big signs on the wall about charges for non residents.

soolin

Brie said:

I'm a bit foggy about my last visit to A&E or any previous ones but despite having an obvious non British accent I was never asked about my residency status or saw anything to indicate that non UK residents would be charged for any treatment.  

I'm not saying that non UK residents shouldn't be charged but just that someone should have stated it outright that there would/might be a charge.  

As for the OP I might suggest that you discuss this further with the department that sent you a letter and perhaps agree that SiL would pay a small amount monthly.  This might come from your bank account but it would remain her debt - that may be sufficient to satisfy Border Control.   ( @Exodi -  your thoughts?  or your wife's??)

Strangely, I’ve had to attend A and E twice in the past year , on one of those occasions I had to complete a form stating that I was normally resident in the UK and was entitled to free care, and if it was found that was not the case, then I confirmed I understood I would receive a charge. On the 2nd occasion I was taken in by blue light ambulance and the only forms completed were by the ambulance team , and I never saw what they completed. 

Same hospital approx 8 months apart. 

DeathByFluffy

It's a good thing they're charging for A&E to non-residents - this is what health insurance is for. 
She doesn't pay tax or reside in the UK, so shouldn't have access to free healthcare. 

For once this is something agreeable the Government is doing - what a pleasant change! 

QrizB

OP isn't a big replier; we might not hear from them again on this thread.