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GOSH owed £30m for treating overseas patients

Britain’s top children’s hospital is chasing more than £30million for treating overseas patients.

Great Ormond Street Hospital for Children, in London, said a large proportion of the debt was owed by foreign governments – rather than individual families.

Managers also confirmed they had taken legal action against one government or embassy to recover £1.5 million of debts.

They would not say which country they were chasing or how many patients had been treated without payment.

The hospital is internationally renowned for treating seriously ill children particularly for heart disease, cancer, epilepsy and kidney failure.

Many governments in less developed countries pay for patients to be treated there, rather than in their own hospitals, as the care is so much better.

The revelation about GOSH chasing £30m raises questions over the NHS’s systems for collecting money from overseas patients


Whitehall research puts the cost to taxpayers of health tourism at anywhere between £200million and £2billion a year.

Such huge figures are being drained from the NHS because of ‘chaotic’ billing, it is claimed.

Hospitals fail to identify overseas patients or never send them bills, MPs warned in a report in February.

GPs were also found to be doing too little to flag up those who should be charged for care. 

The Commons public accounts committee accuses successive governments of failing to tackle the issue. Ministers were first warned to impose charges 30 years ago. 

The scathing report said:

  • Britain is among the worst countries in Europe at extracting payments from foreign patients;
  • Four in five hospitals do not expect to start recouping more money;
  • The Government should draw up an action plan by June;
  • Hospitals could be given extra cash for issuing more invoices. 

Questions raised

But the fact the trust is chasing so much money raises questions over the NHS’s ability to collect money from overseas patients.

Earlier this year a damning report by the Commons’ Public Accounts Committee warned that many hospitals were failing to identify patients and send them bills.

One West London Hospital, Imperial College Healthcare, admitted it chasing £500,000 from a Nigerian woman who gave birth to quadruplets.

Details of Great Ormond Street Hospital’s situation came to light in a report presented to a board meeting, uncovered by Health Service Journal.

It states how a large proportion of debts were over 200 days old, more than six months.

‘Overall, the [international private patient] debt remains high and expedient recovery of monies owing remains a key objective for the trust,’ the report adds.

The trust also said that it had recently been paid £1.5million it was owed by the Saudi Arabia Health Office and £2.7million from Kuwaiti Health Office, in the Middle East.

A spokesman said: ‘The vast majority of the current debt relates to cases of sponsorship by a government or other international organisation.

‘We require pre-payment or letter of guarantee from international organisations so the debt is considered recoverable.

‘For debt collection agencies, we have only referred self-paying debt (as debt through government organisations is considered recoverable). At the moment this is to the value of £105,000.’

Worst in Europe 

The Public Accounts Committee’s report in February noted that Britain was one of the worst countries in Europe for extracting money from foreign patients.

That same week, a hard-hitting BBC documentary highlighted the case of a 43-year old Nigerian mother had given birth to quads shortly after landing at Heathrow airport.

Known only as Priscilla, she had intended to have her babies in the US but had been turned away on arrival by immigration officials.

She began having contractions while flying back to Nigeria via London and was taken to Queen Charlotte’s Hospital,.

Doctors said they had no option but to treat her and the four babies despite knowing she would not be able to pay.

Two of the babies died and two required long-term care on a neonatal ward.

A spokesman for GOSH said: ‘Very sick children from more than 90 countries receive private treatment at GOSH – many of whom are sponsored by their government – because the specialist care they need is not available in their home country.

‘All of the income raised through our International and Private Patients (IPP) service is re-invested back into the hospital. The revenue generated improves the care provided to all GOSH patients and supports the organisation’s financial stability.

‘Payments from embassies can be delayed but only a tiny fraction of embassy debt to GOSH has ever needed to be written-off – 0.006 per cent. 

‘GOSH has robust guarantees in place with governments and other international organisations to ensure their debt is recoverable and we are taking steps to ensure this is recovered in a more timely manner.’