'Maternity Tourists' Using NHS For Free Care

By Jon Craig, Chief Political Correspondent

Hundreds of "maternity tourists" are flying to Britain just days before they give birth to receive free care on the NHS.

On the eve of a Government crackdown on "health tourism", it has been revealed that women are cheating their way into Britain for free birth care.

According to a Government report, immigration officials at Gatwick Airport stopped more than 300 such mothers-to-be over two years.

Most of the women had to be admitted and allowed to give birth on the NHS, the report found, because their pregnancies were too advanced for them to fly home.

Airlines typically do not carry women more than 36 weeks pregnant. However, the women boarded flights in their home countries with a forged doctor's note concealing the length of their pregnancy.

Staff at Guy's and St Thomas' refer to the practice as the "Lagos Shuttle"

The problem has become so acute that staff at Guy's and St Thomas' NHS Foundation Trust, in London, refer to the flow of West African women flying in to give birth as the "Lagos Shuttle", The Sunday Telegraph reported.

The Government says health tourism costs the NHS as much as £80m a year — enough to pay for about 2,000 nurses. However, the true figure may be far higher.

Guy's and St Thomas' alone may be losing more than £5m a year.

Labour MP Kate Hoey, whose central London constituency includes both hospitals, says health tourists head straight to St Thomas's, across the River Thames from the Houses of Parliament, from Heathrow Airport "with something they knew perfectly well they had before they came".

The disclosures come as ministers unveil a range of measures tomorrow to tackle the problem.

They are expected to include a new system for identifying patients who should be charged and new fees for some services currently free for foreigners, including accident and emergency.

And later this week, restrictions on Bulgarians and Romanians working in Britain will be lifted, amid concerns that tens of thousands could arrive and be entitled to benefits.

The disclosures about "maternity tourists" emerged from a previously unpublicised consultation document, prepared in 2010, on plans to refuse entry to foreigners with unpaid NHS bills.

The report found that over a two-year period, immigration officials at Gatwick stopped more than 300 expectant foreigners found to be in an "advanced stage of pregnancy [and] who evidently intend[ed] to access NHS maternity services".

Gatwick has few flights from the countries producing the most health tourists, suggesting the total British figure will be far higher.

MP Kate Hoey said immigrants went straight to the hospital from the airport

Another unpublicised report, Visitor and Migrant Use of the NHS in England: Observations from the Front Line, published this autumn, quotes extensively from staff frustrated at what they see as visitors playing the system.

An immigration officer said: "Sometimes they will come back for their second or third baby.

"Sometimes they will quite blatantly say, 'I'm coming because the care is better'. And once they are here, if they are assessed to a certain gestation, then we are stuck."

An NHS overseas visitor officer said: "People coming into hospital from overseas know the rules better than the hospital staff."

Another said: "They lie through their teeth."

Guy's and St Thomas' Trust was last year owed £8.1m in unpaid bills to health tourists over the past few years, according to freedom of information requests.

The trust recovered £600,000 from health tourists in 2012 — only 30% of the amount billed — according to a recent report compiled by Westminster City Council.

But even this may be a substantial underestimate, the report says, since up to two thirds of health tourists in the NHS are never identified or issued with bills.

This suggests that health tourists could be using up to £6m worth of services a year at these two hospitals alone, with £5.4m of that figure unrecovered.

The trust said it took the problem "very seriously" employing a dedicated team to identify and charge ineligible patients.

A spokesman said the trust did not recognise the £8.1m figure.

Matt Akid said: "Guy's and St Thomas' takes the recovery of money owed by overseas patients who are not entitled to NHS care very seriously and works hard to recover any money owed.

"We have a dedicated team of staff who identify patients who fall into this category and actively pursue costs during a patient's stay.

"Where this is unsuccessful, we employ an international debt recovery agency. We also work closely with the UK Border Agency, participating in their 'notification scheme' which is designed to assist with debt recovery."

Many individual NHS clinical commissioning groups, or CCGs, the 211 local bodies that fund hospital trusts and GPs have also identified substantial "risks" to their finances from foreign visitors.

West London and City & Hackney CCGs put it at up to £2.4m each this year and Camden CCG at up to £5m, though not all was for "fly-in, fly-out" health tourism.

A Department of Health spokesman said: "We have a National Health Service, not an international health service, and we must stamp out abuse of the system."

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