NOTE: Several readers doubt the veracity of this report. Checking a bit further, I found that this incident also been reported by The Independent, which reports that this circumstance was highlighted by the Royal College of Midwives. That’s good enough for me to take it seriously
____________
When I lived in Edinburgh for six months doing a sabbatical, I had to go to the NHS once. I was told, to my delight, that they would treat me for free, and I always thought that was the policy of the NHS: to provide free care for those residing or visiting in the country.
It turns out that this isn’t the case any longer, and the policy of charging overseas patients, or billing their insurance, has had dire consequences in at least one case. Read the article in the screenshot below, which also gives details of another embarrassing case.
Here’s what happened:
A couple whose baby died following an emergency Caesarean were not given the body as they were unable to pay £10,000 in medical fees, one doctor has said.
Joe Rylands said the expansion of charging had caused “disbelief” among many colleagues.
The Department of Health said the charges had raised £1.3bn since 2015.
In 2018, Dr Rylands was working in a maternity hospital when a woman from Western Europe on holiday in the UK came in – she was eight months pregnant and had started bleeding. Obstetricians performed an emergency Caesarean but the baby died.
When she and her partner were recovering on a ward, they were interviewed by an overseas visitors manager, in charge of billing.
Because they did not have a valid European Health Insurance Card (EHIC) they were told they had to pay £10,000 for the care they received – which they could not do.
“There’s a service the NHS offers when you’ve had a miscarriage or when your baby has died – they can present it to you, the body in a bassinet, you take it home to have a funeral,” Dr Rylands explains.
“That can be a really important process in grieving and recovery. And this couple were not allowed to have the body because they hadn’t paid the [treatment] bill.”
The hospital trust involved in the case declined to comment.
It was following the guidelines in billing the parents.
Apparently the policy that led to this barbaric and thoughtless act—holding a body hostage till the parents pay up—is fairly recent:
Since 2017, service providers have had a duty to check the eligibility of patients and charge them before non-urgent treatment in a bid to clamp down on so-called “health tourism”. There are exceptions – such A&E – where treatment is free until a patient is either admitted to hospital or given an outpatient appointment.
Patients from inside the European Economic Area with a non-UK EHIC are treated for free, with the government applying to their home countries to cover the cost.
Those from elsewhere will be charged for the cost of their treatment.
The article reports that several British medical societies, including the British Medical Association, has called for this policy to be abandoned completely, while others have said that maternity care should be exempt from the billing.
Look, it is possible that the NHS is in such dire financial straits that they simply cannot afford to treat people for free who aren’t British citizens or who don’t have European health insurance that can be billed. Fine; one of the reasons for the new policy was the possibility that people would come to the UK from other countries to get good treatment for free: “medical tourism”.
But what one cannot do is hold a parents’ baby hostage until they cough up the fees. It’s unimaginable that any person, much less a hospital, could do such a thing. What about someone who gets treatment and can’t pay but doesn’t have a body that can be held hostage? The NHS can dun them, as do hospitals in the US for people who lack insurance. But do not withhold a corpse!
And this goes against the Department of Health’s spokesperson, who said “Our guidance is clear that urgent treatment must never be withheld, if someone cannot pay.”
I guess what can be withheld is a body. This is shameful, and not worthy of an institution like the National Health Service.
h/t: Matthew
sub
£10,000 for a Caesarean? Whewwee!
In the U.S., a Cesarean costs $50,000. Talk about Whewwee!
‘Paid’ in advance? And if you are foolish enough to visit without (enough) insurance?
Then you’ll get treatment, if urgent, but you will be presented with the bill afterwards.
cr
No wonder the US population growth rate is in decline. If it wasn’t for Hispanics coming north, our malls and hospitals would be empty.
https://www.google.com/publicdata/explore?ds=d5bncppjof8f9_&met_y=sp_pop_grow&idim=country:USA:IND:CAN&hl=en&dl=en
I was talking about the case in the UK (and, as it happens, NZ). What applies in the US I don’t know (but may be the same?)
cr
“No, stupid, the really sharp little one next to the meat cleaver.”
“But, honey, I don’t know nothin’ ’bout no surgery on a kitchen table!”
“Don’t complain. This is the world we live in. Do it yourself, or don’t do it. Pass me another whiskey and restart the YouTube video and do what it says. I’ll close my eyes ’til it’s over.”
Very effective, however horrifying, I’d say.
“Hey! What is this? You got $50,000 in yer pocket to throw around? Don’t make me laugh. Now, get cutting. There ain’t nuthin’ to lose.”
I always enjoy a bit of dark humor. 😉
This one has been doing the rounds today in the UK press. I’m not inclined to believe it and notice that the various newspapers can’t source any documentation behind it so I think we’re looking at sloppy jounalism with unverified fact checking from a Radio 5 programme starting it all off.
Sadly the BBC is no longer dependable when it comes to its journalism. News, if it is reported rather than omitted, often picks up left wing opinion which then dominates the debate.
How would such a case be handled in the USA?
The BBC picks up left wing opinion?
Can’t see that I’ve ever seen that.
The BBC is dominated by Tory types. Every Tory/Brexit party interviewee gets a free ride to spout whatever nonsense they please without question while Corbyn and labour gets pillared for being anti-Semitic despite no actual evidence
https://www.theguardian.com/news/2019/jun/02/labour-antisemitism-probe-ehrc-evidence-from-100-witnesses
But that includes no actual evidence but says that some evidence will be submitted
And that certainly doesn’t suggest that Corbyn has done anything that is anti-Semitic
I’ll happily readdress this later but all surveys/research I’ve read says that anti-Semitism is less common in labour than the Tories, UKIP and the general population
I assumed that it was accurate because it was the BBC. Now I learn that they’re doing sloppy journalism?? OY!
Yeah, living in the US, I used to use the BBC as my main news source because they were usually reliable and relatively unbiased. I watched BBC America for news (and I still do for international news because you never, ever hear about, say, Africa on US news) and read their website for a good portion of US news. Unfortunately, the BBC really seems to have changed in both accuracy and lack of bias over the last few years, and I now treat them like all the other news sources and wait for confirmatory evidence before I believe many stories, and especially ones that follow BBC narratives. I still find them pretty reliable for straight-up factual stories that have no room for narrative bias and for which being first to report isn’t particularly important.
I am fairly sure that the story is true. I listened to an interview with a hospital doctor who was connected to the case, and he sounded authoritative in the way he described the event.
Authoritative as in having dates, places, names?
I am skeptical.
If the story is (mostly) true, they’re likely being vague about the details because the uninsured people are either illegal aliens or gypsies, who “typically neither have European insurance cards [or] their costs paid by the country of residence.”
“sloppy journalism” is just one of those things people say when the journalism doesn’t say what they want. As far as British media goes, the BBC is more reliable than most. This report is more likely true, unfortunately.
Alas, this doesn’t surprise me. The Conservative government adopted a “hostile environment” policy towards immigrants under David Cameron, when Theresa May was Home Secretary, the minister in charge of immigration. One aspect of the new policy was to take a more aggressive stance towards so-called “health tourism”, which assumed that foreigners would try to get free treatment on the NHS that they were not entitled to. It’s hard to find definitive figures, but the extent of “health tourism” in the NHS is estimated to be a fraction of one per cent of the actual operating costs.
One of the ironies is that for many years, Britain has trained too few of its own doctors and nurses, so the NHS now relies heavily on medical staff from Europe and elsewhere.
Interviewed on the subject of taxation a consutant said that many newly qualified doctors are not taking up posts in medicine but are working in finance in the City.
I gather that not a few Americans go overseas (Asia) for procedures, surgical or otherwise, at comparatively bargain prices. Causes me to wonder if the IRS considers this “imputed income.”
Not fair to comment at this stage. The facts are pretty flimsy for now.
Since this story seems to emanate from the doctor who performed the surgery, or at least was on duty in the same hospital at the time, I see no reason to doubt the basic facts of the case.
This story is utterly shaming to the UK. The aggressive hounding of overseas patients for payment, the hostile environment, the Windrush scandal, the demonization of the EU, all emanate from the same repulsive ideology of the present government, who for the past decade have consistently used the post-financial-crisis austerity as cover behind which to systematically destroy what used to be the best aspects of this country.
Any lawyers about? Can you exercise a lien on a corpse in English law? (Taking a 2nd view of the reporting I think it’s more likely that the hospital may have refused a bassinet for the deceased baby, not refused to release the body…bit of a confusion going on with the good Doctor perhaps.)
It has been suggested that this type of case is a reasonably recent phenomenon, possibly dating to a big influx of non-UK hospital administrators three or four years ago. This wasn’t meant to be an anti-immigration point, rather that non-UK staff haven’t acquired the very specific type of values that are natural to long term UK inhabitants. Maybe, maybe not, but certainly a point for discussion.
i don’t think it’s anything to do with that at all. over the past few years of ‘austerity’, there’s been a hardening of the attitude that everyone’s out to game the system, especially all these nasty foreigners coming to freeload and cheat us. spiteful sanctimonious dog-in-the-manger values are becoming ingrained uk traits now.
Note that the incident has also been reported by The Independent, and has been highlighted by the Royal College of Midwives. That’s good enough for me to take it seriously:
https://www.independent.co.uk/news/health/nhs-overseas-charges-baby-death-caesarean-body-royal-college-midwives-a8998196.html
Seems really extreme, I have difficulty believing that even some of the bureaucrats working in the NHS could be so foul. If it turns out not to be paper and scissors jounalism then there’ll be a hell of row.
i have no difficulty believing it; petty, cold-blooded bureaucrats hiding behind ‘the rules’ as justification for institutional monstrosity is nothing new, and the attitude is spreading and hardening in the uk. research some of the decisions and consequences associated with the introduction of ‘Universal Credit’ and your jaw will drop.
the uk has become an increasing callous, sanctimonious and unpleasant place over the past ten years.
If true then it is yet another reason to be ashamed and embarrassed about this country. How did we sink so low?
OK, so what if a living, near-term infant had been born? Would they hold that hostage as well?
But on another note, I was wondering if a solution to these sorts of things would be to have non-insured tourists to pay a ‘medical insurance fee’ before traveling to Britain. The funds would be pooled to offset the costs of these sorts of eventualities. A bit like paying a rental car insurance fee.
Travel insurance often includes a medical component.
For what its worth, last time I took out travel insurance, UK/Europe were the second most expensive area to get cover for. Asia (excluding Japan) was third, South-west Pacific, Australia and Papua New Guinea fourth (i.e. lowest).
The highest? – USA, Canada, South America, Africa, Middle East and Japan.
cr
It’s terrible that this happened. I suspect that the result might have been different in another hospital depending on the personalities of those involved and how well the hospital as a whole as keeping within budget.
As an aside, NZers can also get free treatment by the NHS, and vice versa. Our Ministry of Health has reciprocal agreements with multiple countries relating to the provision of healthcare. All, as would be expected, are countries that provide healthcare to their citizens as a matter of course.
“I suspect that the result might have been different in another hospital”
NHS hospitals in Britain operate as self-governing trusts, so each hospital will have its own approach. I discovered this myself recently when I was referred to the Royal Papworth Hospital by my doctor. A few days before my appointment, the hospital sent me a form to fill in to prove my eligibility for free NHS treatment. I was astonished, and more than a little angry, since I’m British and I’ve lived all my life in Britain. The form was clearly designed to identify foreign visitors, and I refused to complete it as a matter of principle.
I’ve also received treatment at Addenbrookes Hospital, the other major hospital in Cambridge, and they have never asked me to prove my eligibility. Neither have they asked my wife, who is American, but with permanent resident status.
I submitted freedom of information requests to both hospitals to ask how many patients had claimed free NHS treatment in the past five years and had subsequently been proven to be ineligible. The Royal Papworth responded with “none”, whilst Addenbrookes claimed not to keep such information centrally.
Did they charge for the FoI?!
No, although part of the Addenbrookes response was to claim an exemption under a clause of the Freedom of Information Act that allows organisations to decline to provide information if the cost of doing so would be excessive. Currently, “excessive” is defined as £450.
So the event happened in 2018, and came to light on a BBC program with someone from the Royal College of Midwives.
Shouldn’t there have been some follow up by now? Did anything eventually happen? Do they still have the body sequestered, or whatever doing such a thing is called? Did it get resolved?
It seems odd that it wasn’t reported at the time it occurred, and we don’t know how it turned out.
What’s idiotic is that if the hospital people had just let the couple have the body, no one would have blamed them for letting it go. At least it would not have been likely, as it would certainly have been ugly if they did.
I suspect the Midwives are not entirely impartial.
“The 2018 incident has been highlighted by the Royal College of Midwives who told the BBC’s Victoria Derbyshire programme that the practice of charging overseas patients for healthcare must be suspended until it has been established it isn’t harming women.”
Eh? What about men? What about children? Don’t they matter?
It could just be unfortunate wording. But since the incident is a year old, I’m a bit suspicious about the accuracy of the details.
I also suspect the neocons when this sort of story surfaces – their standard operating procedure when faced with a ‘socialist’ system that generally works is, 1. Complain about how much it’s costing 2. Cut funding as much as they possibly can 3. As soon as anything goes wrong due to lack of resources, say the system isn’t working and use it as a pretext to cut funding even more…
We all know what Mr tRump thinks of the NHS…
cr
I wonder if the noble, honorable Mr. Trump has cancelled his private health insurance for the near term.
Note: medical costs, even in ‘Single Payer’ systems are not free… someone has to pay.
Yes, but you don’t have to hold the body of their still born baby hostage in order to make them pay.
They are supposed to be free at the point of service. (Honoured in the breach here, sometimes, I am sad to say.)
It’s a separate issue though. The first issue is should you charge and I note that NHS guidelines say you must not withhold emergency treatment if the patient can’t afford to pay.
The second issue is, having decided you are going to charge, is it legitimate to withhold the body of a baby until payment is made. We can probably agree that is unacceptable.
Personally, I think that nobody should ever be put in a position of having to choose between their financial security and their health and providing healthcare for all is a fundamental function of government.
A complicated case, however –
EHIC – they should have got that ESPECIALLY travelling with a pregnant woman. That was irresponsible. There has been a problem of health tourism – https://fullfact.org/health/health-tourism-whats-cost/ – so it is hardly unreasonable that reciprocal costs are covered.
What is the obsession with dead bodies? It is dead, it is sad, yes. But it is dead, it was not a person.
Do people bury all miscarried foetuses? All aborted foetuses? I have no idea… Do people bury lost limbs? Is that the same or not?
It seems a little unfair however.