The NHS is set to miss its target of recovering £500m a year for treating patients from overseas, the Whitehall spending watchdog has said.
The National Audit Office (NAO) said hospital trusts in England were getting back more money from overseas visitors who were not entitled to free treatment, but were still facing a shortfall of more than £150m by 2017-18.
The target for reducing the cost of treating overseas patients was announced by the Department of Health in 2014 in a drive to cut trusts’ deficits and counter claims the NHS was being overly generous.
The amount collected has risen from £73m in 2012-13 to £289m in 2015-16. However, the NAO said the increase was mainly due to a new surcharge on temporary migrants from outside the European Economic Area (EEA), which brought in £168m last year.
The department’s forecasts suggest trusts will recover £346m in 2017-18, significantly less than the £500m target. The NAO said the shortfall was in part due to the failure to take account of the cost of administering the programme, while patients were still not paying the full amounts they owed.
“The charging regulations are complex. Trust staff may have to rely on judgment in determining whether a patient is chargeable, sometimes with limited information,” the NAO’s report said.
There was a “particular challenge” in collecting payments from patients – mainly from outside the EEA – who were personally liable for the cost of their treatment, it said. On average, only about half the amount due was being collected.
The head of the NAO, Amyas Morse, said: “Hospital trusts remain some way from complying in full with the requirement to charge and recover the cost of treating overseas visitors.
“In the past two years, the amounts charged and amounts actually recovered have increased. Much of this increase is the result of changes to the charging rules. If current trends continue and the charging rules remain the same, the department will not achieve its ambition of recovering up to £500m of overseas visitor income a year by 2017-18 and faces a potential shortfall in the region of £150m.”